Organ Donation

 

Mrs. Deepa Sakthivel

 

INTRODUCTION:

“Death is not the last sleep. It is the final awakening.”

                                    -Walter Scott, Scottish novelist

Organ donation is the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting. Organs and tissues are removed in procedures similar to surgery, and all incisions are closed at the conclusion of the surgery. Simple, effective steps can be taken to provide a traditional funeral viewing whenever this might be desired. People of all ages may be organ and tissue donors.

 

Each year, the National Kidney Foundation develops special public education programs aimed at increasing public awareness of the need for organ and tissue donation .Learning more about organ and tissue donation will help every American to make an informed decision about this important issue. Here are some facts everyone should know:

·        Over 95,000 U.S. patients are currently waiting for an organ transplant; nearly 4,000 new patients added to the waiting list each month.

·        Every day, 17 people die while waiting for a transplant of a vital organ, such as a heart, liver, kidney, pancreas, lung or bone marrow.

·        Nearly 10 percent of the patients currently waiting for heart transplants are young people under 18 years of age.

·        Acceptable organ donors can range in age from newborn to 65 years or more. People who are 65 years of age or older may be acceptable donors, particularly of corneas, skin, bone and for total body donation.

·        Currently there are 59 organ procurement organizations (OPOs) across the country, which provide organ procurement services to 272 transplant centers.

·        By signing a Uniform Donor Card, an individual indicates his or her wish to be a donor. However, at the time of death, the person’s next-of-kin will still be asked to sign a consent form for donation. It is important for people who wish to be organ and tissue donors to tell their family about this decision so that their wishes will be honored at the time of death. It is estimated that about 35 percent of potential donors never become donors because family members refuse to give consent.

·        All costs related to the donation of organs and tissues are paid for by the donor program.                  A family who receives a bill by mistake should contact the hospital or procurement agency immediately.

·        Tissue donation can enhance the lives of more than 50 people. Donated heart valves,bone,skin, corneas and connective tissues can be used in vital medical procedures such as heart valve replacements, limb reconstruction following tumorsurgery, hip and knee joint reconstruction and in correcting curvature of the spine.

·        Donor organs and tissues are removed surgically, and the donor’s body is closed, as in any surgery .There are no outward signs of organ donation and open casket funerals are still possible.

·        Acceptable organ donors are those who are “brain dead” (whose brain function has ceased permanently) but whose heart and lungs continue to function with the use of ventilators.     Brain dead is a legal definition of death.

·        Organ transplant recipients are selected on the basis of medical urgency, as well as compatibility of body size and blood chemistries, and not race, sex or creed.

·        Advances in surgical technique and organ preservation and the development of more effective drugs to prevent rejection have improved the success rates of all types of organ and tissue transplants.

·        Virtually all religious denominations approve of organ and tissue donation as representing the highest humanitarian ideals and the ultimate charitable act.

 

TYPES OF ORGAN DONORS:

v  After  Natural Death 

v   Living person – related to patient

v  Living person -  unrelated to patient

v  After Brain Death

 

Organ donation After  Natural Death	Organ donation by a living person
       Eyes,        Skin and fascia ,        heart valves ,        bones and tendons,        cartilage,        veins and arteries,        middle ear bones	       Blood,        eyes ,        bone marrow ,        Kidneys,        portion of liver,        portion of lung ,        Portion of pancreas.
Organ donation after Brain Death
       Eyes (2)        Kidneys (2)        Liver (1)        Lung (2)        Pancreas (1)        Small intestine (1)        Voice box or larynx (1)        Hands (2)        Penis (1)	       Middle ear bones (2)        Skin and fascia -Numerous        Bones - Numerous        Tendons -Numerous        Cartilage-Numerous        Veins -Numerous        Arteries-Numerous        Nerves- Numerous        Fingers and Toes (20)

 

 

HISTORY OF HUMAN ORGAN TRANSPLANTATION:

      1954  - First Kidney Transplant

      1967  -  First Heart Transplant

      1966  - First Pancreas Transplant

      1967  - First Liver Transplant

      1983  - First Lung Transplant

 

TRANSPLANT ORGAN SURVIVAL:

Ø  Longest living Kidney Transplant -34 years

Ø  Longest surviving Heart Transplant -22 years

Ø  Longest living Liver Transplant – 27 years

Ø  Longest living Lung Transplant – 12 years

Organ Donation	Age in years
Corneas	0 to 100
Heart valves	0 to 60
Trachea	15 to 60
Skin	16 to 85
Kidneys	0 to 70
Heart	0 to 60
Lungs	0 to 60
Liver	0 to 70

 

For that which is born death is certain and for the dead, births certain…Therefore grieve not over that which is inevitable.                                                -Bhagavad Gita

 

ORGAN DONATION AND RELIGION:

·        Hinduism – No prohibition to donating organs.This act is an individual decision.

·        Jainism – Jain religious leaders consider eye donation as a sublime form of charity and stress a powerful link between “daan” (charity) and “moksha” (salvation). Highest eye donation rate in India among Jains of Gujarat.

·        Protestantism – Protestants encourage and endorse organ donation.

·        Catholicism – Transplants are ethically and morally acceptable to the Vatican.

·        Judaism – Judaism teaches that saving a human life takes precedence over maintaining the sanctity of the human body.

·        Buddhism – “We honor those people who donate their bodies and organs to the advancement of medical science and to saving lives.”

·        Islam – In 1983 the Muslims Religious Council initially rejected organ donation by followers of Islam, but it has reversed its position, provided donors consent in writing prior to their death. The organs of Muslim donors must be transplanted immediately and should not be stored in organ banks.

 

TRANSPLANTATION OF HUMAN ORGANS ACT –THO (1994)

Main provisions:

·        Concept  of  “Brain Stem Death “ accepted

·        Only “Living related Donors” are allowed to donate organs without legal problems.

·        For unrelated donors – Permission from “Authority” required prior to surgery

·        Requires – “Regulation and Registration of hospitals” undertaking transplantation.

·        “Punishment for any commercial dealings in organs”

 

Streamlining of THO ACT:

ü  Make it compulsory for doctors or medical social workers to ask for Organ Donation in a Brain Dead situation.

ü  Identify doctors or senior nurses to work as Transplant Coordinators in each ICU.

ü  In Medico-legal cases it should be possible to perform Post-Mortem at same time as organ retrieval in presence of a Forensic Expert.

 

 

PROBLEMS WITH CADAVER ORGAN DONATION PROGRAMME IN INDIA:

Govt. Problem

 

No funding for programme

Hospital problem

 

No efforts to identify and maintain “Brain Dead” donors

Community Problem

 

No Awareness of “Brain-Death” Concept

 

ROLE OF NURSE IN ORGAN DONATION:

Ø  Organ and tissue transplant nurses need comprehensive scientific knowledge

Ø  Besides preparation for nursing care decision making, nurses activities should be multiprofessional and multidisciplinary

Ø  Establishment of a successful transplantation program.

 

People of all ages and background can be organ donors. If you are under age18, your parent or guardian must give you permission to become a donor. If you are 18 or older you can show you want to be a donor by signing a donor card. You should also let you family know your wishes.

 

REFERENCES:

Goyal M, Mehta RL, Schneiderman LJ, Sehgal AR (2002) “Economic and health consequences of selling a kidney in India “ JAMA 288 (13): 1589-93

Appel, Jacob. “Organ Solicitation on the Internet :Every man for Himself” The Hastings Center Report.Vol.35,No 3 (May-June 2005)

Appel, JM. “Wanted Dead or Alive? Kidney Transplantation in Inmates Awaiting Execution,” The Journal of Clinical Ethics. Vol.16, No.1, 2005.

 

 

Received on 27.12.2014           Modified on 02.02.2015

Accepted on 11.03.2015           © A&V Publication all right reserved