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 Medical Charity

November 2009
The Art of Giving: Organ Donation
Dr Subhash Gupta
What if there was a way to live longer, like say, twice your lifespan, or even more? What if people could see you in others, quite literally at that, long after you are dead? That is no fantasy anymore – organ donation makes it possible.

Donating organs following death can help save many lives, and very appropriately, this act has been labelled the gift of life. Although the individual has died, he or she continues to live on in others by this act of donation. Every day, there are more and more people with end stage organ failure who can benefit from transplantation. And most religions would look at organ donation as a major act of kindness too.

Organ transplantation is a success story of modern medicine. Countless people have benefited from kidney, liver, small intestine, pancreas, and heart and lung transplantation.

Better understanding of the principles of organ harvesting, preservation and subsequent implantation is helping us become better givers and receivers. The body is trained to reject any external organ it receives – but immunosuppressive medicines control it effectively.

The Gift of Life
Traditionally, organ donation was from brain dead donors. These were individuals who suffered irreversible damage to their brain, thereby losing not just their consciousness, but also control of brain stem functions such as respiration, temperature control and control of cardiovascular system. If they were taken off the life supporting ventilator, they would succumb to a cardiac arrest – though their ECG tracing on the monitor appeared normal and patient just seemed to be in coma.

As there is oxygenated blood being circulated to all organs even in this condition, these organs are functioning right. If the family agrees, these organs can be harvested and used for transplantation. Since it is impossible to maintain good perfusion of organs artificially for a long time, the window for donation is usually less than 24 to 48 hours once the diagnosis of brain death. This is because cardiac arrest is inevitable in these patients and at such a time, the organs will become unsuitable for harvesting.

Most brain death patients are either victims of major road accidents or would have suffered from massive bleeding in the brain through other ways. Patients with tumours in the brain can also become brain dead and can potentially donate, provided their tumours have not spread outside the brain. Patients who have suffered major hypoxic brain damage as a result of severe asthma can also donate.

Apart from the eyes, many other organs can be retrieved from these potential donors and the organs that can be donated are lungs, liver, kidneys, heart, small intestine, pancreas and even bones and limbs for transplantation.

Be A Donor
Our society has generally been averse to donation mainly because this has been a recent concept and also because organ transplantation in our country has been associated with major scandals which have often been highlighted by the media. It is therefore viewed with suspicion. However, these fears are unfounded as the diagnosis of brain death can only take place in major hospitals which need a license from the government. Not everyone can diagnose brain death and the panel of doctors who can, need to be whetted by the Ministry of Health.

Know this for a fact, that a large number of expectant patients will die waiting on the transplant list - as there are not enough organs available for transplantation. Can you make a difference to at least one life? If you would like to donate your organs after death, do let your family know about this humane wish, and also get a donor card expressing this desire.
Dr. Subhash Gupta is Senior Consultant, Liver Transplant Surgery at Apollo Indraprastha, New Delhi

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