Organ Transplantation Awareness Program - Resident Medical Officer Community Medicine
Organ Transplantation Awareness Program
- Resident Medical Officer Community Medicine
Not an uncommon sight…
Outcome
Common unfortunate outcome
Outcome Can be Changed
OutlineNeed of organ donationTypes of Organ DonationWhich Organs can be DonatedConcept of brain deathCommon conditions leading to brain deathDiagnosis of brain deathMyths related to organ donationReligious views towards organ donation
What is need?
Corneal blindness is very common in India.
More than 3 million cases in India.
60% are <12 years age group.
Only 1.5 lakh/year corneal donations in India.
What is need?1.5 Lakh new Kidney disease patient every
year and only 750 benefitted with renal transplant.
More than 5 million patients suffering from liver diseases
50,000 patients dying due to heart diseases
India is diabetes capital (2nd in world)
Skin DonationLife saving for burn patients.It makes wound healing FAST.Skin is removed using specialized
knife and preserved like a roll.Skin is taken from un exposed parts of
the body: No Disfigurement of body after Skin Donation
There is a provision of SKIN BANK to preserve donated skin.
Situation in INDIA Annually 1.6 lakh people die due to Road Traffic Accidents.
67% death occurs usually due to Brain stem death.
It means that there are 93000 potential organ donors every year.
But in reality, only 0.05 people donate their organs per 1 lakh
population.
The rate of organ donation is highest in Spain (35 per 1 lakh
population)
In India, Tamilnadu ranks first among all states.
What Can be Donated by living donor?
Kidney
Blood
Lungs
Part of liver Liver
Part of Pancreas
Living Donor
Bone marrow
2 eyesLungsHeartLiverPancreasAll Bones & tendonsBlood vessels2 KidneysIntestineMuscles & ligamentsCartilagesSkin & FasciaLarynx2 handsPenis20 Fingers
What can donated after BSD?
Great scarcity of the organs
VSWastage
of cadaveric organs
Real Problem
Deceased Donors Per Million Population
24.2521.721.6521.5
2018.1
13.1512.96
12.1810.62
6.14.3
2.70.75
0.120.05
33.68
0 5 10 15 20 25 30 35
SpainAustria
PortugalBeligium
USAFrance
ItalyCanada
United KingdomGermanyAustralia
HKSingapore
TaiwanKorea
PhilippinesJapan
de Villa VH, Chen CL, et al. Transplantation 2003; 75:S2 (Modified from)
You choose…
Understanding concept
Identify brain-dead patients
Promote Organ Donation
Solution
Concept of DeathUltimate reality of lifeSomething fearful and unwanted No discussionEnd point Clinically cessation of cardio-
respiratory function
Cardio-respiratory Arrest
Complete Cessation Of Breathing And
Circulation
Death
Concept of Brain Stem Death
Common Causes of Brain Death
Head injuryIntra cerebral
hemorrhageIschemic brain
damageTumorHangingDrowning
Diagnosis of Brain stem death(According to Harward criteria)Unreceptivity and unresponsivityNo movements or breathingNo reflexesOnly in ICU settings
HOTA act-1994Brain death a legally accepted formEstablish criteria for brain death declarationTwo independent teams to declareTwo brain death declarations with 6 hr intervalDonation only with consent of next of kinSale of such organs are prohibited
After amendment in 2013, it is called as TOHO (Transplantation of human organs) & Tissue act
Some recent Amendments in LAWSWAP donation permitted.Grand parents and grand children
included in NEAR RELATIVES.To prepare separate regional level
and State level Waiting list of Organ Recipients.
Provision of Appropriate Authority in case of Donor if Living.
Government control
ZTCC
•Maintains list of hospitals registered for organs retrieval and transplantation.•Maintains waiting list of patients who are desirous for organs.• carries fair distribution of organs based on waiting list.• waiting list is prepared on the basis of- Age- Severity of disease- Prognosis/expected survival after transplant
Organ Retrieving Hospitals
Organs Transplanting hospitals
Multi-organs transplant centres
Government control(As per HOTA act-1994)
ZTCC
No hospital can transplant organ without prior information or permission of ZTCC.
1. Today's date there are 55000 waiting for OD.2. At every 16 minutes, new one is added to
the list.3. 10 die daily from the list without the organ.
Tamilnadu is the leading state in India in OD.
New concept of SWAP donation is also emerging out
HLA matching is mandatory for all OD except Cornea, skin, bones.
Some Facts
In Maharashtra, First tissue bank was started in Tata memorial hospital Mumbai
Rates of OD-
India- 0.16/million population
USA – 22/million population
Spain- 36/million population
More than 50 organs can be donated after Brain Stem Death
Exclusion Criteria (for Deceased Donor)Absolute
◦ Age>70 Yrs◦ Renal disease ◦ Malignancy ◦ Hypertension & infective heart diseases◦ Intravenous drug abuse ◦ Seropositive◦ Rabies
Relative◦ Age <6years or >60 years◦ Mild Hypertension◦ Early Diabetes
Problems in Promoting Organ Donation
Religious mythsProfessional Ignorance Apathy to the cause Shy/afraid of discussing donation Don’t know –what to do???? Scared of bad reputation Fear of litigation Poor communication
Religious Views: HinduismBelieve in rebirth of the soulBody is cremated after deathHuman form is the highest in the
order of re-births before the soul reaches the creator
Sacrifice to the fellow humans considered equivalent to service to god
Religious laws and scriptures do not prohibit organ donation
Religious Views: IslamUntil early 90s the religious leaders
failed to approve of organ donationMid 90s the religious leader in saudi
(mecca) passed a fatwa, making organ donation after death permissible under islamic law
Religious Views: ChristianCatholics view organ donation as an
act of charityEthically and morally acceptable to
the vaticanPope john paul ii has given his support
to organ donationProtestant groups generally endorse
organ donation
Overall Religious Views
All other major religions such as Sikhism, Buddhism and Jainism do not oppose organ donation and share similar views as that of hinduism
LIFE IS AMAZING… PASS IT ON…!!!
Positive Changes
Aishwarya Rai, Amitabh Bachhan, Jaya Bhachhan, Rajnikanth, Amir Khan and many other film
personalities have pledged their Eyes at different times on media
Anil Kumble, Sunil Shetty, Yukta Mukhi, Revathi Menon and Madhavan have endorsed their views on multi-organ donation
You don’t need to be DOCTOR to save LIVES !!!
I am an ORGAN DONOR…Are YOU….???
THANK YOU…