Organ Donation Some Things Are Best Left Behind!

The Story of Samareshk

SamareshK, at 30 years of age, was on cloud seven with an annual package of 20 lakhs, a loving wife, and a 3-year-old daughter living in an upmarket Delhi suburb. He had recently been diagnosed with high blood pressure. As there were no symptoms, he was not taking it seriously.

For some weeks, he felt breathless while climbing stairs and noticed swelling over his feet. His wife turned him into the hospital, where he was told that he was suffering from advanced chronic kidney disease (CKD). Life came suddenly to a halt.

The doctors advised kidney transplantation, which means one of his close relatives would undertake an operation where one of their kidneys is surgically removed and transplanted into Samaresh.

However, the impossibility of getting a kidney transplant emanates from the unlikely availability of a blood relative who is healthy, has a compatible blood group, and is motivated enough to donate one kidney to his ailing relative. It is Hobson's choice. Samaresh had no such altruistic acquaintance forthcoming and succumbed to his illness.

The Story of Anees and Maanav

Anees, at 35 summers, is suffering from total liver failure as a consequence of a life led full of spirits. He is admitted to the ICU in a critical condition. He needs a liver transplant to survive.

In the ICU of the same hospital, Maanav Singh is oblivious to all joys and sorrows of life. A day before, he was returning late from his BPO, zipping rapidly home when suddenly a bright flood light blinded him into a head-on collision with a truck veering straight into his path.

Maanav was on a ventilator and life support. He was pronounced brain dead. No medical miracle could bring him out of the coma. The family, being meaningfully educated, wanted to donate his eyes, kidneys, and liver.

However, the story did not have a happy ending. The hospital could not retrieve Maanav’s organs as it did not have the statutory permission from the state government to remove organs from a brain-dead person, although the hospital was already conducting organ transplants from living related donors and had all the infrastructure in place.

Without this statutory permission, even a willing person or family cannot donate their organs. The necessary paperwork to get this permission had been applied for more than a year back but without avail.

Explore the expert guide about - Liver Failure Stages: Symptoms, Causes, Diagnosis & Treatment.

Organ Donation: Some Bare Facts

• Every hour, 14 people are dying of road accidents in India. The total annual deaths due to road accidents crossed 1.18 lakh in the year 2009, according to the National Crime Records Bureau (NCRB).
• Every year, nearly 1.5 lakh new patients requiring kidney transplants are added to the inexhaustible patient numbers.
• Majority of us do not have compatible and willing family donors. This means if one gets kidney failure, it boils down to lifelong dialysis, transplant, or imminent death.
• Liver, lung, and cardiac failure numbers are no less daunting.
• The economics of demand and supply is totally skewed. This encourages unethical practices where the poor are coerced to sell one of their kidneys or part of their liver. Besides exploitation of the poor, there is sexual exploitation too. 85% of recipients are males, and 90% of organ donors are females.
• In many developed nations, the concept of implied consent is in place. Simplistically, it means that the hospital will retrieve transplantable organs before declaring a brain-stem-dead person dead unless the relatives explicitly forbid organ retrieval.

What Is the Way Out?

At the Societal Level

1. Multi-pronged strategy to increase awareness among people about the facts of brain death. (If a patient is brain dead, then it is irreversible and final.)
2. Organ retrieval does not disfigure the body.
3. No religion in the world forbids organ donation.
4. One noble act by a family can give at least half a dozen families a new lease on life. (What goes around, comes around. Society is as good or bad as its individual members.)

At the Government Level

1. Simplifying and expediting the necessary permissions for secondary and tertiary care hospitals to retrieve organs from brain-dead persons.
2. Incentivising both government and private hospitals to retrieve and transplant organs by cutting bureaucratic red tape.
3. Financial support for economically challenged/BPL persons needing an organ transplant.
4. Curb illegal practices by making organ transplant laws more practical and efficient.
5. Promote research in regenerative organ therapies and xenotransplantation (animal organs into humans).
6. Reduce the cost of post-transplant medicines to make them affordable.

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At the Level of Hospitals and Doctors

1. Better interaction among different specialists in identifying a potential brain-dead donor. (Professional ego should not hinder cadaver transplant services.)
2. Dedicated social workers and transplant coordinators should be appointed in major hospitals. (They will have the necessary training to approach distraught families with empathy.)
3. Media involvement: Above all, print and electronic media need to use their reach to educate people about the necessity of organ donation in the unfortunate situation involving brain death of their near and dear ones.

Read more about - Organ Donation in India: Challenges and Progress.

A Final Pledge for Organ Donation

Let's pledge — Don't take your organs to heaven; God knows we badly need them here.