Last week, singer and actor Selena Gomez took to Twitter to express her concerns with television shows using organ transplants as a punchline. Diagnosed with the autoimmune disease lupus, Gomez received a kidney transplant in 2017. This begs the question: why is organ transplantation a laughing matter and does deeming it as a taboo subject prohibit us from knowing more about it?

 

 

According to a study published in the Journal of Education and Health Promotion in 2018, “India currently has a deceased donation rate of 0.05–0.08 per million population.” This implies that among the few donations every year, most of them are living donations and the number of people registering as donors is alarmingly low. Owing to a variety of determinants like age, gender, economic and educational status etc, there seems to be a lack of awareness and confidence among the population about the basic details of organ donation.

With waiting periods for organs ranging for months to years, the demand for donations is always more than supply for them. In India, 2013 was considered one of the best years of organ transplants, notes Organ Receiving and Giving Awareness Network (ORGAN), even though just 852 were carried out. In the US, the number was 22,966. Thus, it is crucial for eligible individuals to register as donors, as it can end up saving someone in their family as well as several other people.

 

When is an organ donation required?

Genetic conditions, chronic illnesses or injuries may cause organ failure in a patient. To save their life and/or prolong their life expectancy, transplantation is the best way to go.

 

Who can donate organs?

Both living and deceased individuals are eligible to become donors. “In case of cadaver transplant, people from all age groups can donate,” says liver and kidney transplant surgeon Dr. Manish C. Varma of Apollo Hospitals, Hyderabad. In case of living donors, they must be over 18 years of age and of sound mental health. However, both kinds of donors should be free from actively spreading cancer, infection, malignancy, human immunodeficiency virus (HIV), hepatitis C virus (HCV) etc.

 

What organs can be donated?

According to Dr. Varma, a single healthy donor can donate a large number of organs and save several lives, including their corneas, heart, lungs, pancreas, liver, intestines, kidneys, ovaries, skin and bones. In some special cases, hands can be transplanted as well.

 

What are the five types of donation?

There are five major types of organ donations based on whether you are a living donor or a deceased donor, explains Dr. Varma.

1. Living Donation

a. Living Related or First Degree Donation: This is when a living donor gives their organ/tissue/blood to another person whom they are related to.

b. Living Unrelated or Second Degree Donation: This occurs when the recipient receives a donation from someone not related by blood, but close to them. They can be friends or partners.

c. Swap Transplant: A more complicated process, a swap transplant occurs when one living donor-recipient pair exchanges an organ with another such pair. When a donor’s organ is incompatible with the patient’s body, they may exchange the organ with another pair of donor and recipient whose organ is a match for them.

 

2. Deceased/Cadaver Donation

1. Donation after brain death: Unlike a coma, brain death is legally confirmed as death as the patient is unable to regain consciousness or survive without life support. In this situation, the family or next of kin have to permit the doctors to allow retrieval of organs and withdraw life support. It is a difficult but noble decision.

2. Donation after cardiac death: Unlike donation after brain death, donation after cardiac or circulatory death is a much more hastened process. Here, the donor’s heart has undergone irreversible damage and stopped circulating blood and oxygen. The organ retrieval in this case has to be done as soon as possible.

 

What is the average cost of a transplant?

For the recipient, an average kidney transplant may cost anything between 6 to 8 lakh INR. A liver is priced around 22 to 24 lakhs, a heart at 18 to 22 lakhs and lungs at around 35 to 40 lakhs. On the other hand, it costs nothing to the donor or their family.

 

How long can one have to wait for a donation?

The first and hardest part of organ transplantation is being placed in the waiting list. A patient may have to wait from 2-4 months (for livers, kidneys) to 1-2 years (for kidneys) to receive a match. With the lack of enough donors, this waiting period is very risky for the patients as the wait may outlive their illness.

 

What are the health risks involving organ transplants?

While the process of organ transplantation is a revolutionary one, it is also a very serious surgery. In the case of a living donor, you may experience pain, infection, hernias, bleeding, blood clots and wound complications. However, the surgery will be very precise, reassures Dr. Varma. There will be a surgical incision made, which will be sutured property from doctors. With the right care, you will be left with minimal scarring and no long term effects.

As for the recipient, there may be unfortunate occasions where their body rejects the foreign organ. “This is because the person’s immune system detects that the antigens on the cells of the organ are different or not “matched”. Mismatched organs, or organs that are not matched closely enough, can trigger a blood transfusion reaction or transplant rejection,” notes Dr. Varma. This is why they are prescribed a healthy lifestyle and long-term anti-rejection medicine to fight off potential infections or flus in the future.

However, these instances are nowhere near in the majority.Though the numbers are few, India has very high success rates of organ transplantation. According to Dr. Varma, 85%-90% of livers, 90% of kidneys and 80%-90% of hearts are successfully transplanted each year.

 

Where can one apply to become a donor?

In cadaver, you can register to become a donor after your death at multiple websites like Jeevandan (Telangana, Andhra Pradesh) and Jeevansarthake (Karnataka). People from all over India can pledge their organs at the Organ Receiving and Giving Awareness Network (ORGAN). You need to declare your last wishes to your family and next of kin as they may have to make the decision for you. In case of a living donor, the first step would be to consult your doctor, recommends Dr. Varma.