Deceased donor organ donation falters

September 29, 2014 10:07 am | Updated 10:07 am IST - Thiruvananthapuram:

At least one brain death occurs every day in the intensive care units (ICUs) of Government Medical College Hospital (MCH) here. Yet, in the past 10 months, the number of deceased donor organ donations that took place in the hospital is just six.

In the two years since Mrithasanjeevani, the deceased donor organ donation programme of the State government, took off, not a single brain death has been reported from the MCH at Kozhikode.

The Kottayam MCH did slightly better, with three deceased donations during this time. In a city private hospital, an active participant in Mrithasanjeevani, there were 99 deaths in its Trauma ICU in the past one year owing to brain stem dysfunction. Yet, just 30 were reported as brain deaths. Of these, only four cases resulted in organ donation.

Under-reporting of brain deaths in the ICUs of major public and private hospitals continues to be a major hurdle in the way of the Mrithasanjeevani scheme, even as hundreds of patients in chronic end-stage kidney and liver diseases are awaiting organs in various hospitals.

With just one-third of the actual brain deaths getting reported, a staggering 75 per cent of these patients die because they do not receive organs on time.

Early identification

Early identification of brain-dead patients in ICUs and mandatory certification of brain deaths by neurosurgeons in all government and private hospitals in the State is the cornerstone of the organ donation programme. Yet, doctors have been reluctant to do this crucial task.

If private sector hospitals are wary of the procedures involved in brain death certification in medico-legal cases, in government hospitals, issues of staff shortage and the huge volume of salvageable brain injury cases in ICUs makes brain death certification process low in priority.

However, neurosurgeons would find it easier to certify brain death if the arduous task of communicating brain death to the victim’s family and counselling them about organ donation is taken over by Grief Counsellors, says Philip G. Thomas, Director, Multi-organ Transplant, Lakeshore hospital, Kochi. The hospital performed the maximum number of organ donations and transplants under Mrithasanjeevani in the past 10 months.

Counsellors needed

The government also needs to appoint more transplant counsellors and coordinators under Mrithasanjeevani in districts where there are active transplant hospitals to coordinate all organ donation activities, including grief counselling, to make the deceased organ donation programme work better.

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