Transforming Lives Through Organ Donation Home Care Centres Institute of Transplant Medicine Transforming Lives Through Organ Donation Overview Organ donation is the act of donating an organ to save or improve the life of someone who is in absolute need for an organ transplant. Organs and tissues for donations are usually harvested from recently deceased people who either volunteered before their death to donate their organs afterward, or their family donated them on their behalf. Healthy people can choose to donate certain organs and tissues that they can spare while protecting their own state of health. Organ donation holds the noble power to save lives.“One organ donor can save up to 8 lives and enhance the lives of many others through tissue donation.” Pledge for organ donation Being an organ donor can make a big difference, and not just to one person. By donating your organs after you die, you can save or improve as many as 50 lives. And many families say that knowing their loved one helped save other lives helped them cope with their loss.Pledging for an organ a simple procedure. In India, one can register for organ donation by visiting the National Organ & Tissue Transplant Organisation (NOTTO) website or their respective state organ donation authorising centre’s (please see the links below) and filling up the registration form.NOTTO National Organ and Tissue Transplant Organization (https://notto.mohfw.gov.in/links.htm)ROTTO-SOTTO: Regional/state Organ and Tissue Transplant Organization (https://www.rottosottokem.in)ZTCC: Zonal Transplant Coordination Centre (https://www.ztccmumbai.org)The interested donors are required to fill out their credential in the organ donation pledge form available on NOTTO website and submit it. Pledged organ certificate is thereafter generated.5 steps to register your pledge to donate organ:Step 1 - Go to website (https://notto.mohfw.gov.in/links.htm)and click on the ‘Register for Pledge’Step 2 - Authenticate using Aadhar and enter OTPStep 3 - Provide details in form and choose organ/tissue for donationStep 4 - e-sign using AadharStep 5 – Download your pledge certificateIt is extremely important to discuss the decision with one’s family or next of kin because in case of an emergency or untoward incident, the family will be the first to be contacted. Only after seeking their permission can the doctors go ahead with retrieving the organs.In the past when the families have not been aware and needed to be counseled on the wishes of their deceased relative, a lot of precious time was lost and sometimes the opportunity to donate was gone. In organ donation, time is of prime importance. It is essential for the organs or tissues to be removed as soon as possible after the event of death, else they become unusable. More About Organ Donation: Types of organ donation Why donate organs? Organ donation process Organ donation scenario in India The Age to Donate Organs Informing Your Family: A Crucial Step in Organ Donation Promoting Organ Donation in Your Community Living Donor Organ Donation: A living person during his lifetime can donate some/part of certain organs if the remaining organ is capable of performing optimum functions for sustaining normal life. The organs that can be donated while living is one kidney (the other kidney is capable of maintaining the body functions adequately for the donor); uterus; and a portion of the pancreas (half of the pancreas is adequate for sustaining pancreatic functions), liver (a part of the liver can be donated for liver transplant as the donor can sustain with the remaining part of the organ), and small bowel.Deceased Donor Organ Donation: A person can donate multiple organs and tissues after death (brain-stem or cardiac). This way, the deceased person’s organs continue to live in another person’s body. As per the Transplantation of Human Organs & Tissues Act (THOTA) of 1994, different organs and tissues can be donated from a brain-dead donor. However, the tissues and organs that can be donated by a donor after cardiac death (DCD) are limited to tissues, such as skin, bones, cornea, and blood vessels. Improved lifestyle assessment has helped increased detection of lifestyle diseases that can cause organ damage or failure; as a result, the need for organ transplant is on the rise. Organ donation provides a second chance at life for those suffering from organ failure or a serious medical condition that has led to the dysfunction or loss of a vital organ and for whom organ donation is the only ray of hope.Organ donation is a noble act that gives the donor an opportunity to not only saves a life, but several other lives that depend on that one life. Organ donation is a multistep process that begins with investigating the cause of death, followed by evaluating the eligibility of the donor (living or dead) to have their organ(s) harvested based on a set of inclusion/exclusion criteria only for the purpose of treatment. According to the World Health Organization, approximately only 0.16 percent people in India donate their organs after death.India is experiencing a severe shortage of transplantable organs. More than a million people are estimated to have end-stage organ failure, but only 3,500 transplants are performed each year. Every day, at least 15 patients die waiting for organs, and every 10 minutes, a new name gets added to the transplant waiting list. Without a doubt, the demand for organs exceeds the supply. Unfortunately, very few people in India are aware of the concept of organ donation or how they might be of assistance after their death. The lack of awareness about organ donation in the country has led to higher demand and a lower supply of organs for those in need.This problem can be addressed by raising awareness about organ donation. The chances of organs being available to save lives increases with number of potential donors.Here are some facts that exhibit the reality of organ donation in India:India's organ donation rate is one of the lowest in the world.Every year, 5 lakh people require organ transplants, but these numbers are not met.For 50 thousand people who need a heart transplant , only 339 hearts are available.The present number of kidney transplantations (11,243) is severely deficient to meet the current need of approximately 2 lakh kidneys transplants a year.Annually, 2 lakh corneal donations are required, but only 50 thousand donated corneas are available for transplant.A Diverging Trend in Organ DonationThe proportion of organ donations from the kin of deceased persons has been declining over the years Source: Union Health MinistryOrgan donation rates per milion The age limit for organ donation in India is based on the type of donor; a cadaver or deceased donor can donate organs without any age barrier, whereas the living donor needs to be of more than 18 years of age. However, in case of minors (< 18 years of age), the consent of their parents/guardian is mandatory for organ donation. A Simple Guide to RegistrationDonating your organ is a simple procedure. In India, one can register for organ donation by visiting the National Organ & Tissue Transplant Organisation (NOTTO) website or their respective state organ donation authorising centres (please see the links below) and filling up the registration form.The interested donors are required to fill out their credentials in the organ donation pledge form (organ donation form 7) available on NOTTO website and submit it. A unique government registration number is thereafter generated.Organs can also be pledged by visiting https://pledge.mygov.in/organ-donation which generates a donor ID. DONOR CARDS are not being issued anymore.Following are the links of organ transplant registries where you can register for organ donation:NOTTO National Organ and Tissue Transplant Organization (https://notto.mohfw.gov.in/links.htm)ROTTO-SOTTO: Regional/state Organ and Tissue Transplant Organization (https://www.rottosottokem.in)ZTCC: Zonal Transplant Coordination Centre (https://www.ztccmumbai.org) According to the Indian law, next of kin will decide whether to donate deceased person’s organs. Therefore, even if you have pledged your organs, organs cannot be donated without the consent of your next of kin. Hence, when you pledge to be an organ donor, you must discuss your decision with your family. It will allow your family to fulfil your wishes after your death. You can help increase organ donation in the country by becoming an organ donor; talking to your family about your decision of saving lives of others; and promoting organ donation by motivating people at work place, place of worship, and in your community and civic organisation.You can also raise awareness about organ donation by organising a rally or walkathon in your community, while using banners, t-shirts, and slogans to grab attention.A large gap exists between demand and supply of organs. It is essential to bridge this gap and which continues to be the main curative option for the majority of patients in India suffering from end-stage liver disease Frequently Asked Questionss What is organ donation? Organ donation is the act of giving an organ to save or improve the life of someone whose survival depends on an organ transplant. What are the organs that can be donated? The organs and tissues that can be donated are liver, kidney, pancreas, heart, lung, and intestine. Who can be an organ donor? Living Donor: Any person not less than 18 years of age, who voluntarily authorises the removal of any of his organ and/or tissue, during his or her lifetime as per the prevalent medical practices for therapeutic purposes, can become an organ donor.Deceased Donor: Anyone, regardless of age, race, or sex can pledge to donate their organ and tissue after his or her death (brain-stem/cardiac). How can I pledge to become a donor? You can become a donor by filling the authorized organ and tissue donation form (Form-7 as per Transplantation of Human Organs & Tissues Act of 1994). You may pledge to donate your organs by filling out the organ donation form available on the following websites: www.notto.nic.in and https://pledge.mygov.in/organ-donation How does my family or I benefit after organ donation? Donation of an organ or tissue provides an unparalleled opportunity to give someone a second chance at life. Your donated organ not only saves the life of one person and the dependent family but helps the society overall. If I had pledged before, can I change my mind to un-pledge later? Yes, you can un-pledge by making a call or writing to the NOTTO office or visiting NOTTO website (www.notto.nic.in) and availing the un-pledge option by logging into your account. Also, let your family know that you have changed your mind regarding organ donation after your death. Can I be an organ donor, if I have been rejected to donate blood? Yes. However the decision regarding the eligibility for organ donation is always made by a specialist, considering your medical history or present medical condition. There may have been specific reasons for you being unable to donate blood at a particular time, such as history of blood transfusion or hepatitis, presence of anaemia or other illness, as simple as a cold, at the time of donation, or use of medication that are contraindicated while donating blood. If you wish to donate organs, your eligibility will be re-assessed, when the need arises. What tissues can be donated? The following tissues can be donated: cornea, bone, skin, heart valve, blood vessels, nerves, and tendon. Myths and facts about organ donation 1. Doctors will not try hard enough to save my life if I am an organ donor In healthcare, all professionals are driven by one principle –‘Your life always comes first’. Hence, only when doctors are unable to save your life despite providing best medical treatment, the question of organ donation will arise. 2. Many religions forbid organ donation Majority of religions encourage organ donation as an act of love and compassion. Donating an organ means giving life to an individual and supporting the dependent family. This is something deeply meaningful for people of faith. 3. Only young and healthy people can become donors For kidneys, anyone between 18 to 80 years of age can become a donor.If you are pledging to donate organs after your death, you can still do so even if you have health problems. However, your medical condition will decide the organs that can be donated. 4. Organ donation causes problem with burial and funeral services Nothing changes after organ donation. Burial plans and funeral services can still be carried out in the usual manner. Additionally, an open casket funeral can be carried out as usual for deceased whose organs have been donated. 5. It is difficult to become an organ donor Becoming an organ donor is simple and can be done online at the organ donor registry. In addition to the online registry, you can also become an organ donor by selecting ‘Yes’ to organ donation option when you renew your driving licence. But remember, if you do so, it is important to communicate your wishes to the next of your kin so that they can make the appropriate decision on your behalf, when necessary.