1 death can save 3 lives: Dr Rajeev Jayadevan dispels misinformation, myths about organ donation

Hyderabad: Despite the fact that a majority of individuals in society are educated, there is a significant lack of information about the many methods of organ donation. This includes people who work in healthcare. A lack of understanding exposes a person to incorrect assumptions, comments, and decisions.

According to 2022 statistics, Telangana leads India in dead organ donation with 194 cadaveric donations. This equates to around five deceased donors accessible per million population in the state, trailing the United States and Spain, both of which have more than 40 deceased donors available per million population.

“Death is an unavoidable reality. Even while not everyone who dies will be able to donate their organs, we must ensure that no organ is wasted needlessly. Unfortunately, a substantial number of human organs are being wasted in India right now due to a lack of knowledge and facilities, widespread disinformation, and ill-advised hostility to organ donation,” says Dr Rajeev Jayadevan.

In conversation with NewsMeter, Dr Rajeev Jayadevan MD, DNB, MRCP(UK), with an American Board Certification in Medicine and American Board Certification in Gastroenterology gives a thorough explanation of organ transplantation and dispels misinformation surrounding the donation.

What is the significance of organ donation?

Diabetes, hypertension, viral infections, and alcoholism can cause gradual organ failure, leading to a lower quality of life and life expectancy. Despite extensive research, creating functional human organs in a lab remains a challenge.

As of 2023, organ donation is the global standard for treating end-stage organ failure, such as kidney and liver failure.

However, widespread misunderstandings and hate campaigns discourage organ donation, limiting the supply of human organs for those in need. India’s availability of organs is around 40 times lower than Western countries, with some states like Telangana doing better.

Dispelling misinformation and misconceptions is challenging, but raising awareness can encourage more people to donate their organs after death. Human organs are priceless and a miracle cure for hundreds of thousands of people in need, and no organ should be wasted.

Where are organs sourced from?

Organs are primarily sourced from deceased donors. The organs are surgically removed after a brain or cardiac death. Organ retrieval should be done immediately after death. It requires strict protocols, consent, and paperwork. It requires coordination between multiple hospitals and specific expertise. Organs, once removed, are quickly transported to patients waiting to receive them. Any delay can potentially become a lost opportunity to restart life.

Brain death occurs when the brain and brain stem stop functioning, but artificial support to the individual such as ventilators and ICU care is provided. Even after brain death, the heart can beat on its own for a limited time, allowing organs to remain in good condition. This limited-time provides the window for organ donation to others in need.

One deceased person can provide a new lease of life to a minimum of three people. It is important to note that once a person is declared brain dead, the risk of damage to organs increases with every passing hour, despite artificial measures.

There are two forms of organ donation:

1. From a donor who is still alive: the individual must be healthy, willing to give, and compatible with the recipient.

2. From a donor who died (cadaveric) - either from brain or heart death. Organs can be sourced from a person who has died of brain death but whose organs are still alive thanks to medical assistance. Furthermore, organs can be taken instantly from a person whose heart has just stopped.

What is cadaveric transplantation?

Contrary to what most people assume, cadaveric transplantation is not about stealing or cutting organs from a dead body, but rather ensuring blood circulation and oxygen delivery to the tissues.

In cases of recent brain death, internal organs can remain in good condition as long as artificial means are used. In cases of heart failure, organs can be quickly retrieved before ischemic damage occurs.

Cadaveric organ transplantation involves surgically removing organs from a deceased donor, transporting them, and transplanting them into another person on the same day.

The process can sometimes be urgent when the potential recipients are several hundred miles away. It must be completed within a short timeframe while the organs are still in good condition.

Delays in organ retrieval can lead to organ damage due to hemodynamic instability, characterised by unstable blood flow and pressure.

How long can organs survive outside the body?

The duration is determined by the organ. A kidney may be preserved for up to 36 hours in an appropriate preservation media and environment outside the body. The time is considerably less for the liver (approximately 12 hours), lungs, and heart (4-6 hours).

What organs and tissues are transplantable?

Hearts, lungs, livers, kidneys, pancreas, and intestines are among the organs that can be transplanted. Bone, skin, cornea (part of the eye), blood arteries, and heart valves are also transplantable tissues. As a result, a single deceased organ donor can save numerous lives.

What is living donor transplantation?

Living donor transplantation is a planned surgery where a healthy person donates an organ or a part of an organ to another person after a thorough medical evaluation. This method eliminates the need for coordination between hospitals, quick transport arrangements, or elaborate certification processes. However, there is a small but significant risk related to anaesthesia and surgical procedures, unlike cadaveric donation, where the donor is already brain dead.

Is organ donation legal?

The altruistic donation, which is legal in India and elsewhere, involves the genuine desire to help others without expecting personal gain. However, compensation for donating organs is not allowed by law in India and is punishable by Section 19 of the THOA 1994. Living donors cannot receive financial compensation in any country, except Iran.

There are concerns about living organ donation being done for the illegal exchange of money under the guise of altruistic donation. Unethical middlemen could exploit vulnerable people facing financial difficulties, persuading them to sell their organs for financial gain. The demand for living donors naturally increases when donations from dead persons decline.