Sunday, October 7, 2012

Brain death & Organ donation



Hi! machan here. Thought I'd give an update. I'm writing this from the ICCU of Lakeshore hospital.
I was taken to the operation theatre on 25th, after completing my 190th dialysis. I had to wait 18 months for this. I got a healthy young man (42 y.o) as a donor, a native of Nenmara (palakkad). We had arranged  about fifty documents for another donor before, but his family was not willing for the procedure towards the end. I was afraid that I wouldn't be able to make those many legal docs again,  it was enough of a pain the first time. But then again, the troubles they (the government) make us go through are justified; a lot of illegal organ trafficking takes place here. During this period my dialysis continued at KIMS, thrice a week. I received extraordinary treatment and mental support from the amazing medical teams at these hospitals. My friends and family (can't possibly mention all your names) gave me their full hearted support. I was happy. And then we found another donor. So we set out to arrange all the necessary documents all over again, but this time we were more familiar with the process. Finally, we had to get an approval for the transplant  from an ethics committee. The process was fairly straightforward and we got our approval. 
After the transplant operation, I feel like I'm improving by the hour. But ultimately it is a foreign body inside me, so I have to take immuno suppressants to avoid rejection. The creatine level in my blood has reduced to 1.5 (prior to the operation it was 7.5). Now that I have close to no immunity, I have to lead an extremely careful life as even the tiniest infections and diseases can have serious consequences. The chances of rejection of the new kidney have been minimized thanks to modern medication. Now I hope to return to my room in 5 days. After discharge i have to be available locally for another 3-4 months, for routine checkup. 
Right now I have my wife, my younger son, my previous manager and his wife staying here with me. My elder son (who had to go back to college for his exams) will be back on the third. I owe them, my relatives, friends, my doctors and everyone who helped me pass  through these difficult times, immensely.  My life now rests in God's hands.
 Lastly, I'd like to urge all of you to opt in to donate your organs after death, it gives those people in need of them a new life. 

Dear Sir,
I respect the courage you have shown & I pray to almighty for your speedy recovery.
Now that you have taken time to describe how you have gone through, I shall write my thoughts on brain death cases & organ donation.

Each year from 2004 it was hard for me to hear about the deaths of friends who studied with me. We are not immortals after all.

Upon seeing the malayalam movie traffic few months back, I did first time come to know about the case of brain death which is the complete cessation of brain function as evidenced by absence of brain-wave activity on an electroencephalogram: sometimes used as a legal definition of death. Its in reality death itself even though the heart may continue beating with the aid of a mechanical ventilator.

Sometime back, I heard Mrs Uma Preman talking in Hit 96.7FM about brain death cases & she gave some statistics. Most of you might be knowing that she runs a charitable institution named Santhi medical information center in Guruvayoor. Her husband died mostly because of non awareness of the disease, Iam not sure what it was, maybe kidney failure. She has now devoted her life to propagate right information’s on diseases through her charitable works... check out her website:


Mostly she is focused on kidney transplant cases, helping people through subsidized dialysis... Now there was a kidney transplant in my family a year back. The laws involved in kidney transplants were too stringent. The Government has made this stringent to maximum avoid the kidney racket. The 31 year old relative had to wait almost 2 years to have the committee approve the transplant. Till then he had to do dialysis regularly. We were able to financially tackle the dialysis costs & the surgery charges but there are several thousands of people who are not able to perform dialysis regularly because of financial constraints. Now the approval of committee is too difficult.  We faced problems in most of the forms & we know the red tape involved in all Govt depts. The interviews by the committee is mostly merciless. First they try to scare the donor by telling that the donor may die eventually, stuff like that to finally make sure that the donor is fully, willingly giving away his kidney. They find out any flaw, the committee just rejects the donor.  As she says the need for organs is so high that if Govt legalizes mercy killing atleast half of the patients may apply for it… because they have spend all their money for dialysis… now the families cant afford anymore… the relatives starts thinking it would be better if the patient dies…. 

Cases of organ failure are bound to increase manifold in India in the next 5 to 10 years, given the burgeoning number of people with diabetes, hypertension, and borderline or end-stage renal diseases. Unless governments support and promote multi-organ harvesting from deceased donors (cadavers), hapless millions cannot even hope to live. Taking up the success of MOHAN foundation, Mrs Uma Preman had submitted a project report to previous LDF & now to UDF government but there was no proper response from either of them other than the word ‘NOKAM’. Now she along with Mr Salil (the patient who received her kidney) has approached the High court for relaxation of the current stringent law and what happened after that Iam not updated on that.

Multi Organ Harvesting Aid Network (MOHAN) Foundation, an NGO works in coordination with the Tamil Nadu Cadaver Transplant Programme, facilitated by the Tamil Nadu government. It has been hailed as one of the best models for organ donation in developing countries by the World Health Organisation.

The current demand in the country for kidney transplants is 150,000; liver, 200,000 and heart, 150,000. We are doing only 3,000 kidney transplants and 500 liver transplants a year because there are not enough donors. In Tamil Nadu alone, over 1,000 people are on waiting list for kidney transplant. According to a study by the All India Institute of Medical Sciences, of the 1,40,000 lives lost through road accidents every year in India , 67 per cent deaths are due to head injuries. If organs could be harvested from even two per cent of these cadavers, the demand for organs in the country can be easily met.

The MOHAN Foundation has been trying to sensitize doctors, public, and governments to the reality of brain death and to the fact that harvesting organs from cadavers can save lives. It has been training medical social workers to act as ‘grief counselors,' to counsel the families of brain-dead victims and to help them come to terms with brain death and organ donation.

The difficult part is eliciting a ‘yes' from families at their time of grief which is not easy. Families are never coerced into agreeing for organ donation. They have to be counseled into giving voluntary consent. In the last 15 years, counselors of MOHAN have managed to do organ harvesting from 500 brain-dead donors, from whom 1,400 organs were harvested. Mostly 54 organs can be transplanted from a brain dead patient.

Now the point I was making is, if we become brain dead (let that never happen) couldn’t we donate the organs to the needy? Most of us might be willing to donate. But we are already brain dead, who will make the decision? You will find a form in Mrs Uma Preman’s website fill it up & keep it with you all times. Most importantly say your wish to maximum people, relatives & friends so that, if somebody objects when we are brain dead your relatives and friends would come up & say that it was your wish to have your organs transplanted in case of brain death. & as M Sreenath said donate your organs after death.

Myself & my wife decided to donate our organs after death but to all those relatives & friends that I talked, the response was negetive. I dont know why. Is it because we are all afraid of dying?? or we hope to go to heaven with all our organs???  

Secondly be aware of the lifestyle diseases…. Brain death is mostly caused through accidents, so drive carefully…


Think about it Friends……

Source: Based on the E-Mail from Br. Anwar Saleem 5th October 2012.

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