Urgent need to clear misconceptions and taboo about organ donation

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Number of organ donors is abysmally low in India

New Delhi, 03 December 2017: According to statistics, every single person can save up to 7 lives by donating organs. Apart from this, at any given point, there are about 8 to 10 potential donors in the ICUs of any major city. Despite this, the number of organ donors in India is abysmally low at about 0.34 persons per million of population. As per the IMA, these statistics indicate the urgent need for people to step in and start donating their organs.

Organ donation is the process of Retrieving or Procuring an organ from a live or deceased person known as a donor. The process of recovering organs is called harvesting. This organ is transplanted into the recipient who needs that organ. There are two types of organ donation: Live Donation and Deceased or Cadaver Donation.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Organ donation is still an unsolved problem in our country. However, there has been a recent amendment to the Organ Transplant Act 2014, according to which it is now compulsory for every doctor to follow mandatory required request for organ donation. Live Donation is from a healthy and living person. This can only be done in the case of a liver or a kidney. When we talk about pledging one’s organs or about organ donation, we talk about deceased organ donation or cadaver organ donation. This is organ donation from a person who has been declared brain dead by a team of authorized doctors at a hospital. A person is said to be brain dead when there is an irreversible loss of consciousness, absence of brain stem reflexes and no spontaneous respiration. Organ donation can even provide someone with a second chance at life. For many, this process is a way to go back to a normal lifestyle, ability to see, freedom from pain, or even the ability to become mobile again.”

The absence of brain stem function is documented by conducting the following five tests: absence of Pupillary reflex response to light; absence of Corneal reflexes; absence of vestibulo-ocular reflex; absence of cranial nerve response to pain; and absence of gag and cough reflexes.

Adding further, Dr Aggarwal, said, “We need to communicate to people that they can live even after death through organ donation. There is also a need to remove myths and misconceptions about organ donation and spread the message around. As per IMA’s policies, 100% IMA members should pledge their organs / tissues after cardiac or brain death.”

Here are some myths about organ donation, demystified.
•    Age is not a barrier for organ donation. Even people above the age of 80 have become organ and tissue donors.
•    There is no requirement to be in perfect health for donation. Even those who smoke, drink or don’t have a healthy diet can donate.
•    Organ and tissue donation do not disfigure the body in any way.
•    In case of an accident, the doctor will always try to save the life of the victim first. Organ donation is considered as an option only when the person dies due to certain circumstances.

Never declare a patient dead under conditions of hypothermia

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A core body temperature below 95 F is hypothermia. Core temperature 90 95 F is mild hypothermia 82 to 90 F is moderate hypothermia and core temperature below 82 F is severe hypothermia. In conditions of severe hypothermia in children body metabolism is suspended which may protect against hypoxia. Patients with core body temperature 82 F have been known to survive anoxia for 12 18 minutes and up to 60 minutes or more at core body temperature 68 F. Sometimes hypothermic patients can be successfully revived with CPR even with total resuscitation time of 9 hours. Because of dilated pupils asystole hypoventilation absence of shivering the patient appears dead. Because of failure to recognize this state the patient may be declared dead. Successful revival is also possible in adults because of the neuroprotective effects of hypothermia. Several hours of CPR may be required for this. Efforts to revive the patient should be continued till the core body temperature reaches 90 95 F i.e. bring the temperature from severe hypothermia to mild hypothermia or normal. If the patient still cannot be revived with CPR then he she can be declared dead. The recent incident of a premature 22 weeks newborn who was alive but allegedly declared dead at a private hospital in the National capital has captured headlines. The other twin was stillborn. While being taken for the funeral the newborn was discovered to be alive and is now on life support system. In light of this incident IMA has issued an advisory that patients should not be declared dead under conditions of hypothermia. It is important to recognize hypothermia so that patient can be timely revived using all resuscitative measures including rewarming CPR.