Experts say doctors’ reluctance a hurdle
Early identification of brain dead patients in critical care units and mandatory certification of brain death in all government and private hospitals by neuro-surgeons will be crucial for the State’s Deceased Donor Organ Transplantation programme to take off, a team of doctors and transplant coordinators from Multi-Organ Harvesting Aid Network (MOHAN) Foundation, one of the key facilitators for Kerala’s multi-organ transplant programme, has pointed out.
The State government has already issued a GO in February this year, making certification of brain death mandatory in government and private hospitals in the State. The GO also clearly details the procedures to be adopted by doctors for the declaration of brain death.
However, in Kerala, despite the enabling legislation, the reluctance on the part of doctors to certify brain death and communicate this clearly to the relatives of the patient seems to be the main hurdle in the way of promoting deceased donor organ transplantation.
At a workshop on deceased donor transplantation programme held here on Saturday—the third in a series of workshops being organised by the Department of Health and the Department of Neurology as the State prepares to launch its own Deceased Donor Organ Transplantation programme—experts pointed out that mandatory certification of brain death was a necessary event to enhance the scope of deceased donor transplantation in Kerala.
Transplant coordination counsellors thus have a huge role to play in communicating the event of brain death to the patient’s family and then giving them the option of organ donation.
Health Principal Secretary Rajeev Sadanandan said that it was time Kerala moved ahead with the implementation of the programme as all enabling legislations had been put in place by the government. Already five GOs covering various aspects of organ donation had been issued by the government.
“The institutions which are already doing the transplantation programme should take the lead and do some mentoring so that other hospitals are also encouraged to follow. We have adopted the Tamil Nadu model almost in its entirety in launching our own programme but the operational guidelines will have to be changed to suit the local-specific situations—about which we will know only when we start the programme,” he said.
Joint effort needed
Dr. Sunil Shroff of MOHAN Foundation pointed out that the deceased donor transplant programme had to be a joint effort of both the government and private sector and corporate hospitals.
Health Minister V.S. Sivakumar launched the web portal ‘Mrithasanjeevani’ or Kerala Network for Organ Sharing (www.knos.org.in), the registry of all potential organ recipients in the State, one of the crucial elementsto ensure transparency in allocation of harvested organs.
Keywords: Brain death certificate, organ transplatation, Thiruvananthapuram hospitals, MOHAN foundation
This is utter rubbish.
Brain death is an established condition and is irreversible. To certify brain death -
a. Cause of brain death should be known - most of these victims have had massive brain hemorrhage due to fatal road traffic accidents
b. All medication as cause of deep coma need to be excluded including sedatives, alcohol etc
c. Hypothermia should be excluded
Brain death was not invented for organ donation, it was first discovered in Paris in intensive care and called coma de passe. Eighty percent or 30,000 organ donation in the world come because of brain death. If testing is done as per the strict guidelines there is no question of it being reversible.
We need to rethink this brain death determination. Many doctors and people are wondering, why does the brain injured victims heart beat rise from 100 to 220 when the knife is inserted? Why would you have to give a neuromuscular blocking agent to a brain dead person to keep his tummy muscles, which are skeletal muscles from contracting? The skeletal muscles are controlled by the cortex of the brain. Many people that have been declared brain dead have recovered to 100%. There are many critics to brain death. Why haven't we've been told that there is controversy? Many people the organs are being harvested from brain alive injured victims without anesthesia. This is horrific. Please stand up against organ donation, it is a present day evil in our society. This is not a dignified to treat the body of your loved one. To skin their body from the nipple down to the thigh, with a dormatone, a big cheese slicer. There has to be a better way to save lives.
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