MOTO

Municipal Corporation of Greater Mumbai

Promoting Organ Donation Dr. Kamaxi Bhate, KEM Hospital Mumbai

MCGM’S ORGAN TRANSPLANT

ORGANISATION

MOTO

Some people have Organ failure like Liver , Kidney, Pancreas due to diseases, or in sever Burns Skin is destroyed - Such people need Organs for survival. Where will these Functioning Organs Come from ? Only from Organ Donation! After natural Death or Brain Stem Death.

WHY ORGAN DONATION

After natural Death

Living Person for once own relative or

others

After Brain Stem Death

HOW DOES ORGAN DONATION TAKE PLACE ?

Eyes Skin Fascia Bones Ligaments Cartilages Blood Vestals ( Veins and Arteries ) Middle ear Bones

Organ donation is possible Even in case of death at Home

Which Organs can be donated after death

Blood

Kidney

Piece of Liver

Piece of Pancreas

Bone Marrow

इदं शरीरं परोपकारार्थम

- शंकराचार्थ

THE ORGANS THAT CAN BE DONATED BY A LIVING PERSON

Bone

Marro

w

2Eyes

2 Kidneys

1 Liver

1 Pancreas

2 Lungs

1 Small Intestine

1 Vocal Cord

2 Hands

2 Middle ear bones

Entire Skin

All Fascia

All Bones

Cartilages

Tendons

Blood Vessels (Veins

and arteries )

Heart Volvos

Nerves

20 Toes and Fingers

WHICH ORGANS CAN BE DONATED

AFTER BRAIN STEM DEATH.

Brain Stem Death is diagnosed in ICU patients only

Maximum Organ Donation is Possible after Brain Stem Death

a. Blood - Living for relatives and for others

b. Kidney - Living person for relatives or others

c. Eyes - Only After Death

d. Skin - Only After Death

TYPES OF ORGAN DONATION IN INDIA

What Is Eye Donation?

Who can do Eye donation?

Who needs eye donation ?

Responsibilities of the Health workers and/or relatives after the death of persons who want to go for Eye donation

DO YOU KNOW THESE ASPECTS OF EYE DONATION

Eye donation can be done only after death

ANATOMY OF THE EYE BALL , BLINDNESS AND WHO IS BENEFITED BY EYE DONATION

Transparent covering of the eye ball (Cornea) Lance in the eye ball.

Transparent covering of the eye ball (Cornea)

Transparent covering of the eye ball (Cornea) has become opaque = Blindness

35 Million people go corneal blind in developing countries . Corneal donation helps.

Cornea

Conjunctiva

In India 3 million people go corneal blind

60% of blind people are children

below 12 years.

These children can get eye sight with corneal transplant,

retrieved from eye donation

Do you know ,only 1.5 lakh corneas are donated per year in India !!!

NEED FOR EYE DONATION IN INDIA

OPAQUE CORNIA

REMOVED

TRANSPERANT DONER

CORNIA IMPLANTED

When there is a death of a person who has wished to donate eyes

Inform the near by Eye Bank telephonically .

Off the Fan and Keep AC on

Raise the head end of the dead body

Close the eye lids of the dead body and keep wet saline swabs on the eyes

To prevent any infection keep on putting antibiotic eye drops every now and then

It takes 20-25 to complete the processes of enucleation of the eye ball

Within 96 hours the process of corneal transplant should be complete

After the death of person wanting to donate eyes the process of eye donation should complete in six hours time

EYE DONATION -WHAT TO DO WHEN THERE IS DEATH AT HOME?

AFTER YOU HAVE USED THEM WILL YOU KINDLY GIVE THEM TO US

At what ever age even if having spectacles, or after cataract operation, person can do eye donation

Let Us Give them After We have used

them to Fullest!

There are 125 Million people in India

There are more than 6 thousand deaths per

day

If 100 % people donate eyes after death

...........

In only 11 days all coronial blinds in India will

get eye sight!

Even if only 5% people donate eyes in India

corneal Blindness can be overcome in 220

days!!

Let Us All Take Oath of Eye Donation after

Death!

Skin of the dead person is the

preferred option for a patient with the

most severe burns for patient to recover

in shorter duration.

As 80 % of burn victims are women

and children. India 100% mortality is

observed in patients having more than

60% burns ...

Skin from the dead

body is life saving

WHY SKIN DONATION?

Cadaver skin still is the

No. 1 substitute, after death

of a person cadaver skin is

removed in 2 – 24 hours.

Commonest sights

from where the skin is

taken

Additional sights from

where the cadaver skin is

taken

HOW IS CADAVER

SKIN DONATION DONE

Skin donation should be over in two

hours, but till 12-24 hours skin can be

taking

Retrieved skin is rolled through a meshing

machine, it creates a pattern of small holes,

like the fishnet stockings.

WHAT IS DONE TO THE SKIN

RETRIEVED FROM THE CADAVER

This skin is taken to

the skin bank,

trimmed into

bandage-like strips,

cryogenically

preserved. Cadaver

skin can be stored in

a freezer at 4-8 C for

up to five years in

85% Glyserol

CADAVER SKIN IS LIFE SAVING

The donated skin can

be used as a temporary

dressing for severe

burns can help prevent

infection, reduce pain

and maintain body

temperature.

CADAVER SKIN GRAFTS HELP

HEALING BIGGER WOUNDS FASTER

•Kidney Disease burden

and Transplantation

Around 150000 new

cases every year

Around 5000 receive

Kidney transplant.

KIDNEY CONDITIONS

•Liver Disease burden

•and Transplantation

Around 5 million affected

with liver disease

Around 1000 receive

Liver transplant.

These organs can be

retrieved only from

Brain Dead Donor

LIVER CONDITIONS

LIVER TRANSPLANT

Transplanted peace of Liver

MIRACLE OF ORGAN DONATION

FROM BRIAN STEM DEAD

Brain Stem death is a new concept while the heart is working , breathing has stopped for ever !!

In 1968 the concept of brain stem death was

accepted , Harvard University accepted and US law

of human organ donation was passed.

In India brain stem death was accepted by 1994 it

was Human Organ Transplant Act (HOTA) This law

was amended in 2011

There is no age limit for Organ donation There is no money exchange !

Is there any law about human organ donation, and brain dead ?

WHAT IS BRAINSTEM ?

Cerebrum

Cerebellum

Respiratory Centres are Situated in Brain Stem . Movement of eyes and pain centres are situated in Brain stem.

Breathing, eye movement and pain sensation stops forever after Brain stem death

WHAT IS BRAIN STEM DEATH ?

Tumour in the brain

Trauma Bleeding in the brain

Blood supply is blocked

Once there is brain stem death patient called “Cadaver”

Causes of Brain Stem death Brain stem Death : is such a state where functions of the brain have totally stopped, Respiration and pain is not there. No movements of any body parts. But the Heart is Beating hence blood supply to the organs is continued, to supply oxygen to the organs cadaver is put on the respirator It is death medically and legally

Brain Stem Death is not COMA

BRAIN STEM DEATH Brain Has stopped working

completely

Respiration has completely stopped, only heart is working and the body organs are getting

Movements have stopped, there is no movement even on stimulation, this is a permanent state

Body is maintained only on machines.

COMA BRAIN HAS NOT STOPPED

WORKING

RESPIRATION CONTINUES

THERE IS BODY MOVEMENT EYE MOVEMENT , THERE IS RESPONSE TO STIMULATION.

IT IS A TEMPORARY STATE

PATIENT CAN GET-WELL AND GO HOME .

DIFFERENCE BETWEEN BRAIN STEM DEATH AND COMA

State of Cadaver organ donation is pathetic in our country

POSITION OF ORGAN TRANSPLANT IN THE WEST

1985 1986 1987 1988 1990 1991 19920

5000

10000

15000

20000

25000

Kidneys - Cadaver

kidneys - Living

Liver

Heart

SITUATION OF ORGAN DONATION IN INDIA

In India only fifty Cadaver Transplant Take place

NUMBER OF CADAVERIC DONORS PER MILLION POPULATION

24.25

21.7

21.65

21.5

20

18.1

13.15

12.96

12.18

10.62

6.1

4.3

2.7

0.75

0.12

0.05

33.68

0 5 10 15 20 25 30 35

Spain

Austria

Portugal

Beligium

USA

France

Italy

Canada

United Kingdom

Germany

Australia

HK

Singapore

Taiwan

Korea

Philippines

Japan

Rate of cadaveric donations in India is <0.16 per million population

How many Brain Stem deaths are there in our country ?

In any big Hospital of a city there are around 20-22 accident cases per day, and one perscent cases are of Brain stem deaths

There are no experts who could diagnose Brain stem deaths

There is no awareness about organ donation in the society.

It is important to create social awareness

About Organ donation !!

CAN WE IMPROVE THE SITUATION OF CADAVER TRANSPLANT IN OUR COUNTRY

Accident Cases coming to the

Hospital

Out of them 10% Die

1% are Brain Death

Donor

In India Accident rate and Brain Stem Deaths are in large number and still organ donation is very low. WHY ? There is no awareness It is necessary to create awareness

Accident cases

coming to Hospital

Cases in ICU

COMA

ICU

BRAIN DEAD

WARDS Special

Care

Ward

• Giving Information

of OD to Family

• COUNSELLING for

importance - OD

• Giving Necessary

Help to the family

ICU BRAIN DEAD

• Team Of

doctors Give

Final Report BD

& Certificate

ICU

BRAIN DEAD

IEC Team &

Counseling Team

with Family

IDENTIFICATION TEAM

BD Certifying

Team

Maintenance of

the cadaver in

ICU

Retrieval Group

& transplant Group

Treatment

Team of

Recipient

GOVERNMENT CONTROL

ZTCC

•Maintains list of hospitals registered

for organs retrieval and

transplantation.

•Maintains waiting list of patients

who are desirous for organs.

• carries fair distribution of organs

based on waiting list.

• waiting list is prepared on the basis

of-

-Age

-Severity of disease

-Prognosis/expected survival after transplant

Organ

Retrieving

Hospitals

Organs

Transplantin

g hospitals

Multi-organs

transplant

centres

Government control (As per HOTA act-1994)

ZTCC

No hospital can transplant organ without prior information or permission of

ZTCC.

Working from

2000, in

Mumbai

1. In Mumbai 29 hospitals are registered under ZTCC

2. Today's date there are 55000 waiting for OD.

3. At every 16 minutes, new one is added to the list.

4. 10 die daily from the list without the organ.

• Tamilnadu is the leading state in India in OD.

• New concept of SWAP donation is also

emerging out

• HLA matching is mandatory for all OD except

Cornea, skin, bones.

SOME FACTS ABOUT ZTCC AND

ORGAN DONATION-

In Maharashtra, First tissue bank was started in Tata memorial hospital Mumbai

Rates of OD-

India- 0.16/million

population

USA – 22/million

population

Spain- 36/million

population

Even If a person has not pledged, relatives can take the decision to donate eyes/ skin

After Brain Stem death Close -Relatives can take the decision to donate Organs

Spouse

Son - Daughter

Brother – Sister

Any other

YOU MUST KNOW THIS

Diabetic

Hypertension

Person suffering from any other chronic diseases

Learn More About Brain Stem Death

CAN ILL PERSON DO ORGAN

DONATION

Person who dies of

Rabies

HIV / AIDS

Septicaemia

Downing

Cancer

Can not do eye donation or any other organ donation

WHO WILL NOT BE ABLE TO DO ORGAN DONATION

VERY POWERFUL AND INTELLIGENT KING

Had lot of palaces, Jewels ....... , Whated all that to be managed well after his death.

DECIDED TO MAKE A WILL

King’s Will

KING’S WILL

Give me Agnee after

Keeping my body in

my the Biggest Palace

with all my jewels..

MAD KING !!

King’s Will

KING’S WILL

WHO IS MAD!!?

King’s Will

What Lord Shiva could not have done himself The organ donor could do !!