Request for Organ Donation
Usually the organ donation request is made in the time interval between the diagnosis of brain death and discontinuation of the ventilator. If the relatives are agreeable the process of organ donation is undertaken and vital organs like kidney’s, heart, lungs, liver, pancreas, etc are removed for transplantation. In case of corneas & skin, retrieval can be done for up to 6 hours after cardiac standstill. Other tissues like heart valves,bone and cartilages can be removed for up to 48 hrs after death; however in India due to the heat it is advisable to do it sooner and an upper limit of 12 to 24 hours can be followed. The process of organ donation and transplantation requires co-ordination between different teams operating almost simultaneously and sometimes in different locations. It may require getting surgeons from different specialties together for both donor and recipient surgery.
Generally, there is no bar to organ donation and one or the other organ or tissues can be donated at any age. However, it is important to do some essential virology screening before accepting the donor. All potential donors will require a virology screen to prevent possible transmission of disease from donor to the recipient. The next of kin should be made aware that this is necessary if there are any objections these should be respected. However, it does mean that donation cannot then take place.
A severe shortage of organs the world over has led to increased pressure on the intensive care staff for early identification of the brain dead donor and optimum management of this condition. The diagnosis of brain death as per the Transplantation of Human Organs Act is based on simple clinical bedside tests. The passing of this Act in 1994 (Amendment 2011) and its subsequent adoption by many Indian States has made it possible in India to use this pool of patients for organ retrieval and transplantation.