Every year on 13th August, the world observes Organ Donation Day to raise awareness about the critical need for organ donation. The gap between organ demand and supply is a global issue, and encouraging more people to donate organs can save countless lives.
Organ donation involves the selfless act of donating healthy organs or tissues from living or deceased individuals to those with organ failure. Living donors can contribute a kidney, part of the liver, or part of the pancreas. Deceased donors can offer organs such as two kidneys, two lungs, heart, liver, intestine, pancreas, as well as tissues like heart valves, cornea, skin, bone/cartilage, and blood vessels.
In India, the shortage of organs is particularly severe. Every year, approximately 2,50,000 people need kidneys, 80,000 need livers, 50,000 need hearts, and 1,00,000 need corneal transplants. However, only about 10,000 organ transplants were performed in India in 2018, and the majority of these were kidney transplants. A mere 15% of transplants utilized organs from deceased donors, despite around 1,50,000 people dying in road accidents each year, many of whom could have been potential donors.
Various barriers hinder organ donation in India. Religious beliefs sometimes discourage individuals from donating organs, although no religion explicitly prohibits it. Lack of awareness about the benefits of organ donation is another issue. The private healthcare system also faces a trust deficit, with some families distrusting hospitals when approached for organ donation proposals.
To increase the donor pool, it is crucial to address these barriers and implement effective strategies. Governments and NGOs play a vital role in spreading awareness about organ donation and organizing programs to educate the public. Introducing an opt-out policy, as seen in Spain, where presumed consent for organ donation is the norm unless families opt-out, could be considered in the future.
There are strict criteria for living donation, however in context of deceased donation, by and large any age group person can donate the organs, but the quality of organ deteriorate with age and many centres do not accept organs of more than 70 years. For minors, the consent of parents/legal guardian is required before donation.
One essential prerequisite for organ donation is the confirmation of brain death. Brain death is the irreversible cessation of brain function, and it requires careful clinical assessment by a team of medical experts. Proper training of healthcare workers, especially in intensive care units, can improve the identification and handling of potential organ donors.
To increase organ utilization, some countries accept organs from expanded criteria donors, individuals who don't meet standard donation criteria but still offer viable organs. Donation after cardiac death (DCD) is another approach, though the quality of organs obtained this way is not as good as from brain death donors.
In India, one can register as an organ donor by expressing the wish in an authorized organ and tissue donation form (Form-7) as per the Transplant Human Organ Act (THOA) since 1994. The act prohibits the buying and selling of organs to prevent illegal organ trade.
World Organ Donation Day serves as a reminder of the urgent need for action. Encouraging brain death certification, raising awareness, and addressing barriers are essential steps to bridge the organ donation gap in India and save countless lives. Together, we can make a difference and give hope to those waiting for a second chance at life.
About the author:?Dr Shyam Bihari Bansal is a Nephrologist at Medanta Hospital. All views/opinions expressed in the article are of the author.