Basic Guidelines For Organ Donation – Who Can Donate & Who Can’t

Donating your organs is a way to convey your desire to help lives after you are gone. It is not legally enforceable. Here are some factors to consider when making such a decision.

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Human cell, tissue, or organ transplantation saves many lives and restores vital capabilities when no other options are available.

According to the World Health Organisation (WHO), transplantation has become a successful worldwide practice in the last 50 years. However, there are significant discrepancies between countries in terms of the availability of acceptable transplantation as well as the level of safety, quality, and efficacy of human cells, tissue, and organ donation and transplantation. The ethical aspects of transplantation are prominent. The temptation to traffic in human body components for transplantation is heightened by unmet patient needs and a scarcity of transplants.

"One organ donor can save up to 8 lives if all the vital organs are donated after their death in what is referred to as deceased donation. While we are alive also, we can also donate a kidney or a part of our liver to a person who may need it. This is called Living Donation. Both donations save lakhs of lives every year across the globe," Sunayana Singh, CEO of Organ India stated. 

In India, the Transplantation of Human Organs & Tissues Act of 1994 clearly regulates the removal, storage, and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs.

However, not everyone can be an organ donor. The CEO of Organ India explained some things to keep in mind while making the decision to donate organ: 

Deceased donation is something we can all pledge to do in our lifetimes. People can take the pledge online or at an event by filling up a donor form and submitting it to the concerned government authority or NGO. However, not everyone will be able to donate their organs once they have passed away. Organ donation in India can typically only take place if the deceased has died a Brain Death.

Brain death or brain stem death results from a severe irreversible injury to the brain which causes all the brain activity to stop, due to which a person cannot sustain his/her own life. In cases where the patient who has been injured is taken to the hospital and put on life support, despite being declared brain dead, he or she is still breathing (artificially) and circulation to vital organs is maintained for a period of time. Therefore, the organs can be kept viable at the time of brain death and can be surgically removed for organ donation after the consent of the deceased’s family is taken. Without family consent, there will be no donation. So, ensure that you communicate your wish to be a donor to them.

Doctors will of course ensure that the organs are in a condition in which they can be donated. Those suffering from any form of cancer, sepsis (infection), or having a severe viral disease at the time of death cannot be donors. Those suffering from HIV or Hepatitis can possibly donate to others suffering from the same disease. The decision will be taken by the treating physicians.

If someone dies outside of a hospital the vital organs cannot be donated as the heart stops beating (cardiac death or what we may call natural death) and organs will cease to function within minutes of the heart-stopping.  In a cardiac death, all tissues such as corneas (eye donation), skin, heart valves, bones, ligaments, etc. can be donated.

In the case of a living donation, a person may wish to donate one kidney or a part of their liver to someone who is suffering from organ failure. In India, the law restricts these donations to ‘near relatives’ of the donor (grandparents, parents, children, siblings, spouse, and grandchildren above 18 years of age. If a person wants to donate an organ to someone other than a near relative (uncles, aunts, in-laws, stepparents, close friends, etc.), then they need to take approval from the state or district Authorization Committee. This is to prevent any kind of organ trading. 

The fitness of the donor must be assessed by the transplant team before the donation takes place. The primary importance for the treating team is the health of the donor.  A committee will evaluate the independent decision-making of the donor and will approve the case for donation only once they have assessed the mental stability of the donor and the motivation behind the donation.

Last but not least, pledging your organs for donation is a way of expressing your wish to save lives after you are gone. It is not legally binding. The decision-makers are going to be your family and next of kin who will give consent upon your death. So if you want to be an organ donor, that’s wonderful, but do let your family know.