Organ donation: Rules you should know

An HIV positive man has managed to get a kidney transplant after seven months and fourteen days of waiting. The man's mother was willing to donate her kidney, but had to wait for seven months, for approval from the Maharashtra government. Unlike other states that allow family members to donate their organs to their relatives without any red tape, Maharashtra's laws prohibit it without issuing an NOC.

If you do find yourself in a position where you want to donate an organ to a relative or require one yourself, here is a layman's guide to organ donation:

There are namely two types of donations, a live donation (where a patient's family member or close friend, chooses to donate their organ to a loved one) and cadaveric donations (where a person pledges their organs for harvesting and donation after their death).

Here are a few things you should know before you opt to donate to your own family member;

• A person can choose to donate an organ to a family member at any point, but in the state of Maharashtra you will require an NOC from the government. In other states this rule is exempt.
• Before you donate, you will be given a complete health check up along with a blood cross matching test. This is done to see if the organ you are donating will match the recipient.
• Once an NOC is obtained, you can donate your organ as per your surgeon's directions.

Cadaver donation: a cadaver donation is one where a person pledges his/her organs after death. This is a system where the organs of the person are harvested after the person is declared brain dead. If you do pledge your organs there are a few things you should keep in mind:

• In order to be an organ donor, you have to register with any NGO that will help you get an organ donation card. This card will declare you as a person who would like to donate after death.(hyperlink to nemo's article)
• Make sure you inform your family about your wishes to donate. This is important because after your death, your close family has the right to deny the doctor permission to harvest your organs.
• Transplant and organ donation rules state that after the organs have been harvested, the coroner or physician will return the body of the deceased to the family members in an aesthetic manner. This means that he/she will suture all cuts made and wrap the body appropriately.
• After death or being declared brain dead, a person's organs will be tested for viability (usability of the organ for transplantation).
• If you suffer from any chronic condition such as liver failure, kidney disease or heart conditions etc, that organ is not harvested since it cannot be used.
• The organs you can offer to donate are eyes, lungs, kidneys, liver, skin and in some cases intestines.

Recipients:

If you or your family member requires an organ transplant, the patient has to be put on a transplant registry. This will help the treating hospital to know when an organ is available for donation.

Here are a few things you should know.

• Depending on which form of organ transplant can be used for you, you will have to be registered with the Zonal Transplant Coordination Center (ZTCC) for cadaveric donations or get an NOC, in case one of your family members desires to donate an organ.
• Your treating physician will be better equipped to guide you through the process of registry and is obliged to tell you when an organ is available.
• Every organ that is available for transplantation will go through a cross match test. If the compatibility tests fail, the doctor has the right to not transplant that organ.

Irrespective of the kind of transplant that you may need to go through, the person donating will go through the following tests:

1. Blood Type Testing: This test establishes yourABO blood group. There are four blood groups - A, B, AB, and O. Since everyone has an inherent blood group, this is a basic test to avoid any adverse reactions due to blood group mismatches.
2. Human Leukocyte Antigens (HLA): The second test, which is a blood test for human leukocyte antigens (HLA), is also called tissue typing.
3. Crossmatch: We all have antibodies that are produced in order to protect us from infections and illness. In this test, the pathologist will test if your body already has antibodies to the donor kidney; if it does, your body will destroy the kidney.
4. Serology: Blood testing is conducted for potentially transmissible diseases, such as human immunodeficiency virus (HIV), hepatitis and cytomegalovirus (CMV).