Shortage of organs for transplantation is a worldwide problem and million of lives are lost every year because the organ transplantation option cannot be offered to them.
IN India nearly 200,000 persons develop terminal kidney failure each year and their life can be sustained only through lifelong dialysis or kidney transplantation. Unfortunately, only 10 per cent of them are fortunate to get the benefit of such treatment and the remaining 90 per cent succumb to their condition, often in a short time.
As dialysis centres are mostly located in major city hospitals and the procedure has to be carried out within urgent time frames, the benefit cannot reach common people living in remote areas. Affordability is another concern with chronic kidney disease treatment. Although the State Government of Andhra Pradesh has come out with a unique scheme of free dialysis for people Below the Poverty Line under the Arrogya Shree initiative, the quality of life on dialysis is far inferior to that after a successful transplantation. Hence, more and more patients with terminal kidney failure prefer to undergo a kidney transplantation rather than lifelong dialysis.
Over the years the number of kidney transplantation centres has steadily increased throughout the country. However, the number of transplantations is almost static at 4000-5000 operations per year, against the approximately 50,000 operations required. Shortage of human organs for transplantation is the single most important reason for such a low rate of organ transplantation in our country.
According to the Human Organ Transplantation Act passed by the Indian Parliament in 1994, only first degree relatives of the patient (parents, children, sibling and spouse) are entitled for organ donation. Unfortunately, either sufficient numbers of entitled organ donors are not coming forward for donation or else they are rejected on medical grounds, leaving the patients with no other option except continuing with lifelong dialysis.
Organs from “Brain Dead” donors are another source of organs for transplantation. As the brain controls most of the body functions, permanent loss of brain activity following extensive damage to the brain due to injuries, and consequent haemorrhage or stroke, a person can be pronounced dead on medical ground though major body functions can be sustained for a short period of time ranging from a few hours to a few days with artificial life support measures.
Even the Indian Parliament has accepted brain death as the end of life when diagnosed and confirmed meeting approved and validated guidelines and endorsed Clinical Pathways.
These “Brain Dead” individuals can be considered as potential organ donors and their organs can be used for transplantation after obtaining permission along stipulated guidelines and procedures from the next of kin. After brain death a person can donate corneas (eyes), liver, kidneys, lungs, heart or heart valves and pancreas for transplantation to the needy.
In most of the western countries more than 70 per cent of organ transplants are carried out using organs from brain dead donors. According to the United Network of Organ Sharing (UNOS), which oversees the cadaver transplant programme in the US, 28663 patients underwent cadaver kidney transplantation in 2010 and there are still 1,1100 patients with terminal kidney failure waiting for their turn to receive a kidney from a brain dead donor. Shortage of organs for transplantation is a worldwide problem and million of lives are lost every year because organ transplantation option cannot be offered to them. Organ donation rate is the highest in countries like Mexico and Spain where more than 30 per million population (PMP) agrees for organ donation after death against a dismal figure of about 0.1 PMP in India.
Lack of public awareness about usefulness of organ donation after death and non-acceptance of ‘brain death criteria’ as cessation of life are found to be the main reasons behind such a low rate of organ donation in our country. Due to the concerted efforts of many individuals, hospitals and NGOs, the organ donation rate is higher in the states of Andhra Pradesh, Maharashtra and Gujarat as compared to the rest of the country. The state government controlled deceased organ donation and transplantation programme in the state of Tamil Nadu is showing encouraging results and the Andhra Pradesh government too is planning to introduce a similar programme (Jeevan Daan) in the near future.
There are still thousands of such patients with terminal failure of vital organs at various hospitals in the country waiting for their turn to receive a human organ to save their lives. On the other hand more than a lakh persons die every year due to traffic accidents in our country. Projections are that this is likely to increase to 1,50,000 by the year 2020. At any given point of time there are about eight to 10 brain dead patients in hospitals in any major Indian city sustained on artificial life support systems alone, who can be considered as ideal cadaver organ donors. Even if the next of kin of a small percentage of them agree for organ donation, it would be possible to save many more lives. Ultimately it is the responsibility of the government and society in general to create awareness about brain death and organ donation. The medical fraternity can act only as facilitators in the process.
A well-known quote in the organ transplantation circles says, “Don’t take your organs to heaven with you. Heaven knows we need them here.” Those who have learned to know and accept death rather than to fear and fight it, become our teachers about LIFE. Registered organ donors and enlightened kin of brain dead individuals who consent for cadaver organ donation are giving the world an ultimate and final gift…the gift of life!
Organ donation is still a topic not well understood
Human organ donation yet to make a significant mark in India. India lags behind in the implementation of a cadaveric donation programme. For example: merely 3000 are lucky to get kidney donor, while over 100,000 Indians suffer from End Stage Renal Disease.
IN India nearly 200,000 persons develop terminal kidney failure each year and their life can be sustained only through lifelong dialysis or kidney transplantation. Unfortunately, only 10 per cent of them are fortunate to get the benefit of such treatment and the remaining 90 per cent succumb to their condition, often in a short time.
As dialysis centres are mostly located in major city hospitals and the procedure has to be carried out within urgent time frames, the benefit cannot reach common people living in remote areas. Affordability is another concern with chronic kidney disease treatment. Although the State Government of Andhra Pradesh has come out with a unique scheme of free dialysis for people Below the Poverty Line under the Arrogya Shree initiative, the quality of life on dialysis is far inferior to that after a successful transplantation. Hence, more and more patients with terminal kidney failure prefer to undergo a kidney transplantation rather than lifelong dialysis.
Over the years the number of kidney transplantation centres has steadily increased throughout the country. However, the number of transplantations is almost static at 4000-5000 operations per year, against the approximately 50,000 operations required. Shortage of human organs for transplantation is the single most important reason for such a low rate of organ transplantation in our country.
According to the Human Organ Transplantation Act passed by the Indian Parliament in 1994, only first degree relatives of the patient (parents, children, sibling and spouse) are entitled for organ donation. Unfortunately, either sufficient numbers of entitled organ donors are not coming forward for donation or else they are rejected on medical grounds, leaving the patients with no other option except continuing with lifelong dialysis.
Organs from “Brain Dead” donors are another source of organs for transplantation. As the brain controls most of the body functions, permanent loss of brain activity following extensive damage to the brain due to injuries, and consequent haemorrhage or stroke, a person can be pronounced dead on medical ground though major body functions can be sustained for a short period of time ranging from a few hours to a few days with artificial life support measures.
Even the Indian Parliament has accepted brain death as the end of life when diagnosed and confirmed meeting approved and validated guidelines and endorsed Clinical Pathways.
These “Brain Dead” individuals can be considered as potential organ donors and their organs can be used for transplantation after obtaining permission along stipulated guidelines and procedures from the next of kin. After brain death a person can donate corneas (eyes), liver, kidneys, lungs, heart or heart valves and pancreas for transplantation to the needy.
In most of the western countries more than 70 per cent of organ transplants are carried out using organs from brain dead donors. According to the United Network of Organ Sharing (UNOS), which oversees the cadaver transplant programme in the US, 28663 patients underwent cadaver kidney transplantation in 2010 and there are still 1,1100 patients with terminal kidney failure waiting for their turn to receive a kidney from a brain dead donor. Shortage of organs for transplantation is a worldwide problem and million of lives are lost every year because organ transplantation option cannot be offered to them. Organ donation rate is the highest in countries like Mexico and Spain where more than 30 per million population (PMP) agrees for organ donation after death against a dismal figure of about 0.1 PMP in India.
Lack of public awareness about usefulness of organ donation after death and non-acceptance of ‘brain death criteria’ as cessation of life are found to be the main reasons behind such a low rate of organ donation in our country. Due to the concerted efforts of many individuals, hospitals and NGOs, the organ donation rate is higher in the states of Andhra Pradesh, Maharashtra and Gujarat as compared to the rest of the country. The state government controlled deceased organ donation and transplantation programme in the state of Tamil Nadu is showing encouraging results and the Andhra Pradesh government too is planning to introduce a similar programme (Jeevan Daan) in the near future.
There are still thousands of such patients with terminal failure of vital organs at various hospitals in the country waiting for their turn to receive a human organ to save their lives. On the other hand more than a lakh persons die every year due to traffic accidents in our country. Projections are that this is likely to increase to 1,50,000 by the year 2020. At any given point of time there are about eight to 10 brain dead patients in hospitals in any major Indian city sustained on artificial life support systems alone, who can be considered as ideal cadaver organ donors. Even if the next of kin of a small percentage of them agree for organ donation, it would be possible to save many more lives. Ultimately it is the responsibility of the government and society in general to create awareness about brain death and organ donation. The medical fraternity can act only as facilitators in the process.
A well-known quote in the organ transplantation circles says, “Don’t take your organs to heaven with you. Heaven knows we need them here.” Those who have learned to know and accept death rather than to fear and fight it, become our teachers about LIFE. Registered organ donors and enlightened kin of brain dead individuals who consent for cadaver organ donation are giving the world an ultimate and final gift…the gift of life!
Organ donation is still a topic not well understood
EVERY year in our country there is a need of approximately 175,000 kidneys, 50,000 hearts and 50,000 livers for transplantation. As against the need, only 5000 kidney transplants in 180 centreers, 400 livers in 25 centreers and 10-15 hearts in very few centers are done annually. 95 per cent kidneys and livers are from living donors.
Human organ donation yet to make a significant mark in India. India lags behind in the implementation of a cadaveric donation programme. For example: merely 3000 are lucky to get kidney donor, while over 100,000 Indians suffer from End Stage Renal Disease.
Although the contemporary science has brought in tremendous success in the field of healthcare. aAnd one such advancement is organ transplant, but due to lack of awareness, nobody comes forward to donate organ. People are not aware of organs that can be donated, other than eye.
Many patients succumb to death suffering from chronic illnesses, waiting for organ transplants and they die without receiving suitable organ. To encourage organ transplantation procedures and reduce mortality rate through timely transplant, a major improvement is required to happen in the existing organ donation and transplant system.
Facts on organ donation/transplant
COST:It is important to note that the cost of organ donation is incurred by the transplant recipient and the donor’s family is never charged for it. Also in case of cadaver transplant, the cost charged by the hospital to save the patient’s life is usually misinterpreted as the cost related to organ donation. While, the additional expenses that a living donor experiences like loss of wages, child care expenses during recovery, food, lodging and travel costs, are to be incurred by the donor only.
COST:It is important to note that the cost of organ donation is incurred by the transplant recipient and the donor’s family is never charged for it. Also in case of cadaver transplant, the cost charged by the hospital to save the patient’s life is usually misinterpreted as the cost related to organ donation. While, the additional expenses that a living donor experiences like loss of wages, child care expenses during recovery, food, lodging and travel costs, are to be incurred by the donor only.
A person should be well aware of the cost of the donation, if he/she is considering to be an organ donor.
The cost of organ transplant, principally include preliminary testing, the surgery cost and the post-operative recovery costs. The cost of an organ transplant can be segregated in terms of Medical costs and non-medical costs.
Medical costs may include:
n insurance deductibles
n pre-transplant evaluation and testing surgery
n fees for the recovery of the organ from the donor
n follow-up care and testing
n additional hospital stays for complications
n fees for surgeons, physicians, radiologist, anesthesiologist and recurrent lab testing rehabilitation
n Non-medical costs include:
n food, lodging and long distance phone calls for you and your family
n transportation, to and from your transplant center, before and after your transplant
n Air travel to get to your transplant hospital quickly
n lost wages if your employer does not pay for the time you or a family member spends away from work
The costs or organ transplant vary in different countries, hospitals and the type of organs.
One of the driving forces for illegal organ trafficking and for "transplantation tourism" is the price differences for organs and transplant surgeries in different areas of the world. According to the New England Journal of Medicine, a human kidney can be purchased in Manila for $1000–$2000, but in urban Latin America a kidney may cost more than $10,000. Kidneys in South Africa are sold for as high as $20,000. Price disparities based on donor race are a driving force of attractive organ sales in South Africa, as well as in other parts of the world.
In China, a kidney transplant operation runs for around $70,000, liver for $160,000, and heart for $120,000. Although these prices are still unattainable to the poor, compared to the fees of the United States, where a kidney transplant may demand $100,000, a liver $250,000, and a heart $860,000. Chinese prices have made China a major provider of organs and transplantation surgeries to other countries.
In India, a kidney transplant operation runs for around as low as $5000.
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