- Deceased Donor Related Transplant
- Legal & Ethical Issues
- Living Donor Related Transplant
- Organ & Tissues Donation
- Organs & Tissues Transplant
No, in Cadaver Organ Donation Programme confidentiality is always maintained, unlike in the case of living donors who usually already know each other.
If the family wishes, they will be given some brief details such as the age and sex of the person or persons who have benefited from the donation. Patients who receive organs can obtain similar details about their donors. It is not always possible to provide recipient information to donor families for some types of tissue transplant.
Those who have wish to exchange anonymous letters of thanks or good wishes they can do it through the transplant coordinator. In some instances donor families and recipients have arranged to meet.
There is a huge disparity between demand and supply for transplant. There are more numbers of patients requiring different organs as compared to a number of organs available for transplantation. That is why there is an urgent need to create awareness about organ donation. As more persons decide to take the pledge and donate organs, the waiting list will go down.
Transplant Coordinator and Treating Registered Medical Practitioner will explain you about the process of Transplant.
Transplant Coordinator means a person appointed by the hospital for coordinating all matters relating to removal or transplantation of Human Organs or Tissues or both and for assisting the authority for removal of human organs.
Though their work is more related to deceased organ donation, they are responsible for living organ donation also. The current Transplantation of Human Organ Act envisages that every hospital doing transplant activity, whether retrieval or organ transplantation must have a transplant coordinator in the hospital before the center is registered for transplantation under the act. Transplant coordinator is a pivot of the organ donation and transplantation.
Living Donor: Any person not less than 18 years of age, who voluntarily authorizes the removal of any of his organ and/or tissue, during his or her lifetime, as per prevalent medical practices for therapeutic purposes.
Deceased Donor: Anyone, regardless of age, race or gender can become an organ and tissue donor after his or her Death (Brainstem/Cardiac). Consent of near relative or a person in lawful possession of the dead body is required. If the deceased donor is under the age of 18 years, then the consent required from one of the parent or any near relative authorized by the parents is essential. Medical suitability for donation is determined at the time of death.
A list of people waiting for receiving an organ.
Transplantation is the act of surgical removal of an organ from one person and placing it into another person. Transplantation is needed when the recipient’s organ has failed or has been damaged due to illness or injury.
Tissue means a group of cells performing a particular function in the human body. Examples would be bone, skin, cornea of the eye, heart valve, blood vessels, nerves and tendon etc.
The transplant coordinator has to counsel the grieved family, make them comfortable and approach the subject of eye donation and later on solid organ donation.
If the family gives consent for organ retrieval, then the coordinator has to inform the Nodal Officer and coordinate with the ICU staff to maintain the patient on a ventilator and organize organ retrieval. The coordinator has to ensure that all paperwork is correctly done and that the family receives the body as soon as possible.
As per protocol, patients who require cadaver organs are put in the waiting list. But in India, number of patients requiring organs are more as compared to number of organs available.
There are two types of waiting list; one is urgent waiting list and another one is regular waiting list. Urgent listing of patients for cadaver organ transplant is primarily based on medical criteria, i.e. patient needs organ on urgent basis otherwise he/she may not survive.
Regular waiting list is also based on medical criteria and these criteria are different for different organs. Like for kidney transplant, main criteria is time spent on regular dialysis. Similarly, for other organs, criteria are different.
The organs would be distributed locally within the State first, and if no match is found, they are then offered regionally, and then nationally, until a recipient is found. Every attempt would be made to utilize donor organs.
When a transplant hospital adds an individual to the waiting list, it is placed in a pool of names. When any deceased organ donor becomes available, all the patients in the pool are compared to that donor. Factors such as medical urgency, time spent on the waiting list, organ size, blood type and genetic makeup are considered
Donation of an organ or tissue provides an unparalleled opportunity to give someone a second chance of life. Your donation is not only giving impact to the life of one person or family, but it is of overall help for the society as a whole.
Organ Donation is the gift of an organ to a person with end-stage organ disease and who needs a transplant.
An organ is a part of the body that performs a specific function: like your Heart, Lungs, Kidney, Liver etc.
The tissues that can be donated are Cornea, Bone, Skin, Heart Valve, blood vessels, nerves, and tendon etc.
The organs that can be donated are Liver, Kidney, Pancreas, Heart, Lung, Intestine.
Doctors are concerned with the possible emotional/ financial exploitation of donors, by recipientsҠfamilies, and from transplant hospitals. They are worried that, with the increasing demand of organs, the rights of the poor donor to live with dignity may be abused.
Transplant hospitals have become more careful with a good system of screening in place, and an Authorization Committee of Hospital/ District/State scrutinizes all the applications. Today, Living Unrelated donations have become more transparent and streamlined.
Here are some end stage diseases which can be cured by the transplantation:
heart failure:- Heart
terminal lung illnesses:- Lungs
kidney failure:- Kidneys
liver failure:- Liver
Corneal Blindness:- Eyes
Heart Valvular disease:- Heart valve
severe burns:- Skin
No, Only few people die in the circumstances where they are able to donate their organs. That is the reason we need people to take pledge for Organ Donation and registered them self as potential Donor.
Till a few years back, transplant cost both for the donor as well as the recipient was not covered by most of the insurance companies. Now a day many insurance companies are covering cost related to transplant. It will be better to be sure when you are going for insurance.
Yes, the patient should be fit for transplant and age is one of the criteria for assessing the fitness of patient for transplant.
Age limit for Organ Donation varies, depending upon whether it is living donation or cadaver donation; for example in living donation, person should be above 18 year of age, and for most of the organs deciding factor is the personӳ physical condition and not the age. Specialist healthcare professionals decide which organs are suitable case to case. Organs and tissue from people in their 70s and 80s have been transplanted successfully all over the world. In the case of tissues and eyes, age usually does not matter.A deceased donor can generally donate the Organs & Tissues with the age limit of:
Kidneys, liver:up-to 70 years
Heart, lungs:up-to 50 years
Pancreas, Intestine: up-to 60-65 years
Corneas, skin: up-to 100 years
Heart valves: up-to 50 years
Bone: up-to 70 years
Yes, you may know your status in the waiting list as this is a quite transparent system. But this will not help you significantly as getting an organ depends on many other factors other than just waiting list number.
Yes, you can unpledge by making a call to the NOTTO office or write or visit NOTTO website www.notto.nic.in and avail of the un-pledge option by logging into your account. Also, let your family know that you have changed your mind regarding organ donation pledge.
No, getting a call for transplant does not mean that you will definitely receive an organ. The transplant team will examine your immediate fitness for transplant. There is a possibility that the tests are done just before possible transplant may not be normal to make you fit for transplant. Further, more than one patient is called for possible transplant and it may be a chance that someone else will be more fit than you for that particular organ transplant.
A-In India there is a growing need of Organ and tissue transplant due to large number of organ failure. As there is no organized data available for the required organs, the numbers is only estimates. Every year, following number of persons needs organ/tissue transplant as per organ specified:
Once you are added to the national organ transplant waiting list, you may receive an organ on the same day, or you may have to wait many years. Factors affecting are how well you match with the donor, how sick you are, and how many donors are available in your local area compared to the number of patients waiting.
There is no time line on how long one will have to wait for an organ that the individual requires. This depends on his/her medical situation and how frequently organs are becoming available in a city or state.
Organ donation for therapeutic purposes is covered under the Transplantation of Human Organs Act (THOA 1994). Whole body donation is covered by the Anatomy Act 1984.
Organ and Tissue donation is defined as the act of giving life to others after death by donating his/her organs to the needy suffering from end-stage organ failure.
Body donation is defined as the act of giving oneӳ body after death for medical research and education. Those donated cadavers remain a principal teaching tool for anatomists and medical educators teaching gross anatomy.
The patient can register for inclusion in the waiting list through a registered transplant hospital. The treating physician of the hospital shall make an evaluation (based on medical history, the current condition of health, and other factors) and decide if the patient needs a transplant and meets the criteria to be listed. Like for kidney transplant, other than blood group, the main criteria is time since the patient is on regular dialysis. Similarly, for other organs, criteria are different based on medical history, the current condition of health, and other factors.
Every patient who has developed end stage organ failure may not be fit for organ transplant. Basic principle is that patient must be screened on medical grounds (based on medical history, current condition of health, and other factors) for the development of end stage organ failure. Your treating doctor will decide whether you are medically fit for transplant and other issues before listing in the wait list.
You can help by:
A. Becoming a donor, and talking to your family about your decision of saving the lives of others.
B. Promoting donation by motivating people at the workplace, in your community, at your place of worship, and in your civic organizations.
You can be a donor by expressing your wish in the authorized organ and tissue donation form (Form-7 As per THOA). You may pledge to donate your organs by signing up with our website www.notto.nic.in and register yourself as donor or for offline registration you may download Form 7 from our website. You are requested to fill the form 7 and send signed copy to NOTTO at below mentioned address:
NATIONAL ORGAN AND TISSUE TRANSPLANT ORGANISATION
4th Floor, NIOP Building, Safdarjung Hospital Campus, New Delhi-110029
Many medical factors need to match to ensure a successful organ transplant. Blood group is one of the major factors taken into account. Organ size of the donor & recipient is also considered. For kidneys another important factor is tissue matching which is more complex than blood grouping matching and also takes more time. The best results can be achieved if there is a perfect kidney match.
There is a local, regional and national computerized list of patients waiting for an organ transplant. Most of the time, computer will identify the best matched patient for a particular organ and organ is offered to the transplant unit who is treating that patient. Also, priority is given to patients who most urgently need a transplant. NOTTO operates the waiting list and organ allocation system. It works round the clock, every day of the year. In case of tissues, matching is usually not required.
No, if you have already pledged with one Organisation & received a Donor Card, you need not to register with any other organization.
Yes, it will be helpful for the health professionals and your family.
Yes, it may be better to be mentally prepared and have some funds for an urgent organ transplant. Cadaver transplant is mostly on an urgent basis. That is why it is better that your investigations for cadaver transplant are updated all the time so that whenever you receive a call, you can get the organ. Getting a cadaver organ is a gift and one should not miss it.
This query can only be answered by the treating doctor depending upon medical condition and stage of damage of the organ. For example in a case of kidney failure, dialysis is an alternative treatment and for kidney failure patient transplant is usually not an emergency. Also, for a heart failure patient, some patients can be maintained on artificial cardiac assistive devices. Similarly for other organs criterias are different, that can be maintained on medical therapies for the time being.
As per the Transplantation of Human Organ Act 1994, sequence of allocation of organs shall be in the following order:
State List-Regional list-National List-Person of Indian Origin-Foreigner
Yes, The decision about whether some or all organs or tissue are suitable for transplant is always made by a specialist, taking into account your medical history. There may be specific reasons why it has not been possible to donate blood, such as having anemia or had a blood transfusion or had hepatitis in the past or there may be reasons why you could not donate blood because of your health at the time – sometimes a simple thing like a cold or medication that you are taking can prevent you from donating blood.
Yes, in most circumstances you can be a donor. Having a medical condition does not necessarily prevent a person from becoming an organ or tissue donor. The decision about whether some or all organs or tissue are suitable for transplant is made by a healthcare professional, taking into account your medical history.
In very rare cases, the organs of donors with HIV or hepatitis-C have been used to help others with the same conditions. This is only ever carried out when both parties have the condition. All donors have rigorous checks to guard against infection.
Yes, you can pledge, but you need to preferably inform the person closest to you in life, a friend of long standing or a close colleague, about your decision of pledging. To fulfill your donation wishes, healthcare professionals will need to speak to someone else at the time of your death for the consent.
Can a dead body be left for medical education or research after the organs have been retrieved for donation?
No, Bodies are not accepted for teaching purposes if organs have been donated or if there has been a post-mortem examination. However, if only the corneas are to be donated, a body can be left for research.
No, none of our major religions object to donate organs and tissues, rather they all are promoting and supporting this noble cause. If you have any doubts, you may discuss with your spiritual or religious leader or advisor.
Yes, Blood is taken from all potential donors and tested to rule out transmissible diseases and viruses such as HIV and hepatitis. The family of the potential donor is made aware that this procedure is required.
Informed consent is a process, which is not specific to organ and tissue donation. This is a process of reaching an agreement based on a full understanding of what will take place, in the form of medical treatment. Informed consent involves information sharing as well as the ability to understand and freely make a choice in relation to medical treatment.
Required request is a way of getting consent of the person for the cadaver donor transplantation. Any person, who wishes to donate his/her organ and tissue after his death, has to affirmatively make a pledge that his/her organs after death can be used for transplantation and saving life of other person.
At the time of death, Hospital staff approaches family of the deceased person for donating their loved ones organs and tissues to save life of others. This approach is also called as үpting inҠapproach.
A required request is a way of getting the consent of the person for the cadaver donor transplantation. Any person, who wishes to donate his/her organ and tissue after his death, has to affirmatively make a pledge that his/her organs after death can be used for transplantation and saving lives of other people.
At the time of death, the Hospital staff approaches the family of the deceased person for donating their loved ones’ organs and tissues to save the life of others. This approach is also called as үpting inҠapproach.
In case, anybody submitting false records or any other delinquency should be reported to the Appropriate Authority of the State Government, Department of Health & Family Welfare. Any hospital, Authorization Committee, or a person can approach the State Appropriate Authority. The Appropriate Authority can file a case against the party.
As per the Amended 2011 THO Act offenses/punishments are as follow:
Offence ( THO Act 2011 Amendment) Imprisonment Fine
Removal of organs without authority 10 years Rs. 20 Lakh
No. As per Transplant of Human Organ Act (THOA), buying/ selling of organ in any way is punishable and has significant financial as well as judicial punishment. Not only in India but in any part of the world, selling of an organ is not permissible.
Organ Transplantation and Donation is permitted by law and covered under the “Transplantation of Human Organs Act 1994”, which has allowed organ donation by living & Brain-stem Dead donors. In 2011, amendment of the Act also brought in donation of human tissues, thereby calling the Amended Act “Transplantation of Human Organs & Tissues Act 2011”.
The national registry for organ donation & transplant is as follows:-
I – Organ Transplant Registry:
The Organ Transplant Registry shall include demographic data about the patient waiting for transplant (Organ/hospital wise waiting list), donor (Living Donor including Related Donor, Other than Near Related Donor, Swap Donors, and Deceased Donor), hospitals, follow up details of recipient and donor etc., and the data shall be collected from all retrieval and transplant centers.
Data collection may preferably be through a web-based interface or paper submission and the information shall be maintained both specific organ wise and also in consolidated formats.
The hospital or Institution shall update its website regularly in respect of the total number of the transplantations done in that hospital or institution along with reasonable detail of each transplant and the same data should be accessible for compilation, analysis and further use by authorized persons of respective State Governments and Central Government.
II – Organ Donation Registry:
The Organ Donation Registry shall include demographic information of donor (both living and deceased), hospital, height and weight, occupation, primary cause of death in case of deceased donor, associated medical illnesses, relevant laboratory tests, donor maintenance details, driving license or any other document of pledging donation, donation requested by whom, transplant coordinator, organs or tissue retrieved, outcome of donated organ or tissue, details of recipient, etc.
III – Tissue Registry:
The Tissue Registry shall include demographic information on the tissue donor, site of tissue retrieval or donation, primary cause of death in case of deceased donor, donor maintenance details in case of brain stem dead donor, associated medical illnesses, relevant laboratory tests, driving license or any other document pledging donation, donation requested by whom, identity of counsellors, tissue(s) or organ(s) retrieved, demographic data about the tissue recipient, hospital conducting transplantation, transplant waiting list and priority list for critical patients, if these exist, indication(s) for transplant, outcome of transplanted tissue, etc.
IV – Organ Donor Pledge Registry:
The National Organ Donor Register is a computerized database which records the wishes of people who have pledged for organ and tissue donation. A person during their life can pledge to donate their organ(s) or tissue(s) after their death through Form 7 and submit it in paper or online to the respective networking organization and pledger has the option to withdraw the pledge through intimation.
There are many hospitals and organizations those are also maintaining the list of persons who have pledged organ donation with them, will be passed to National Organ & Tissue Transplant Organisation for National Register.
Organ transplantation is undertaken only as a lifesaving treatment. It is best for the transplant team to decide whether to go ahead with a live organ donation, keeping in mind the two issues of doing no harm to the donor, and doing good for the recipient. Only the transplant team can decide whether the benefit to the patient is worth the risk faced by the donor. The transplant team takes into account the mortality and morbidity of the donor, though this can be accurately predicted.
Any special appeal usually results in more people agreeing to become donors and can increase the number of organs pledging.
However, family appeals through the newspapers and television will not result in an organ immediately becoming available for the person on whose behalf the appeal was made. The patient will still be on the waiting list, just like everyone else, and the rules that govern the matching and allocation of donor organs to recipients still apply.
No. In India, the allocation of organs to recipients on the waiting list is based on predetermined criteria which include date of registration and medical criteria.
The wealth, race, or gender of a person on the waiting list has no effect on when and whether a person will receive a donated organ. The Transplantation of Human Organs Act of 1994 makes it illegal to buy or sell human organs in India.
Yes. Government of India has started National Organ and Transplant Program (NOTP), under which patients below poverty line are supported for the cost of transplant as well as cost of immunosuppressant after transplant for one year. Other than this, renal transplant in all public hospitals is subsidized as per Government of India policy.
The police department has to be informed that a patient is brain dead if it is a medico-legal case, but the declaration of brain-stem death is only done by a panel of doctors.
When an accident victim is brought to a hospital for emergency treatment, an FIR has to be filed by the family in the nearest police station. Such cases are usually called medico-legal cases. Also, any medical treatment (for suicide, assault, poisoning or fall) which needs that the police should be notified becomes a medico-legal case.
The police will conduct an inquest about the incident and take charge of the case. A forensic doctor will examine the patient and will allow or deny organ retrieval.
A registry is an essential part of understanding who and where potential donors are. A registry gives a planner enough information to devise strategies to get more public cooperation and commitment towards organ donation. Having a registry in place allows doctors and transplant coordinators to check if a brain dead person wished to donate and then approaching the family for consent becomes easier. It helps in saving crucial time in the process of organ donation.
Everyone irrespective of age or health can join the NOTTO Organ Donor Register. Joining the Register expresses a wish to help others by donating organs or tissues after death but importantly, joining the Register also is a way to give legal consent or authorization for donation to take place.
The NOTTO Organ Donor Register is a computerized database which records the wishes of people who have pledged for organ and tissue donation and decided that, after their death, they want to leave a legacy of life for others. There are many hospitals and organizations that are also maintaining the list of persons who have pledged organ donation with them, will be passed to NOTTO website for National Register.
The Central Government has established a National Human Organs and Tissues Removal & Storage Network named NOTTO, which stands for National Organ and Tissue Transplant Organisation. NOTTO will have five Regional Networks ROTTO (Regional Organ & Tissue Transplant Organization) and each Region of the country will develop SOTTO (State Organ and Tissue Transplant Organisation) in every State/ UT.
Each hospital of the country related to transplant activity, whether as retrieval or transplant, has to link with NOTTO, through ROTTO/SOTTO as a part of National Networking.