One body, many lives
Organ donation refers to the process in which an individual allows to be removed an organ of his/her
own and to be transplanted to another individual without compensation. It may be by the consent of a
live donor or with the assent of the next of kin in instances of brain death where an irreversible and
complete cessation of the functions of the brain and brain stem. Organ donation can either be the full
organ donation or a partial organ from another person.
Organ donation has become the only option to lives in patients with terminal organ failures to improve
the quality of their lives. Many of lives are lost due to the discrepancy between the demand and supply
of the required organs. Due to the advancement of modern surgical technology, the number of organ
transplantations are gradually increasing. Although the success rate is high in children and young adults,
it is still proportionally low among adults due to existing comorbidities among them. The success is
contributed by improvement in immune suppressive medications and other perioperative
managements. Commonly transplanted organs and tissues are kidneys, heart, liver, pancreas, intestines,
lungs, bones, bone marrow, skin, and corneas. Living donors are usually able to donate a part of the
pancreas, lung, liver, intestine or kidney. According to the World Health Organization, majority of
transplanted organs in the world are by living donors. Usually, people of any age are can be qualified to
donate their organ on the if they do not have certain medical conditions. like active cancer, systemic
infection, HIV positive status, sickle cell anemia or a history of intravenous drug abuse.
The Transplantation of Human Tissue Act in Sri Lanka established in 1987 provides the opportunity that,
any person above the age of twenty-one years to consent in writing for the donation to take effect upon
their death. This may include their body or any part or tissue thereof. If consent has been given in such a
manner, it cannot be revoked thereafter. If the deceased had not given prior consent for organ
donation, a next of kin over the age of twenty one years is permitted to legally provide consent on the
condition that the diseased was not opposed to the donation of his/her organs when alive. In the case of
homicides where the deceased has been affected on the head and/or chest, they can still be considered
as potential liver, kidney, bowel and pancreas donors. In addition to that, when the death occurs due to
unnatural cause like external causes (such as injury or poisoning), the responsible medical practitioner
checks on the possibility of organ donation once the postmortem examination is complete and consent
has been previously provided by the deceased or the next of kin. Sri Lanka Eye Donation Society
undertakes the donation of eyes and tissues upon. Eyes and tissues should be donated within 4 hours
and 12 hours of death respectively. Considered the age of the donor, no limit for eye donors, but limited
to 70 years for tissues. Further, cause of death should not be an infectious disease, if post mortem has
been performed, cause of death should be confirmed. Donations of eyes and tissues can either be done
through prior consent of the deceased or next of kin following the death of the potential donor. Sri
Lankan patients are given priority of organ recipients.
Organ donation is permitted when the brain death is confirmed according to the transplant act in Sri
Lanka. Brain death is defined where an irreversible and complete cessation of the functions of the brain
and brain stem occurs. According to the national Health statistics, 400 renal transplants have been
performed in the year 2017 while another 2000 have lost lives while waiting for transplantations.
Further, nearly 1,700 die due to Cirrhosis or advanced liver disease; accounting for more than 4,000
people die every year due to liver and kidney failure alone in this country. The medical community
considers this as one of the biggest health problems that needs to be immediately addressed. The
approximate ratio of organ transplantation per total population of Sri Lanka (as of 2018) stands at 1: 52,
477 which signifies the unfinished requirement of life saving events. In Sri Lanka, eight kidney transplant
centers are function attached to national hospitals in the country with nearly 400 transplants done
every year. However, Sri Lanka still does not have an effective liver transplant program. At the moment,
only two programs pertaining to liver transplant and one is at the National Hospital in Colombo and the
other is at the North Colombo Teaching Hospital.
However, non-availability of a recognized database of potential donors or a donor card system in order
to expedite the process of harvesting organs from a potential donor has become the main challenge.
The Ministry of Ministry of Health in Sri Lanka should pay attention on this matter to enhance the
quality of life of its residents through tissue and organ transplantations. Since the general knowledge
and awareness is minimal in this regard, a long process has to be followed including influencing through
Mass media and programs through health care personals.
References:
1. Vadysinghe A.N, Dassanayaka P.B, Edussuirya D.H & Rukshana M.J.F. TISSUE DONATION AND
TRANSPLANTATION PROGRAM IN SRI LANKA. A Medico-legal point of view. Sri Lanka Journal of Forensic
Medicine, Science & Law-May 2018-Vol.9 No.1
2. What you need to know about organ donation in Sri Lanka. Accessed via
http://www.pulse.lk/everythingelse/what-you-need-to-know-about-organ-donation-in-sri-lanka/ on
08.09.2021
Name: L.A.D. Amali Nelunika
Admission No: 215823