One family's loss could be a gift of life to another family

Fifty-year-old Arshad (name changed), a resident of Kanpur, was suffering from cirrhosis of liver. Every day for him was a fight with impending death. Liver cirrhosis had left his body extremely weak for the past two years. His abdomen was increasingly tense due to fluid accumulation and legs were getting more and more swollen, limiting any physical activity.

Besides he would often lose his consciousness and vomit blood leading to frequent hospitalization and costly medications. His liver had failed and doctor had given him three months to live. He was advised liver transplantation in order to save his life. His wife and brother frantically tried to find a suitable liver donor in the family. Unfortunately, the blood group of both wife and brother did not match with him and his children were too young (less than 18 years) to donate.

Not ready to give up the fight to save him, his family approached doctors at King George's Medical University, Lucknow. Here he was placed on a waiting list for organ donation. He was also told that organ donation in Uttar Pradesh is very infrequent, so there was no guarantee or fixed timeline within which he could get an organ. He was told to hope for the bestand wait.

One family's loss was a gift of new life to another family

Luckily for him, an organ was available for him after three months of waiting. A 30-year-old man from a village near Amethi was returning home on a motorbike late in evening, when his bike met with an accident.Some people who were passing by, spotted him and admitted him to a hospital in Amethi and his family was informed. The man was fully unconscious and was having difficulty in breathing. Suspecting severe head injury, he was referred to King George's Medical University, Lucknow. He was put on a ventilator.A CT scan of his brain revealed severe hemorrhage in the brain. He was operated in emergency and the blood clot was removed.However, the damage to the brain was extensive.

For the next three days, he failed to regain consciousness and his limbs would not move. He was unable to breathe either and was dependent on the ventilator. Suspecting brain death, doctors performed tests which confirmed the same. Family was informed that any further treatment is now futile. The family was obviously devastated. It is difficult to come to terms with unexpected loss of a dear one, however his family carefully listened to the request for organ donation made by the doctor and social worker at this time. Finally understanding that their patient was no more, a generous decision to donate his organs was made by the family at this time of grief.

Arshad got this gift of life from a person and family totally unknown to him. It has been three years and now. Arshad is fully healthy, taking care of his family and doing his day to day job. One family's loss was a gift of new life to another family. This is a case of community member helping another community member.

Need many such good Samaritans

We have a few more cases --a person from Deva giving his kidney to a lady from Barabanki after his death, a young girl from Raebarielly giving a new lease of life by donating her liver to a 40-year-old man from Meerut. We salute organ donors from various parts of the state of Uttar Pradesh, including Siddharnagar, Sitapur, Amethi, Barabanki, Gorakhpur, Harouni and Lucknow. Atleast 20 such donors have donated their organs after death in the past three years, giving new lease of life to more than 50 patients. However, these few cases are not enough to bridge the gap. We need more, many more, such stories of community helping out community.

Why Organ Donation is so important?

In certain cases, despite major advances in Medical Science, transplant is the only alternative to save a life. More than two lakh patients in India suffer from kidney failure and about 50,000 have liver failure. Only 1,500 liver transplants and about 4,000 kidney transplants are performed annually. This means thousands of patients are dying each year due to lack of enough organs.

There are two situations under which Organ donation occur-- when the person making the donation is alive (Live Donations) or after the person dies (Deceased Donations).

Live Donations

As per the Transplantation of Human Organs Act 1994 , only blood relatives (parents, siblings and children) are allowed to be Live Donors. Living person can donate one kidney and a part of the Liver. Heart, cornea and lung transplants are not possible from living donor. The donor has to be healthy without any serious medical problems like uncontrolled diabetes and hypertension and should be of the same blood group as the patient. Many patients cannot find a suitable living donor in their own family and so need organs from a deceased donor.

Deceased Donations

Death is of two main types -- Brain Death and Cardiac/Natural Death

Organ donation after Brain Death

Brain death is the irreversible and permanent end of all brain functions.

Such persons are kept on artificial support (ventilators) to maintain breathing and cardiac function. This usually is seen after a major head injury in an accident or major brain hemorrhage (stroke). Brain death is certified by especially appointed committee of doctors by government which includes neurosurgeon/neurologist/anesthetist and a number of tests are done before brain death is diagnosed. It is possible to donate all organs in the case of Brain death.

Cornea and body donation after Cardiac Death or Natural Death

When a person suffers a cardiac death, the heart stops beating. Due to the lack of circulation of blood the vital organs quickly become unusable for transplantation. Cornea donation is possible till six hours after death. For this Eye Bank has to be called (1919 Toll free) by the family of the deceased and the eye bank team can come to retrieve the cornea, by a small procedure which can be done at home. Another possibility after heart beat has stopped is body donation that will help to carry out medical research and teaching of medical students.

Why pledge your organ?

By being an organ donor, you can save the lives of eight individuals by way of organ donation and enhance lives of over 50 people by way of tissue donation.

What can you donate?

Eyes (cornea), heart, liver, lungs, intestines, pancreas, kidneys, skin, bone marrow, limbs, face etc.

Who can donate?

Organ donations have no age limit. Anyone, regardless of age, race or gender can become an organ donor. A doctor assesses the medical suitability in each situation.

How to Donate

Any adult age 18 Years or more can pledge to donate. Donation of organs of deceased donors under the age of 18 years, require the consent of their parent or legal guardian. It may not possible to make an organ donation if you are HIV/AIDS Positive, have any type of cancer or blood related infection.

The most important aspect about organ donation is that the person, who wishes to donate his organs after death, must let this known to the immediate family members. This is because two immediate family members have to give legal permission for organ donation after the donor is deceased even in the presence/absence of donor card as per current law.

Care of donors and their families

Donation of organs is an act which deserves utmost respect and honour. Procedure of organ donation will not lead to major delay in handing over of body for last rites. If postmortem exam is required, it can be done at same time as procurement.Priority is given to the donor so that the body is released early for cremation. Procedure for organ procurement lasts for only 2 to 3 hours and does not lead to any disfigurement except for a stitch in the middle of chest and abdomen. Family does not have to bear any extra charges related to donation and our hospital will facilitate transport of body to native place. Organ donations are anonymous, free from any monetary transactions and all organ allotments are done by national agency (NOTTO) in free, fair and transparent manner to waiting lists of hospitals.

Anyone who wishes to register as donor can email us at [email protected] or sent a postal mail or visit the Coordinator, Department of Organ Transplant, Ground floor Shatabdi Hospital Phase 1, Shameena Road, King George Medical University, Chowk, Lucknow, UP, PIN 226003. Please provide two passport sized photographs and copy of ID (Driving license, passport, voter ID) and Aadhar card. Pledge for organ donation should be signed by two family members. A donor card will be provided.

Dr Vivek Gupta is an assistant professor (organ transplant) at King George's Medical University, Lucknow

(Views are personal)