The success of cadaver transplantation programme to be launched at NTR University of Health Sciences (NTRUHS) here in the last week of this month depends on the extent of public awareness and a host of issues that doctors have to sort out.
Basically, declaring a patient as brain-dead is a tricky thing to do because of the absence of definite criteria for doing so. As a consequence, most physicians hesitate to announce that the brain stem of a patient has died and has suffered a loss of consciousness permanently.
There will also be legal problems associated with objections that the family members (spouse and children) of a patient might raise in spite of having a written consent by him or her to donate organs after death. Requirement of round-the-clock availability of police and forensic experts for conducting post-mortem and inquest in medico-legal cases is another hurdle to be overcome.
To deal with the complex issue of declaring a person brain-dead, a Non-Transplant Organ Harvesting Centre/Organ Transplantation Centre is supposed to constitute a medical board comprising medical superintendent of the hospital, a post-graduate with five years experience as a physician/surgeon/intensivist to be nominated by the medical superintendent from a list of names approved by the Appropriate Authority for Cadaver Transplantation (AACT), a neurologist/neurosurgeon to be nominated by the medical superintendent from AACT-approved list and doctor on-duty treating the patient. These medical boards have to take decisions on declaring brain-death.
The basic impediment is lack of awareness of the need for organ donation. The misconceptions of people have to be cleared so that the number of organ donors rises.
NTRUHS Director (R&D) G. Krishna Murthy said a cut-off period for pronouncing brain death would be helpful in dealing with the sensitive issue as the possibility of a person regaining consciousness after being declared brain-dead could not be dismissed. It would be impossible for any one, including doctors, to predict how a situation evolves, he observed.
A cut-off period for pronouncing brain death will be helpful in dealing with the sensitive issue as the possibility of a person regaining consciousness after being declared brain-dead cannot be dismissed
G. Krishna Murthy
NTRUHS Director (R&D)
