The Presentation gives brief information about recent statistics of Organ donation figures, problem statement and Recent amendments in Law. It also mentions some examples of positive changes in view of Organ Donation in India.

1. Organ & Tissue Transplantation
Awareness and Recent Updates
Dr Amol Kinge
Res. Medical Officer
Seth GSMC & KEM Hospital,
Mumbai

2. Outline
• What is Organ Donation
• Need of organ donation
• Types of Organ Donation
• Which Organs can be Donated
• Concept of brain death
• Common conditions leading to brain death
• Diagnosis of brain death
• Myths related to organ donation
• Religious views towards organ donation

3. Facts…
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
4. Annually only about 7000 solid
organ transplantations done.
5. Kidney-6000,
Liver-1200,
Heart-17,
Cornea- 25000 (Annually)
Rates of OD-
India- 0.16/million
population
USA – 22/million
population
Spain- 36/million
population

4. Corneal Blindness
 very common PROBLEM in India.
 More than 3 million cases in India.
 60% are <12 years age group.
 Cornea REQUIRED : 1 lakh / year,
 Cornea DONATED : 25000 / year

5. Anatomy of Normal EYE

6. After CORNEAL TRANSPLANT

7. What is need?
• 2.5 Lakh new Kidney disease patient every
year and only 750 benefitted with renal
transplant.
• More than 80000 patients suffering from Liver
diseases
• 50,000 patients dying due to Heart diseases
• India is Diabetes capital (2nd in world)

8. Situation in INDIA
• Annually 1.6 lakh die due to Road Traffic Accidents.
• 67% deaths: Brain stem death.
• 93000: Potential organ donors / year.
• But in reality, only 0.05 / Lakh people donate their.
• Rate of OD is Highest in Spain (35 per 1 lakh population)
• In India, Tamilnadu ranks first among all states.

9. Deceased Donors
Per Million Population
24.25
21.7
21.65
21.5
20
18.1
13.15
12.96
12.18
10.62
6.1
4.3
2.7
0.75
0.12
0.05
33.68
0 5 10 15 20 25 30 35
Spain
Austria
Portugal
Beligium
USA
France
Italy
Canada
United Kingdom
Germany
Australia
HK
Singapore
Taiwan
Korea
Philippines
Japan
de Villa VH, Chen CL, et al. Transplantation 2003; 75:S2 (Modified from)

10. Great
scarcity
of the
organs
VS
Wastage
of
cadaveric
organs
Real Problem

11. Understanding concept
Identify brain-dead patients
Promote Organ Donation
Solution

12. Types of Organ Donation
• After NATURAL DEATH
• By LIVING RELATED DONOR
• By LIVING UNRELATED DONOR
• After BRAIN STEM DEATH

13. Which Organs Can be Donated by living
donor?
Kidney
Blood
Lungs
Part of liver Liver
Part of Pancreas
Living Donor
Bone marrow

14. 2 eyes
Lungs
Heart
Liver
Pancreas
All Bones & Cartilages
Blood vessels
2 Kidneys
Intestine
Muscles & ligaments
Skin & Fascia
Larynx
2 hands
20 Fingers
What can donated after
BSD?

15. More than 50 organs can be donated
after Brain Stem Death

16. Organs needed in different
conditions
Diseases Organs
Heart Failure Heart
Terminal Lung illnesses Lungs
Kidney failure Kidneys
Liver failure Liver
Diabetes Pancreas
Corneal Blindness Eyes
Heart Valvular disease Heart valve
Severe Burns Skin

17. Age limit for Organ DonationOrgans Age limit
Age limit of Different
Organs to Donate

18. 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

19. Skin Donation
• Life saving for burn patients.
• Makes wound healing FAST.
• Removed using specialized knife
and preserved like a roll.
• Taken from un-exposed parts of
the body: No Disfigurement.
• SKIN BANK to preserve
donated skin.

20. Concept of Death
• Ultimate reality of life
• Something fearful and unwanted
• No discussion
• End point
• Clinically cessation of cardio-respiratory function

21. Cardio-respiratory Arrest
Complete Cessation Of
Breathing And Circulation
Death

22. Concept of Brain Stem Death

23. Common Causes of Brain Death
• Head injury
• Intra cerebral
hemorrhage
• Ischemic brain
damage
• Tumor
• Hanging
• Drowning

24. Diagnosis of Brain stem death
(According to Harward criteria)
• Unreceptivity & Unresponsivity
• No Movements / Breathing
• No Reflexes
• Only in ICU settings
• Two independent teams to
declare
• Two brain death declarations
with 6 hr interval

25. Body Donation
• Whole body donation is covered by the Anatomy Act
1984.
• Defined as the “Act of giving only Body after
death for Medical Research and Education.”
Those donated cadavers remain a principal teaching
tool for anatomists and medical educators teaching
gross anatomy.
• Bodies are not accepted for teaching purposes if
organs have been donated or if there has been a
post-mortem examination.

26. You can Help by:
• A. Becoming a Donor, and talking to your
family about your decision of saving lives of
others.
• B. Promoting donation by motivating people
at work place, in your community, at your place
of worship, and in your civic organizations.

27. Who will tell me..???
Transplant Coordinator
and Treating Registered
Medical Practitioner will
explain you about the
process of Transplant.

28. Transplant Coordinator
Counsel the grieved family
Make them comfortable
Approach the subject of
eye donation
solid organ donation
If the family gives consent
Inform the
Nodal Officer

29. HOTA act-1994
• Brain death a Legally Accepted form
• Established criteria for Brain Stem
Death Declaration
• Donation only with Consent of next
of kin
• Commercial Dealings of such organs
are prohibited

30. Some recent Amendments in LAW
• TOHO (Transplantation of human organs) & Tissue
act
• SWAP donation permitted.
• Grand parents and grand children included in
Near Relatives.
• Waiting Registries: Regional level and State
level
• Provision of Appropriate Authority in case of
Donor if Living.

31. SWAP Donation

32. • Located at 4th and 5th Floor of Institute of
Pathology (ICMR) Building in Safdarjung
Hospital New Delhi
Divisions:
• "National Human Organ and Tissue Removal
and Storage Network”
• "National Biomaterial Centre”.

33. Zonal Transplant Coordination
Committee
• 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
Government control
(As per HOTA act-1994)
ZTCC
No hospital can transplant organ without prior information or
permission of ZTCC.
Organs
Transplanti
ng hospitals
Multi-organs
transplant
centres

34. Problems in Promoting
Organ Donation
• Religious myths
• Professional 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

35. Religious Views: Hinduism
• Believe in rebirth of the soul
• Body is cremated after death
• Human 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
LIFE IS AMAZING… PASS IT ON…!!!

36. Religious Views: Islam
• Until early 90s the religious leaders failed to
approve of organ donation
• Mid 90s the religious leader in saudi (Mecca)
passed a fatwa, making organ donation after death
permissible under islamic law
LIFE IS AMAZING… PASS IT ON…!!!

37. Religious Views: Christian
• Catholics view organ donation as an act of charity
• Ethically and morally acceptable to the vatican
• Pope John Paul ii has given his support to organ
donation
• Protestant groups generally endorse organ donation
LIFE IS AMAZING… PASS IT ON…!!!

38. 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.

41. 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

42. Green Corridor
LIFE IS AMAZING… PASS IT ON…!!!

45. LIFE IS AMAZING… PASS IT ON…!!!

46. You choose…
LIFE IS AMAZING… PASS IT ON…!!!

47. You don’t need to be DOCTOR to
save LIVES !!!
I am an ORGAN DONOR…
Are YOU….???
THANK YOU…