Mass awareness should be generated on organ donation

Union Health Minister Dr Harsh Vardhan has said that he would request the Ministry of Human Resource Development to include in school text books passages and essays that generate in young children a positive attitude towards organ donation in general and eye (cornea) donation in particular.


The minister, who was speaking at the centenary celebrations of Shroff’s Charity Eye Hospital in Delhi on Saturday, stated that the ongoing National Eye Donation Fortnight (August 25 – September 8), an annual event organised by the National Programme for Control of Blindness, is meeting with good response in a large number of states, including Delhi. It is now felt that youngsters should be exposed to the enormity of the problem of blindness in India and their responsibility to contribute to its end.

“We teach the young the life stories of great savants and leaders with the hope that the new generation will imbibe their qualities. It is also necessary to instil in them their responsibility towards the blind population of India which could benefit if cornea donation becomes part of the nation’s culture,” Dr Harsh Vardhan said.

He said that eyesight is one of the biggest gifts of God. Unfortunately, the corneal blind population of India is the largest in the world. At a rough estimate, the country needs 1 lakh corneas every year but only about 17,000 are procured. Of these only about 50 per cent are utilised.

According to WHO, there are 45 million blind persons in the world, of whom 12 million are in India. Corneal blindness accounts for 1 per cent of the total blind population of the country. WHO also estimates that the blind population may double by 2020 owing to the rise in population and longevity.

The minister observed, “We need more eye banks. But that is not enough. There should be synergistic interaction among professional health services and community engagement. Increasing public awareness, promoting eye donation, implementing quality standards and organising a network of trained professionals for procurement, preservation and distribution of tissues are vital cogs in the wheel.”

Dr Harsh Vardhan said the history of ophthalmology in the country is inextricably linked to the vision of Dr S P Shroff, who founded the institution in 1914. “Dr S P Shroff was a founding father of the Delhi Medical Association, the precursor of the Indian Medical Association. Both Shroff’s hospital and DMA were established in the same year and have proved to be lasting institutions that have contributed much to India’s development,” he remarked.

The tradition of pledging one’s eyes after death is quite old in Delhi thanks to the pioneering work by Shroff’s Hospital, the minister said. At the function, a number of facilitators and donors’ families from Delhi, Karnal and other places of northern India were honoured, including the parents of a 14-year-old girl and the son of a 65-year-old man. In both cases, the family members showed exemplary presence of mind while making the emotionally heavy choice of donating the just-deceased’s eyes.

In this context, Dr Harsh Vardhan recalled the case of Surabhi, the 16-year-old girl from Krishna Nagar, Delhi, who was declared brain dead in 2013 after being admitted to AIIMS. Her parents took the tough decision to donate her organs for the benefit of people who needed her cornea, heart, liver and other body tissues.

Dr Harsh Vardhan said that within a month, the web portal of the National Organ and Tissue Transplant Organisation (NOTTO) will become functional. With that it would be possible to establish a transparent interface between donors and recipients of all organs including cornea.

The government intends implementing a nationwide programme for setting up regional centres modelled on NOTTO at Chandigarh, Guwahati, Kolkata, Chennai and Mumbai. All the upcoming AIIMS at six cities will also have similar infrastructure.

Dr Noshir M Shroff, medical director of Shroff Eye Centre; Dr Madan Mohan, a reputed ophthalmologist; Dr Sara Varughese, a senior ophthalmologist who heads the “Vision 2020” organization; Dr Umang Mathur, medical director of Shroff’s Charity Eye Hospital; and A K Arora, administrator of Shroff’s Eye Charity Hospital, were present on the occasion.

Source: IMT

Organ donation after cardiac death


At only 32, Sarah Beth Therien suddenly became unconscious. She was rushed to hospital — and would never wake up. An unexpected heart arrhythmia had left her on life support. “A machine kept her heart pumping, but we knew she was gone,” said Emile Therien, her father.

After a week, Emile Therien and his wife, Beth Therien, made the difficult decision to withdraw life support.
Their daughter had always wanted to donate her organs, but she didn’t meet the brain death criteria required for donation. Her Ottawa family was determined to fulfill her final wish. In 2006, she became the first Canadian in nearly four decades to donate her organs after cardiac death — not brain death. And the decision didn’t go unnoticed.

Six years later in 2012, among the 540 deceased organ donors in Canada nearly 14 per cent donated after cardiac death. Cardiac death donation, also called non-heart-beating donation is now practised in Ontario, British Columbia, Alberta, Quebec, and Nova Scotia.

Canada joins other countries like the United Kingdom, United States, Spain, and the Netherlands, where non-heart-beating donation is more widespread.

Donation guidelines revised

Donation after cardiac death was the only method of deceased organ donation prior to the advent of brain death criteria in the 1960s — when the concept of someone being “brain dead” was first introduced. Because the brain dies before the heart, organs taken after brain death aren’t damaged from a lack of blood flow. As a result, donation after brain death replaced cardiac-death donation.

But over the last two decades, organ shortages, improved organ preservation, and public support led to the re-emergence of donation after cardiac death. In Canada, a national forum of transplant experts in 2005 led to the development of new guidelines that paved the way for this type of donation. And made it possible for Sarah Beth Therien to be a donor.

The potential impact is huge. Brain death accounts for only 1.5 per cent of in-hospital deaths. For the majority of patients with non-survivable illness, death occurs as a result of cardiac death after life support is removed.

Donation after cardiac death could increase the number of available organs by 10 to 30 per cent, according to experts. This could mean the difference between life and death for the nearly 4,500 Canadians currently waiting for a transplant, many of whom will die before getting organs.

The most common organs donated after cardiac death are kidneys, followed by livers, lungs, and pancreases.
Success depends on timing of organ removal

The success rate at which potential donors end up donating organs after cardiac death depends on the organs being removed — kidneys last longer than livers after the heart stops, for instance — how long it takes for the patient to actually die, and the person’s blood pressure and oxygen levels during the dying process, Shemie says.

And organs donated after cardiac death may not always work as well as those donated after brain death.

Higher rates of dysfunction have been seen in livers taken after cardiac death, says Dr. William Wall, director of the multi-organ transplant program at London Health Sciences Centre in Ontario. Kidneys donated after cardiac death have trouble working initially, but “one-year functioning is similar for kidneys taken after cardiac versus brain death,” Wall says.

For Emile and Beth Therien, pioneering the process meant a lot. Sarah Beth Therien donated two kidneys and two corneas, changing the lives of four Canadians. Each donor has the potential to save up to eight lives.

“Sarah was able to save other Canadians. Nothing could have made us happier,” Emile Therien says.

Source: CBC


Woman donates kidney to stranger online


Most kidney donations come from folks who’ve just died or from living family members or close friends. Not many come from living strangers, just looking to do a good deed but that’s what happened Thursday morning.

Priscilla Naccarelli spent her morning at the hospital, a nervous wreck. Her 28-year-old daughter Lauren had just undergone surgery to surrender a perfectly healthy kidney to someone she doesn’t know and may never meet.

“It was very nerve-racking. I’m very proud of my daughter. I’m not so nervous and scared anymore. Right now, I just want to be with her and make sure she’s getting better,” Naccarelli said.

Lauren first raised the idea of donating to a stranger on her Facebook page last summer. The idea, she said, was simple: “I have a strong desire to help people.”

The thought that she could save somebody’s life is just very important to her. Nearly six months of tests and interviews and hospital visits later, she landed on the operating table for the two hour procedure. Shortly after noon, Lauren reported via
Facebook, “Totally tired and confused but I’m out of surgery and doing okay. Thanks everybody.”

Source: Fox news