Organ and Tissue Donation

Body donation & organ donation

Body donation is as the act of giving one's body after death for medical education & research and is covered by the anatomy Act 1949. The donated bodies remain a principal teaching tool for anatomists, medical educators teaching gross anatomy and to carry out research. People pledge to donate their bodies during their life and communicate their wish to their family members. 

Organ and tissue donation is meant for therapeutic purposes only and not for education or research purposes. After retrieving organs/tissues the bodies of such noble donors are returned to their families with utmost dignity for performing last rites. 
 

Organ donation-at hospital or home?

Organ donation is only possible when the patient dies in the I.C.U. and is declared brain stem dead. No vital organs can be retrieved if the death occurs at home. However, tissues like cornea (eyes) & skin can be retrieved within a specified time limit, even if the individual dies at home. 
 

No disfigurement after organ donation

The organs are removed carefully by taking the donor to the operation theater and there is no disfigurement. There is a cut on the body which is sutured just like any surgery performedon living persons.

Compensation or payment 
 

Any kind of compensation or payment for donation of organs is not permissible under the THOTA 1994. However, the family is not charged for any procedure after the consent for organ donation is given.

Body donation after organ & tissue donation

Usually bodies are not accepted for teaching or research purposes after retrieval of organs/tissues or if there has been a post-mortem examination. However, if only the corneas are donated, a body can be left for research.

Organ donation

Organ donation is a noble act, which gives an opportunity to save lives after death. An organ is a part of the body that performs a specific function like heart, lungs, kidney, liver, pancreas & intestine, etc. Many patients suffer from end stage disease of various organs; organ donation is the only hope for them. The donated organs are transplanted into these patients for therapeutic purposes. 
 

Tissue donation

Tissue is a group of cells that performs a particular function in the human body, for example cornea (eye), bones, skin, heart valves, blood vessels, nerves and tendon etc. Transplantation of different type of tissues can improve quality of life of many recipients. 

 

Different types of organ donation

1. Living organ donation: a person, not less then 18 years of age, during his life, can voluntarily authorize the removal of organs for therapeutic purposes within the legal framework of the country.

   He/she can donate one kidney (the other kidney is capable of maintaining the body function adequately for the donor), a part of the liver (the segments of liver will regenerate after a period of time in both recipient and donor), and a portion of the pancreas (half of the pancreas is adequate for sustaining pancreatic functions).

   Types of living organ donation are:

   1. Near related donors
   2. Other than near related donors
   3. Swap donors
2. Deceased organ donation: a person, regardless of age can donate multiple organs/tissues and give life to many patients after brain-stem/cardiac death. Consent of near relative or a person in lawful possession of the dead body is required. If the deceased donor is under the age of 18 years, then the consent is required from one of the parents or any near relative authorized by the parents. Medical suitability for donation is determined at the time of unfortunate event of death.

Is it possible to receive organs from a friend or other than near relative?

As per the transplantation of human organs and tissues act (THOTA), 1994, any living person other than near relative can also donate organ for the reason of affection and attachment towards recipient or for any other special reason. Such cases have to be approved by the authorization committee of the hospital, where the transplant is going to take place. Approval of authorization committee is mandatory in all, other than cases those involving relatives. 

If such authorization committee is not existing in the hospital then it can be approved by the respective district or state level authorization committee. 
 

Transplantation

Transplantation is the act of surgical removal of an organ from one person and placing it into another person. Transplantation is needed when the recipient's organ has failed or has been damaged due to illness or injury

End stage diseases that can be treated by organ transplantation

Diseases	Organs
Heart failure Heart	Heart
Terminal lung illnesses Terminal lung illnesses	Terminal lung illnesses
Kidney failure Kidney	Kidney
Liver failure Liver	Liver
Diabetes Pancreas	Pancreas
Corneal blindness Eyes	Eyes
Heart valvular disease Heart valve	Heart valve
Severe burns Skin	Skin

How quickly donated organs should be transplanted

Healthy organs should be transplanted as soon as possible.

Different organs can be transplanted within different time frames as mentioned below:

Heart 4-6 Hours	4-6 Hours
Lungs 4-8 Hours	4-8 Hours
Intestine 6-10 Hours	6-10 Hours
Liver 12-15 Hours	12-15 Hours
Pancreas 12-24 Hours	12-24 Hours
Kidneys 24-48 Hours	24-48 Hours

Brain stem death (BSD)

Brain stem is an important part of brain that sustains life. Brain stem dead person is an unconscious, dependent patient, who cannot breathe on his own and is breathing through a ventilator, even though one can feel his pulse, blood pressure and other signs of life. The lack of functioning of the brain stem is a sign of death and the rest of the body will eventually stop functioning even if the ventilator is continued.

There is a difference between coma patients and brain dead individuals. The coma patients are not dead whereas brain stem death is the irreversible stage beyond coma, as the person can neither regain consciousness nor breathing capability. The heart can continue to function due to ventilator for a few hours to few days & it is during this period that the organs can be retrieved after obtaining consent from the close relatives. Organs are never taken at the cost of donor's life. 
 

Declaration of brain stem death

Brain stem death is declared by the brain stem death committee, which involves team of four doctors recognized by the Govt. and who are not involved in performing the transplant surgery. The team has to perform the brain stem death tests twice with at least a gap of 6 hrs. This death is declared only in hospitals recognized for retrieval/transplantation. 
 

The vital organs are taken only after the person is declared brain stem dead.

Required Request

The doctor/transplant co-ordinator/counsellor on duty are required under the THOTA 1994, to request you for donation of organs & tissues in the unfortunate event of death (brain stem death/cardiac death). Relatives of patients are requested to kindly cooperate in this noble cause.

Process to register pledge for organ and Tissue donation

You can be a donor by registering your wish in the authorized organ and tissue donation form (Form-7 As per THOTA, 1994) by signing up through web portal NOTTO.abdm.gov.in using your Aadhaar number. This is the only official organ donor registry meant for Indian citizens of age 18 years or older to give their intention to be an organ/tissue donor. You can download the digital donor pledge certificate immediately after registration. The whole process takes just one minute. The web portal also has provision to un-pledge in case you wish to change your decision after pledging. Even if you have previously expressed your intention to donate organs and/or tissues, it is very important to record your decision on the aforesaid web portal of NOTTO.