‘Brain-dead donor treated with deserved dignity’
Dr Kishore D Phadke
(Convener, Jeevasarthakathe)
The only organisation in Karnataka through which organ donations and transplants are coordinated is Jeevasarthakathe.
Jeevasarthakathe is a state-governed body that works with centres recognised by the government for cadaveric transplantation and co-ordination for the same. A list of patients awaiting transplant is maintained. On receiving information about a potential donor, Jeevasarthakathe assesses suitability for donation of the organ. Based on the blood group and other criteria for organ matching, the recipient is selected, admitted to hospital and prepared for the operation. A team of surgeons perform the organ retrieval from the donor. In medico-legal cases, Jeevasarthakathe helps the family with formalities involved.
According to Jeevasarthakathe, around 80 million people need a transplant. But, only 20-30 people out of every million may be potential donors. Potential donors are those who have been diagnosed to be brain dead. Brain death is ‘death’ and not coma. As per law, this must be confirmed by four doctors on two occasions at least six hours apart.
Anybody regardless of age, race, religion or gender can become a potential organ donor. If he/she is under the age of 18 years, then consent of their parent or legal guardian becomes essential. Health of the organ, rather than the age of the donor, is the vital factor. Organs that can be donated are kidneys, liver, pancreas, heart, heart valves, lungs, eyes, bones, skin, nerves and other tissues. Strictly, the sale of organs retrieved from the dead or living is absolutely illegal.
Once admitted, all efforts are made to stabilise the patient. If all efforts fail, the patient is then pronounced brain dead after evaluation, testing and documentation. Consent from the family is obtained to proceed with donation and organ procurement organisation (OPO) is informed. Consent from coroner/ legal authorities is also obtained.
In the meantime, the organ donor is maintained on a ventilator, stabilised with fluids, medications and is put through numerous laboratory tests. Recipients are also identified for placement of organs. Surgical teams are mobilised and co-ordinated to arrive at hospital to remove the donated organs and tissues. The donor is brought to the operating room. Multiple organ recovery is performed with organs being preserved through special solutions and cold packing. Ventilator support is then discontinued. Finally, the donor’s body is surgically closed and released.
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