Professional Documents
Culture Documents
patients with end stage organ failure where therapy with drugs or restorative
surgery is not feasible. Approximately, 25 different organs and tissues including
kidney, heart, lung, liver, pancreas, bone, cartilage, bone marrow, skin and cornea
can
be
transplanted.
This
is
due
to
important
break
throughs
in
immunosuppressant drugs and tissue typing. More than 1 million people world
wide have benefitted from successful
organ transplantation.
Of these kidney
transplant results have been the most gratifying. With improvement in results, the
demand for human organs for transplantation has increased. The source of donor
organs are living related donors (LRD), living un-related donors (LURD), cadaver
non heart beating donors (NHBD) and cadaver heart beating donors (HBD). Most of
cadaver transplanted kidneys are obtained from brain dead donors with functional
circulation.
The recipient
should also follow up regularly, at the center where he is registered so that the
nephrologist is aware of his/her medical fitness for surgery.
cross is positive the recipient next on the list is considered for the transplant,
provided lymphocyte cross match is negative. The shortage of organs can be
expanded by including non-heart beating donors (NHBD) i.e. organs are retrieved
only after heart stops functioning. The main issue with NHBD is higher rate of
delayed graft function compared with that associated with heart beating brain dead
donors. However at 3 months graft function is not significantly different between
the two.
Most of the kidney transplants performed in India are from live donors. For
those patients who do not have an option of related kidney transplantation, the only
option is to wait for a cadaver kidney. The Human Organ Transplantation act was
passed in 1994 following which a few cadaver transplants have been carried out all
over India. In Maharashtra, the first cadaver transplantation after the act was
performed on the 27th of March 1997, thereafter about a hundred and fifty more
have been performed up to date.
carried out in India far short of what is required. This is in spite of 8500 fatal road
traffic accidents per year. Per city about 8 to 10 brain dead patients would be there
at a time, however, the conversion rate is less than 19%. This is due to multiple
factors like poor infrastructure for quick and safe transportation of accident victims,
lack of ventilatory facilities, ignorance, failure to convince the near relatives to
donate organs, indifferent attitude of health care professionals and lack of organ
sharing agencies.
sentiments, family pressures all contribute to bringing down the number of actual
organ retrieval from potential cadaver donors.
The organ
procurement team is responsible for the whole organ donation process from donor
identification to organ retrieval and they are accountable for their performance,
there are 127 such teams. Their organ donation rate has more than doubled over
the last one decade and the percentage of multi-organ retrieval has soared from 35
to 83% enabling a 3-fold rise of possible solid organ transplant.
Currently, organ shortage is the main obstacle to the full development of transplant
programme. It is possible to increase the cadaveric organ donation rate and also
promote living donation. It is still possible to improve graft survival rates and thus
reduce the need for re-transplantation.