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80-member joint family from Maharashtra pledges to donate bodies, organs

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Maharashtra

Palghar (Maharashtra): An 80-member joint family living in Agashe village near Virar in Maharashtra has suddenly come into prominence after all of them voluntarily pledged to donate their bodies or organs and tissues.

Headed by retired farmer Baptista Lopes, the East Indian Christian family was inspired by a talk by Puroshottam Patil-Pawar, the chief trustee of the Bapusaheb Patil-Pawar Charitable Trust which runs NGO Dehmukti Mission that creates awareness on eye and cadaver donations.

Starting with the 82-year old patriarch Baptista, four members have already signed pledges to donate their full bodies, while the other 76 will donate organs or tissues.

“Around 20-odd family members either live or work elsewhere, but they have agreed to come and pledge their donation in due course,” said Baptista’s son Elvis Lopes, a 60-year-old retired private company employee.

The Lopes family is one of the rare and huge single joint families in the coastal Konkan region with around 100 members living peacefully and happily in one single wadi in Agashe village, around five km from Virar station.

“When we heard Patil-Pawar’s simple and scientific explanations on the benefits of body or organ donation, we were impressed and convinced to do our bit. In fact, on January 10, when most of my family was present, a majority raised their hands in the auditorium,” Lopes said..

Patil-Pawar said: “The Lopes family asked me to speak about the topic on which we are campaigning and creating awareness. It was on January 10, when the family was marking the 25th death anniversary of their former patriarch Bascao Dinya Lopes, who died in 1991 at the age of 79.”

After that, around 60 Lopes family members filled up forms pledging tissues like eyes and skin, and organs like blood, lungs, kidneys, intestines, heart, pancreas, liver, bones and bone marrow, and four members including Baptista pledged their full bodies.

The rest, some not living there currently, or the 12 minors — the youngest to pledge is only 12 years old and others, including school and college going children — have announced their intention to sign up after they become majors.

Charged by the cause, Patil-Pawar said the Lopes family members were now enthusiastically reaching out to other villagers and also their own distant relatives in other parts of Maharashtra and elsewhere to make similar pledges. (IANS)(Photo: donatelifecalifornia.org)

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Public sector suffers as organ donations go to private hospitals

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source: http://financialtribune.com

Mumbai: Public hospitals in the city have only received five organ donations this year, as compared to the 111 donations which went to private sectors, thus calling for a more even distribution. Though the cause behind this issue is most likely the poor participation of public hospitals in the cadaver donation programme, demands have risen to improve the distribution practice.

Since 1997, 453 cadaver kidneys transplants were carried out, according to statistics from the Zonal Transplant Coordination Committee (ZTCC) which is in charge of organ distribution. Out of that number, the public sector received only 40 donations. It also needs to be mentioned that over the last 18 years, the four major hospitals-cum-medical colleges–KEM, Sion, Nair and JJ—collectively contributed less than 40 donations.

Liver transplants are exclusively offered in the city by the private sector. The KEM hospital in Parel ran a short unsuccessful programme and received eight livers of the 135 cadaveric transplants all over the city in the last decade. Experts comment that the city or the state would do good to follow the Tamil Nadu model or the US model in this regard.

The policy for organ sharing in Tamil Nadu directs every alternate donation, of the lungs, heart or liver, towards public hospitals, thus ensuring that both private and public sectors benefit equally from the donation programme.

The US model makes use of a central database of patients where each is attributed a ‘patient score’, which takes into account the seriousness of the patient’s condition and his/her blood group, stated the general secretary of ZTCC, Dr Sujata Patwardhan to TOI. The patient on the waiting list who has the highest ‘patient score’ gets the organ. “The hospitals do not know who is likely to get the next organ. It depends on the patient’s score,” she said.

Questions often crop up with an increase in awareness, as to who benefits from the donations, remarked a senior transplant coordinator. “In public hospitals, particularly, donor families always want to know if the hospital or anybody else will monetarily benefit from the donation. It is in the larger interest of the programme that more donations as well as transplants happen in the public sector,” added the senior coordinator.

Dr Sanjay Nagral, a liver transplant surgeon opined that public hospitals could very well carry out more kidney transplants as they were less complicated than liver transplants, which are still largely carried out in private hospitals, even in Tamil Nadu.

Director of the major BMC hospitals, Dr Suhasini Nagda, said that a major issue in the public hospitals of the city is cadaver identification, though steps are being taken to rectify that.

However, Union Health Minister JP Nadda at the sixth Indian Organ Donation Day at Vigyan Bhavan, Delhi, said that the government has taken initiatives to open facilities for organ transplantation in public hospitals. Steps are also being taken to improve the number of donations.

“We have also decided to train the paramedics in hospitals and sensitise them about organ donation, so that they can further pitch about the issue in the society,” said Nadda.

The minister has also called upon individuals, NGOs and voluntary organisations to come forward and work with the health ministry.

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Mumbai roads make way for speedy heart transplant

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By NewsGram Staff Writer

For the second time in five days, the chaos and clutter on a stretch of Mumbai roads made way on Friday for a donated heart to be speeded across the metropolis from a donor to a recipient – covering 19 km in just 14 minutes, officials said.

The heart was harvested from a 63-year old man at MGM Hospital in Vashi in Navi Mumbai, and was taken to Fortis Hospital in Mulund in north-east Mumbai, to be transplanted to a 29-year-old recipient.

Chipping in for the noble cause, Mumbai and Navi Mumbai traffic police authorities collaborated to create a ‘green corridor’ and enable the donated organ to reach its destination in the shortest possible time.

It was no doubt a tall order, considering the morning peak hour and congestion on the Vashi-Mumbai routes, but the effort paid off in the end.

A heart transplant must take place within four hours of the harvest, and sooner the better, medicos said.

Mumbai Police swung into action along with Navi Mumbai counterparts after the request for making suitable arrangements at around 3.45 a.m. on Friday.

“They readied a route plan within 20 minutes, including diversions and clearing congested roads, stalling traffic signals and synchronising all other aspects,” an official said.

“It is extremely heartening to see the city’s second heart transplant in less than a week – while the organ donation month awareness is underway,” said Fortis Healthcare Regional Director Sukhmeet Sandhu.

The hospital’s chief cardiac surgeon Dr Anvay Mulay said the recipient will be under observation for the next one-two days.

This was the second heart transplant in the city after a gap of 47 long years.

The first one after this many years was carried out last Monday in a similar well-coordinated operation when the harvested heart was taken from Jehangir Hospital, Pune, by road to the airport in the city, then to Mumbai airport and then again a road journey to Mulund’s Fortis Hospital – all in less than 90 minutes.

The country’s first heart transplant operation was carried out at Mumbai’s KEM Hospital by Dr. P.K. Sen in 1968.

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Organ donation: From grief there comes hope

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By Dr. H. R. Keshavamurthy

Organ donation and transplantation provides a second chance at life for thousands of people each year. The growing disparity between the rich and poor, demand for human organs and availability of technology in the country makes the trading of organs a quick means to riches for some and a relief for others. Invariably Organ trade leads to exploitation of the poverty-stricken people by tempting them with financial gains to meet their immediate short-term financial needs.

Each year hundreds of Indians die while waiting for an organ transplant. The reason being there is acute imbalance between the number of organs donated and the number of people waiting for a transplant. While 2.1 lakh Indians require kidney transplantation annually, but only 3000 – 4000 kidney transplants are done. The situation is not very different in relation to heart transplants. While annually around 4,000–5,000 patients in India require a heart transplant, so far only 100 heart transplants have been conducted across the country. According to the National Programme for Control of Blindness (NPCB) 2012-13 report, only 4,417 corneas were available in 2012-13 against a whopping requirement of 80,000-1, 00,000 per year.  There are currently over 120 transplant centres   in India performing approximately 3,500 to 4,000 kidney transplants annually. Out of these four centers undertake approximately 150 to 200 liver transplants annually while some do an occasional heart transplant.

Finding a donor is the main issue in the country. Lack of awareness and improper infrastructure facilities are the main reasons behind the existing scenario. Administrative hurdles and conservative mindset further affect organ transplantation scenario in India.  There are a lot of myths associated with organ donation which needs to be addressed to solve this problem. Most Indians generally believe that it is against the nature and religion that body parts are mutilated. Some are suspicious that the hospital staff may not work hard to save their lives if they want organs. Others believe that there might be a temptation to declare them dead before they are actually dead. Lack of a centralized registry for organ donation acts as another major hurdle for the people to donate organs or get data about donors. Also, there is a problem of certifying brain deaths; if people are not aware of brain deaths; it becomes difficult to convince the relatives of the patients for organ donation.

Kidney transplants in India first started in the 1970s and since then India has been a leading country in this field on the Asian sub-continent. The evolutionary history of transplants in the last four decades has witnessed commerce in organ donation becoming an integral part of the program. The Government passed the Transplantation of Human Organ Act (THO) in 1994 which made unrelated transplants illegal and deceased donation a legal option with the acceptance of brain death. Overcoming organ shortage by tapping into the pool of brain-dead patients was expected to curb the unrelated transplant activity. But, despite the THO Act, neither has the commerce stopped nor have the number of deceased donors increased to take care of organ shortage. The concept of brain death has never been promoted or widely publicized. Most unrelated transplants currently are being done with the approval from an Authorization committee.

Government of India enacted the ‘Transplantation of Human Organs (Amendment) Act in 2011 which made provisions for simplifying the procedure for human organ donation. The provisions included retrieval centres and their registration for retrieval of organs from deceased donors, swap donation and a mandatory inquiry by the registered medical practitioner of a hospital in consultation with transplant coordinator (if available) from the near relative(s) of potential donor admitted in Intensive Care Unit and informing them about the option to donate and if they consent to donate, inform the retrieval center for retrieval of organs.

In India, the potential for deceased donation is huge due to the high number of fatal road traffic accidents and this pool is yet to be tapped. At any given time, every major city would have 8 – 10 brain deaths in various ICUs. Some 4 – 6% of all hospital deaths are due to brain death. In India, road accidents account for around 1.4 lakh deaths annually. Out of these, almost 65% sustain severe head injuries as per a study carried out by AIIMS, Delhi.  This means there are almost 90,000 patients who may be brain dead.

It is not that people don’t want to donate, but that there are no mechanisms in hospitals to identify and certify brain deaths. Plus, no one empowers the relatives of a brain-dead person to save lives by donating his organs. Anyone from a child to an elderly person can be a donor. Organ donation from the brain dead – also referred to a cadaveric donation is still very low in India. While Spain has 35 organ donors per million people, Britain has 27 donors, US 26 and Australia 11, India’s count stands at a mere 0.16 per million people.

Donor Card

Signing a donor card is the first step in making your wishes about donation known. A donor card is not a legal document but an expression of one’s willingness to donate. While signing a donor card demonstrates one’s desire to donate organ after death, letting the family or friends know about the decision is very important. That is because family members will be asked to give consent for the donation. The decision will be considered final when they give consent. Vital organs such as heart, liver, lungs, kidneys, pancreas and intestines, and tissues such as corneas, heart valves, skin, bones, ligaments, tendons, veins, etc. can be donated in case of brain death.

THOT Rules 

The recently notified Transplantation of Human Organs and Tissues Rules(THOT), 2014 has many provisions to remove the impediments to organ donation while curbing misuse/misinterpretation of the rules. To mention a few:

  • The medical practitioner who will be part of the organ transplantation team for carrying out transplantation operation shall not be a member of the Authorisation Committee constituted under the Act.
  • When the proposed donor or recipient or both are not Indian nationals or citizens whether near relatives or otherwise, the Authorisation Committee shall consider all such requests and the transplantation shall not be permitted if the recipient is a foreign national and donor is an Indian national unless they are near relatives.
  • When the proposed donor and the recipient are not near relatives, the Authorisation Committee shall evaluate that there is no commercial transaction between the recipient and the donor and that no payment has been made to the donor or promised to be made to the donor or any other person
  •  Cases of swap donation referred to under subsection shall be approved by Authorisation Committee of hospital or district or State in which transplantation is proposed to be done and the donation of organs shall be permissible only from near relatives of the swap recipients.
  • When the recipient is in a critical condition in need of life saving organ transplantation within a week, the donor or recipient may approach hospital in-charge to expedite evaluation by the Authorisation Committee.
  •  The quorum of the Authorisation Committee should be minimum four and is not complete without the participation of the Chairman, Secretary (Health) or nominee and Director of Health Services or nominee.
  • Every authorised transplantation centre must have its own website. The Authorisation Committee is required to take final decision within twenty four hours of holding the meeting for grant of permission or rejection for transplant and the decision of the Authorisation Committee should be displayed on the notice board of the hospital and the website within twenty four hours of taking the decision. The website of transplantation centre shall be linked to State/Regional/National Networks through online system for organ procurement, sharing and transplantation.
  • There would be an apex national networking organization at the centre. There would also be regional and State level networking organizations where large of number of transplantation of organ(s) or tissue (s) are performed. The State units would be linked to hospitals, Organ/Tissue matching Labs and Tissue Banks within their area and also to regional and national networking organisations. Such networks shall coordinate procurement, storage, transportation, matching, allocation and transplantation of organs/tissues and shall develop norms and standard operating procedures.
  • A National Registry on Donors and recipients of Human Organ and Tissue accessible on-line through dedicated website having National, Regional and State level specificities will come into force. National/Regional registry shall be compiled based on similar registries at State level. The identity of the people in the database shall not be in public domain.

NOTTO

National Organ and Tissue Transplant Organization (NOTTO) is a National level organization set up under Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India located Safdarjung Hospital New Delhi. Website of NOTTO (National Organ and Tissue Transplant Organization) has been launched recently.

NATTO has following two divisions:

  • National Human Organ and Tissue Removal and Storage Network”
    This has been mandated as per the Transplantation of Human Organs (Amendment) Act 2011. The network will be established initially for Delhi and gradually expanded to include other States and Regions of the country. National Network division of NOTTO would function as apex centre for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.
  • National Biomaterial Centre (National Tissue Bank)
    The main thrust & objective of establishing the centre is to fill up the gap between ‘Demand’ and ‘Supply’ as well as ‘Quality Assurance’ in the availability of various tissues.

Making organs a commodity is fraught with erosion of social, moral, and ethical values and is not an alternative that can be acceptable to meet organ requirements in a civilized society. The World Health Organization (WHO) in its statement on the sale of organs clearly states that it violates the Universal Declaration of Human Rights as well as its own constitution: “The human body and its parts cannot be the subject of commercial transactions. Accordingly, giving or receiving payment… for organs should be prohibited.” Enhanced awareness among people is needed to encourage people to donate organs. This requires involvement of the civil society, religious leaders and other stakeholders in creating awareness.

 

Source:PIB