Organ Donation Dr. Rahul Pandit Senior Consultant Intensive Care MD, FCICM, FJFICM, FCCP, DA Senior Consultant Intensive Care Fortis Hospital Visiting Consultant Gosford and Wagga Wagga base Hospital Australia

What is Death The Transplantation of Human Organs Act, 1994 (Central Act 42 of 1994),- 'Deceased person' means a person in whom  permanent disappearance of all evidence of life occurs, by reason of brain-stem death or in a cardio-pulmonary sense at any time after live birth has taken place. 'brain-stem death' means the stage at which all functions of the brain stem have permanently and irreversibly ceased.

Governed by law Only Recognized hospitals Recognized Doctors Organ distribution managed by ZTCC/SOTTO/ROTTO/NOTTO NO chance for any mischief as all governed by government

Why Organ Donation

Organ Failure Incidence in India Around 150,000 patients on RENAL waiting list 3000 transplants/year Around 50,000 heart transplant needed Less than 100/year Around 100,000 Liver needed Less than 1000/year

Why do people need transplants? Inherited genetic condition Cardiomyopathy (affects the heart) Cystic fibrosis (affects the lungs) Bilary atresia (affects the liver) Disease or damage to eyes Congenital defects in young children Severe trauma from accidents leading to organ failure Rheumatic fever and other severe illness or disease Burns can require skin grafts Many people have an inherited genetic condition, a severe illness or disease that will kill them, often at a young age. Common genetic conditions are cardiomyopathy which affects the heart, cystic fibrosis which affects the lungs, and bilary atresia which affects the liver. Corneal transplants restore sight to people following a disease or damage to their eyes. Heart valves are used to repair congenital defects in young children and replace defective valves due to disease such as rheumatic fever, degeneration and fever. Sometimes people can have severe trauma from accidents which can lead to organ failure. And grafting skin tissue can assist people who have suffered severe burns.

Anatomy

Causes of Brain Death Cerebral Anoxia Normal

Causes of Brain Death Normal Cerebral Hemorrhage

Causes of Brain Death Subarachnoid Hemorrhage Normal

Causes of Brain Death Normal Trauma

Did you know? The majority of Individual are willing to become organ (78%) and tissue (75%) donors. One organ and tissue donor can transform the lives of 10 or more people. Even if you register as a donor, your next of kin will be asked to confirm your decision. In India the family will always be asked to confirm the donation decision of the deceased before donation for transplantation can proceed. Less than 20% of families give consent for organ and tissue donation to proceed. The majority of Australians are willing to become organ and tissue donors. 78% of Australians are willing to become organ donors and 75% are willing to become tissue donors. Did you know that one organ and tissue donor can transform the lives of 10 or more people? Did you also know that even if you register your decision on the Australian Organ Donor Register, your family still need to know your donation decision. This is because your family will always be asked to confirm the donation decision of a deceased person before donation for transplantation can proceed. The most important thing for families in deciding to consent to donation is knowing the donation decision of the deceased person. Families that know the donation decision of the deceased person are more likely to consent to donation. Some people believe if they have signed on to the Australian Organ Donor Register that this is all they are required to do. Many Australians are not aware that it is their closest family member who will ultimately confirm a decision regarding donation, should the situation arise. We need more Australians to discuss their donation wishes with the people close to them, so that we can increase the family consent rate in Australia to our target of 75%—up from our current level of approximately 60%.

Organ donation rates in India were 0 Organ donation rates in India were 0.05 per million Now has increased to 0.8 per million

International comparison It is difficult to draw direct comparisons between countries in terms of their progress in organ donation reform, as there are many differences between health care systems, population size, community attitudes and the relative starting points for national organ and tissue donation reform. The key lesson to learn from leading countries is that reform of organ and tissue donation is an incremental process that takes time as national systems are developed and hospital based clinical practice is reformed. Spain ~ 35 dpm- Opt out System Australia- 15 dpm- Opt in System

Who can become an organ and tissue donor? Almost anyone can donate – Allowed 2 years upto 80 years Don’t assume you are too old, too young or not healthy enough People who cannot donate organs may still be able to donate tissue Most religions support organ and tissue donation Living donors can donate a kidney or partial liver Almost anyone can donate their organs and tissue. While your age and medical history will be considered, you shouldn’t assume you are too old, too young or not healthy enough. Many Australians think they are too old to donate. There’s every chance that, whatever your age, some of your organs and tissue will be suitable for donation. Only some medical conditions may prevent you from being a donor and if your organs are medically unsuitable you may still be able to donate your tissue. While a person needs to die in specific circumstances to be a potential organ donor, that is in an Intensive Care Unit (ICU) or Emergency Department, many more people can become eye and tissue donors as the requirements are not as restricted. Others believe they have medical conditions which preclude them from donating, or that their cultural or religious beliefs are contrary to donation. But most religions support organ and tissue donation as generous acts that benefit people. This includes Christianity, Islam, Buddhism, Judaism and Hinduism. You can also read more about religion and donation at www.donatelife.gov.au

What can people donate? ORGANS TISSUE KIDNEYS CORNEAS LIVER HEART VALVES HEART PANCREAS ISLETS LUNGS SKIN PANCREAS BONE INTESTINE TENDONS LIGAMENTS The types of organ and tissue that can be donated includes: Organs: Kidneys Liver Heart Lungs Pancreas Tissue: Corneas Heart valves Pancreas islets Skin Bone Tendons Ligaments Living donors can also donate their femoral head when undergoing total hip replacements.

Ask and know your loved one’s donation decision Ask your friends if they have discussed their donation decision with their next of kin. Organise a speaking event in your community. Use facebook, whatsapp etc to promote .. Discuss with your workplace/sporting organisation about becoming a Gift A Life Friend. There are many ways that you can get involved to promote organ and tissue donation. It can start with asking your friends if they have discussed their donation decision with their next of kin, and if they know the donation decision of their family members. You might like to become a volunteer with one of the community organisations dedicated to organ and tissue donation and transplantation, or with the DonateLife Agency in your state or territory. You can join in the many community events which take place each February during DonateLife Week, or you might like to register your own awareness-raising event. You could even discuss with your school, workplace or sporting club the idea of becoming a DonateLife Friend to show your support for organ and tissue donation. You can find out more about this at donatelife.gov.au.