Dr. (Prof). S.L. Kachroo/Anshu Sharma
The History of Mankind is a history of Diseases. Since its inception, the Challenge of multitude of diseases confronted the human and animal world. Although many of these challenges have been overcome as a result of the advances in the medical research, newer technologies and the developments of newer and newer antibiotics and the drugs, there still remains a large no. of diseases which still are posing a threat to the life of humans. One such group of diseases is because of the “Organ Failure” or also called as “End-stage Diseases”in medical parlance.
Organ Transplantation
The failure of many vital organs of the human body like kidneys, liver, heart, lungs, pancreas, etc, can be a consequence of many diseases. These situations can be managed for some time with the help of drugs/medications but invariably a time comes when there is need for replacement of this particular organ by a healthy Organ. This process of replacement of a failed organ by another organ taken from a healthy human being is called “Transplantation”.
In the case of kidney failure, there is availability of an option or alternative of replacement therapy called “Dialysis”. Notwithstanding the fact that Renal transplantation is a better option in terms of the quality of life, survival time and the cost/benefit ratio. Dialysis may be the only option available for those patients who do not give consent for surgery or do not have donor availability.
Moreover, the option of dialysis is available at present to patients with Kidney failure only and such an option of replacement therapy, unfortunately, cannot be offered to patients with failure of other organs like liver, heart, lungs, etc. and so the only option available to these patients is “Transplantation” and for it to be successful, the need for a robust Transplant Programme is very critical so that organs for transplantation are available whenever needed
Organ availability & Donation
There is a wide gap between the demand for transplantation and the availability of organs. This shortage of organs is virtually a universal problem but Asia lags behind much of the rest of the world and even India lags far behind other Asian countries. It is not that there are not enough organs to transplant, but nearly every person who dies naturally, or in an accident, is a Potential Donor. Even then, a large no. of patients cannot find a donor.
An estimated around 1.8 lac persons suffer from Kidney (Renal) failure every year in India and the number of transplant done is around 6000 only and the ratio is 30:1. An estimated two lac patients die of liver failure or liver cancer annually in India, about 10-15% of which can be saved with a timely liver transplant. Hence about 25-30 thousand liver transplants are needed annually in India but only 1500 are being performed. Similarly, about 50,000 persons suffer from heart failure annually but only about 10-15 heart transplants are performed every year in India. In case of Cornea, about 25,000 transplants are done every year against a requirement of one lac transplants.
National Organ Transplant Programme (NOTP)
To overcome the paucity of organs available for transplantation, the GOI enacted “THOA, 1994” (Transplantation of Human Organs Act, 1994) and amended it in 2011, which was duly notified in March, 2014 to extend it further. The objective of this law is to promote organ donation from Living (related and unrelated donors) and from deceased donors, especially after “Brain Stem Death” in an unfortunate victim of Road Traffic Accident (R.T.A) etc. where the brain stem is dead and the person cannot breathe on his own but can be maintained by ventilator, oxygen, fluids, etc. to keep the heart and other organs working and functional. Other type of deceases donor could be donor after cardiac death.
In India, like many other countries Brain Stem Death is recognized as a legal death under THOA and this has revolutionized the concept of organ donation after death. After natural death, only a few organs/ tissues can be donated (like cornea, skin, bone and blood vessels) whereas after brain stem death almost 37 different organs and tissues can be donated including vital organs such as kidneys, liver, heart, lungs etc.
It is a fact that many human lives can be saved and improved, if more and more people pledge their organs and tissues for donation during their life time. The act of donation can also be considered by the kith and kin or the legal heir of the deceased person of the time of unfortunate death.
Moreover, the pledge of donation can also be withdrawn by the relatives of the said donor at the time of unfortunate death of the donor, if they wish so. The need of the hour is to come forward for organ donation and save precious human lives who desperately need them. This can be a biggest “Gift of Life” (Jeevandan) to somebody who is otherwise doomed to die due to “vital organ failure”.
No gift can be bigger than the “Gift of Life”.
(The authors are Joint Director and Consultant (IEC/Media) in State Organ and Tissue Transplant Organization {SOTTO} J&K)
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