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‘Raise awareness among doctors about organ donation’
Tamil Nadu may lead in the race for organ donation, but there is a lot more awareness required among doctors about donation and the concept of ‘brain dead’, say experts in the field
When Mayank, a 25-year-old professional wanted to register for organ donation, he was in the dark. “I wanted to know if the next of kin can donate organs, after a person dies. However, several general physicians weren’t able to guide me,” he says.
Professor J. Amalorpavanathan, Member Secretary, Transplant Authority of Tamil Nadu (TRANSTAN) and Convenor — Cadaver Transplant Program, Government of Tamil Nadu, says that while awareness is being created regularly through programmes among doctors across districts; general physicians have a role to perform when a family is being counselled for organ donation. “When a family member is declared brain dead, there are grief counsellors who sit with the next of kin to talk about organ donation. At that time, the first person the family gets in touch with is their general physician. Their words play a pivotal role in convincing them on organ donation,” he says.
The concept of brain dead
In 1994, India accepted the concept of brainstem death and passed an act to this effect and called it the Transplantation of Human Organ Act (THO). However, Dr Sunil Shroff, founder trustee, MOHAN Foundation, which promotes organ donation, says that several doctors don’t understand the concept of ‘brain death’. “Some doctors tell the patient’s family that the person is 90 to 95 per cent dead. As a result, the family is a little hopeful about the person’s survival. In such a condition, why would any family be willing to donate the organs. Half dead is a misnomer—either a person is dead or alive. Many senior doctors are not convinced about brain death as there is jerking of fingers and spinal reflexes,” he says.
Including a chapter on organ donation in the medical curriculum could go a long way in creating awareness among medical professionals, says Dr. Paul Ramesh, Senior Consultant, Cardiothoracic Heart and Lung Transplant, Apollo Hospitals. He adds that ‘brain death’ is a condition that happens in an ICU setting and doctors specific to critical care or a neurosurgeon are the ones largely involved in such a situation. “It is a small group that is directly involved and they are aware. Usually there is a small window between a person becoming brain dead and for the rest of organs to stop functioning and that’s a critical time for organ donation,” he says.
Need more transplants
Despite growing awareness, there are organs that are wassted and at the other end we have patients who need transplants, points out Dr Suresh Rao KG, Head of Cardiac Critical Care, Fortis Malar. “He adds that of late, green corridors (a stop-less route for transportation of a harvested heart, which is transplanted in a recipient) have raised awareness. “If we look at a country like the US, our numbers are still low. We need to conduct at least 15,000 heart transplants annually,” he says.
Professor Amalorpavanathan says that a boost in infrastructure will help. “Air ambulances are expensive and unpredictable. However, five years down the lane, this bottleneck can be sorted,” he says. Dr Rao adds that in such a situation, commercial airlines help in quick transportation of organs. He adds that it’s not only about cadaver donation. “We want people to live. The emphasis is on acute care,” he says.
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