Brain dead may be life-givers

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States like Tamil Nadu, Andhra Pradesh and Karnataka have made it mandatory for doctors to make queries and encourage relatives of the brain dead to donate organs

Swathi Krishna, the 17-year-old girl, who will soon be out of hospital with a slice of her aunt’s liver, has brought in to focus issues connected with organ donation in a State that still fights shy of the life-saving option.

Organ donation is intricate in Kerala even if one volunteers to donate out of humanitarian concern. If the donor is not a first degree relative, some 50 certificates have to be produced to facilitate organ donation.

A lot needs to be done in the State apart from relaxing laws and creating more awareness among people. It’s easier to use healthy organs of the brain dead patient and save lives, but that’s easier said than done.

“On the average 4,000 road accident deaths occur in Kerala and 10 per cent of them are brain-dead patients. However, at Amrita we’ve been able to get only three brain-dead patients in road accidents for liver donation in the last six years against a total 170 transplants,” says Dr S Sudheendran, who fixed the liver on Swathi and gave her a fresh lease of life.

Compared to this, Amrita used livers of 10 stroke victims to save as many lives. Of the 23 liver transplants done at Lakeshore Hospital so far, only one brain-dead patient’s organ was available.

Dr Philip Augustine, managing director and gastro chief at Lakeshore, said doctors, who broached organ donation with relatives, would be looked up on with suspicion in Kerala.

“There is a lot of apprehension regarding organ donation in Kerala because of exposes on organ racketeers. However, we have to go ahead and create an atmosphere conducive to transparent and genuine organ donation,” he said.

Dr Augustine said Andhra Pradesh, Tamil Nadu and Karnataka had moved ahead and made it mandatory for doctors to make queries and encourage relatives of the brain dead to donate organs.

“This makes it easier to find donors in these States and we direct a few patients there. But the cost of surgery there is higher than in Kerala. In TN, it comes to `30-40 lakh”, says Dr Augustine.

Some of the hospitals in these States work as harvesting centres, engaged in collecting and supplying organs to hospitals with transplant facility.

But both doctors and relatives of brain-dead patients are themselves victims of circumstances.
“Doctors are often confused and unable to broach the humanitarian aspect of harvesting organs from the brain-dead because it takes time for relatives to come out of the shock.

But we have to overcome this and follow neighbouring States. In the West, dead donors outnumber living donors,” he said.

Dr Augustine and Dr Sudh-eendran said a number of patients go brain dead from strokes and other illnesses. Relatives of such patients should be advised to don-ate organs.

“Two kidneys, liver and the heart can be donated in the case of brain dead patients. If we make use of this option, the current backlog can be cleared and more lives can be saved,” said Dr Augustine.
In case of living donors, other than first degree relatives, the law needs to take a new turn, say the experts.