Major hindrance on the way for human organ harvesting in India is commonly assumed to stem from patients' kin who would be scandalised at the mere thought of removal of body parts from their beloved.
However, field level experience speaks otherwise. In 85 per cent of the cases, the close relatives do agree for organ retrieval upon being approached and persuaded by the volunteers.
Many potential donations stop short of reaching the needy, instead, because doctors would not declare the patient brain-dead even after the brain stops functioning for good.
“Apart from lack of awareness about organ donation, one major obstacle in our work is that the doctors do not declare brain death even when it happens. They keep the patient on ventilator support till the heart stops functioning,” said Lalitha Raghuram, the Country-Director of the Multi Organ Harvesting Aid Network (MOHAN) Foundation which is involved in educating people about organ donation.
Protests from patients' kin aside, the doctors in India are simply not tuned to declaring the cases of brain-death, which, Ms. Raghuram insists, are deaths anyway, clinically as well as legally. Only difference between a cardiac death and a brain death is that the heart and other vital organs are kept functioning in the latter case by providing external support.
The Transplantation of Human Organs Act, 1994 clearly defines the ‘brain-stem death' as “the state at which all functions of the brain stem have permanently and irreversibly ceased”, and the ‘deceased person' as “a person in whom permanent disappearance of all evidence of life occurs, by reason of brain-stem death or in a cardio-pulmonary sense.”
However, the death should be certified by a team of medical experts, which is rarely done here.
While the retrieval of organs is limited to eyes and heart valves in cases of cardiac death, a brain death allows harvesting of other major organs such as heart, liver, pancreas and kidneys which could give a lease of new life to many.
In India, where annually 1.4 lakh people die in accidents, scope for organ harvesting from the brain-dead is very high. On an average, 10 per cent of the accident victims would be brain-dead, of whom organ retrieval from a minimum of 10 percent could prove providential for 7,000 patients.
The active waiting list with the MOHAN Foundation has 600 people in need of kidney, 100 people, of liver, and two of heart.
In the West, where deaths by accidents have declined over the years, hospitals are experimenting with retrieval from cardiac dead too, by harvesting the organs immediately after death in controlled atmosphere, Ms. Raghuram says. It involves a lot of preparatory work and special infrastructure too which Indian hospitals are not equipped with.
