What is Organ donation? Organ donation is the process of removing tissues or organs from a live, or recently dead, person to be used in another. The former is the donor and the latter is the recipient. People of all ages can become donors. NEED OF THE HOUR In India 10 Lakhs need Organ Donation Organ Donation Type of donors Some organs can be donated by a living person Almost all organs can be donated by someone dead but this has to reach the recipient within a few hours after the donor's death. In case of live donation the donor should give his consent. In case of cadaver donation, relatives need to provide consent. Voluntary Donation Organ Donation Everywhere organ donation is voluntary Two voluntary systems include – 1.Opt In - Where the donor gives consent 2.Opt Out - Where anyone who has not refused is considered as a donor In India we have the Opt in system, while many western countries practice the opt out system Organs for Donation Some of the organs that are commonly donated …, KIDNEYS EYES HEART LUNGS LIVER PANCREAS SKIN BONE MARROW BLOOD DONATIONS BEFORE DEATH • BLOOD • KIDNEY • LIVER (1/4) From each cadaver organ donor 50 persons will be benefited Pre-Transplantation Evaluation • Blood Type (A, B, AB, and O) Rh factor does not matter • Human Leukocyte Antigen (HLA); antigens on WBC; familial matching can be 100-50-or 0% • Crossmatch • Serology; for HIV, CMV, hepatitis • Cardiopulmonary, cancer screening Recepient Qualification • Most cases <60 yr old • Disqualified if: – – – – – Recent MI Active infection Malignancy Substance abuse Limited life expectancy from unrelated disease Diagnosis of Brain Death • Pt suffered irreversible loss of brain function (either cerebral hemisphere or brainstem) • Establish cause that accounts for loss of function • Exclude reversible etiology: Brain Death • Ancillary Testing to Include: – EEG – Nuclear scan – Angiography for absence of cerebral blood flow - Brain death determined after 6 hr with cessation of brain function, 12 hr without confirmatory testing - Documentation In SPAIN, BELGIUM, AUSTRIA almost every Brain Death patient will donate Organs Organ Donation after Cardiac Death • Death declared on basis of cardiopulmonary criteria— irreversible cessation of circulatory and respiratory function. Key Elements in the Process of Donation after Cardiac Death • Withdrawal of life sustaining measures • Pronouncement of death from time of onset of asystole (usually btwn 2-5 minutes); 60 sec is longest reported time of autoresuscitation • Liver within 30 min and kidney within 60 min Organ shortage - reasons Family consent, and negative attitude contribute towards organ shortage. This could be due to the following reasons – Religion Fear, ignorance and misunderstanding Legal aspects • Media reports on scandals involving organ rackets Improving Organ Donation Currently organ donation can be termed as a "crisis with a cure." The following are some ways to improve organ donation• Improved patient care to facilitate easier approach for organ donation, in case of patient death • Trained transplant co-ordinators and grief counsellors • Improved hospital infrastructure • Qualified Intensivists and Surgeons contd.., Improving Organ Donation • Increased HLA typing and cross matching facilities • Improved facilities in packing,transport and retrieval of organs • Supporting organization for networking and registry maintenance • Effective use of technology to facilitate organ donation Role of society Society plays a crucial role in transplant programme especially in case of cadaver transplants. There is a urgent need for increased public awareness regarding organ donation and greater effort must be taken to dispel public concerns regarding the same. Organ donation can give a new twist to tragedy. Remember "organs wasted are lives lost".