Last Updated on May 21, 2023 by Shabnam Sengupta
Organ donation is a profound act of compassion that has the power to save and enhance countless lives. With a population of over 1.3 billion people, in India, our need for organ transplants is immense. It has emerged as a critical way of bridging the gap between the demand and availability of organs for transplantation.
Pallavi Kumar is the Executive Director at MOHAN (Multi Organ Harvesting Aid Network), Delhi-NCR Region. MOHAN is a dedicated organisation that has tirelessly promoted deceased organ donation for the past 25 years. Pallavi has been working in the field of organ harvesting for over a decade now and has been a key to saving and changing many lives. In an exclusive chat with THIP Media, she highlights the process, challenges and way ahead in the field of organ donation.
What is the process of organ donation in India? Also, seeing the lack of organ donations in general in our country, where does the process fail?
In the realm of organ donation, two significant avenues exist. The first is living donation, where an individual can donate one of their kidneys or a portion of their liver. The second avenue is deceased donation, which occurs in the cases of brain death and is an integral part of organ donation practices in our country.
When an individual experiences brain death and receives hospitalisation and ventilator support, the ventilator aids in maintaining cardiac function, ensuring that the organs receive oxygenated blood. Although the person is no longer alive, their organs continue to function. In such circumstances, we approach the grieving families to consider organ donation. Over the course of my 12 years in the field, I have engaged in numerous conversations with families. And I must admit it is a challenging task. While for professionals, it might be another conversation in a long line of experiences, but for the family they are speaking to, the grief of losing their loved is still raw and profound. Consequently, this dynamic can sometimes lead to communication gaps and difficulties.
Furthermore, it is important to understand that when observing a brain-dead person connected to a ventilator, their breathing may appear intact. They might resemble someone in a coma, in a profound state of unconsciousness. For families who are unfamiliar with the concept of brain death, accepting the death of their loved ones becomes even more challenging, as they perceive signs of breathing. In the absence of any prior discussion about organ donation before this intense moment of grief, it becomes an additional decision to make for the families. In many cases, the simplest choice for them is to refuse.
It can be quite emotionally challenging for someone to convince families for organ donation after the death of their loved one. How do you deal with it?
Our focus remains on the families who consent to organ donation and the good that comes out of it. It is these instances that serve as our motivation to persist. Despite encountering numerous refusals, we constantly remind ourselves of the families who have agreed to this life-saving act. Nevertheless, it is important to acknowledge that the journey is far from easy. One of the most frequently asked questions we receive regarding organ donation is about the timing of donation. I want to emphasise that every individual should decide whether to become an organ donor and communicate their wishes to their loved ones. After that, our dedicated team will assess the suitability of the organs for donation.
I would like to share the story of Mr Tej Ramji, former member of the board of directors at Sir Ganga Ram Hospital. At the age of 88, Mr Ramji experienced brain death, and his family expressed their wish to donate his organs. Considering his age, we initially had reservations about the organs that could be retrieved. However, owing to his healthy lifestyle, we were able to successfully retrieve his kidneys and liver. It’s important to note that organs from older donors typically do not go to younger recipients, as a general practice.
Do you have any activities to promote organ donation from MOHAN Foundation?
Our efforts encompass a range of initiatives to raise public awareness, including impactful public awareness programmes and active engagement through media. Moreover, we prioritise comprehensive training programmes aimed at enhancing the capabilities of our transplant coordinators. They are the people entrusted with coordinating both living and deceased organ donations within a hospital setting. Additionally, we invest considerable resources in training critical care staff who possess the expertise to identify and declare brain death. We also invest in training neurosurgeons who play a vital role in this process. The training aspect is of utmost importance to us, as we remain dedicated to ensure a skilled and knowledgeable workforce in the field of organ donation.
If there is a death in the house, it may not be possible to donate solid organs that have the potential to save lives. However, there is still an opportunity to contribute through corneal donation. Unlike organ donation, corneal donation is a relatively straightforward process. This procedure is minimally invasive, devoid of disfiguration or bleeding. It can be performed at various locations, including the home, mortuary, or a hospital setting.
Religion bars organ donation. Is it a myth or a fact?
There is no mention about organ donation in religious texts. The concept of organ donation and transplantation did not exist during the time those texts were written. Therefore, it is a misconception to assume that religion prohibits or discourages organ donation.
Is it true that the donor’s family is charged for donating organs?
No, in fact, hospitals do not bill the donor family for the organ donation-related expenses. As per the law, once the family provides consent for organ donation, billing for their loved one’s medical care ceases. Doctors conduct numerous tests and procedures, while the person remains on the ventilator until after all the procedures and the body is taken for the surgery. Although there are significant costs during this process, the hospital doesn’t burden the donor’s family financially. Typically, either the hospital or the organ recipient covers these expenses. Additionally, many hospitals demonstrate their respect by waving the entire bill, especially if the family arrived recently. According to the law, billing ceases the moment the hospital receives consent for organ donation.
At what age a person can take decision on organ donation?
In accordance with the law, living organ donor must be 18 years of age or older. However, when it comes to deceased organ donation, the decision-making authority lies with the parents. Consequently, we have witnessed cases where children as young as a few days old have become donors. However, this is specific to situations involving deceased children. You must know that for living organ donation, the individual must be 18 years or older, as mandated by the law.
How do you decide for transplant, considering there is a long waiting list?
We have a well-established and reliable systems in place. Many states with defined organ transplant programmes have implemented state registries. To be eligible for an organ, an individual must be a patient at a hospital. They should be on the hospital’s official waiting list. This list is then transferred to the state waiting list, ensuring a transparent, systematic, and equitable process for organ allocation. These measures ensure fairness and integrity in the distribution of organs to those in need.
How can one inform about his/her wish for organ donation?
If you wish to donate organs after your death, it is essential that you communicate your intentions to your immediate family members. In our country, the law dictates that the final decision regarding organ donation lies with the family responsible for the deceased individual. Regardless of any prior arrangements made, like writing a will or possessing a donor card, the family’s decision is fairly sacrosanct in our country.
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