World Organ Donation Day, 13th August, What is Organ Donation? Types, Most Important Significance and Unknown Facts

World Organ Donation Day: World Organ Donation Day is observed on August 13 every year globally to raise awareness about the importance of organ donation and to make people aware of the misconceptions of organ donation. Donating organs is considered a noble cause as it amounts to leasing a person a new life. The earliest successful organ donation had been made possible in the year 1954. A man named Ronald Lee Herrick donated a kidney to his identical twin brother. Since then, this field of medicine has come a long way.

Ronald Lee Herrick was the first person to donate his organ. In 1954, he denoted his kidney to his twin brother, and Dr Joseph Murray was the doctor who carried out this successful organ transplantation process. Later in 1990, He was honoured with Nobel Prize in Physiology and Medicine for bringing advances in organ transplantation.

In 1954, the kidney was the first human organ to be transplanted successfully. Until the early 1980s, the potential of organ rejection limited the number of transplants performed. Medical advances in the prevention and treatment of rejection led to more successful transplants and an increase in demand. Liver, heart and pancreas transplants were successfully performed by the late 1960s, while lung and intestinal organ transplant procedures were begun in the 1980s.

Today, the U.S. system for organ donation and recovery is among the best in the world. As a result of innovation and continuous improvement, more patients in need of organ transplant than ever have received the gift of life.

World Organ Donation Day

According to the World Health Organization, only around 0.01 percent of people in India donate their organs after death. In India, one can pledge to donate their organs to the nodal body, National Organ and Tissue Transplant Organisation (NOTTO), an organisation under the union health ministry.The organisation is headquartered at the Safdarjung Hospital in New Delhi. Please be noted that one donor can save upto eight lives.

Concerning the organ donation initiatives, different parts of the world tackle the unawareness and importance of organ donation based on their conditions and capacity. In India, to promote the act of organ donation, national organ day is celebrated on 27th Nov, which was started in 2010 under the Ministry of Health & Family Welfare by the National Organ and Tissue Transplant Organization (NOTTO).

What is Organ Donation?

Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin. Donation may be for research or, more commonly, healthy transplantable organs and tissues may be donated to be transplanted into another person.

Common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Some organs and tissues can be donated by living donors, such as a kidney or part of the liver, part of the pancreas, part of the lungs or part of the intestines, but most donations occur after the donor has died.

Organ donation is the entire practice of retrieving a human organ from a living or deceased person, who is referred to as a Donor, and transplanting it into a recipient. The recipient will be a patient who is suffering from organ failure and who will not survive unless she/he receives an organ replacement. The process of recovering organs is called Retrieval.

Which Organs Can Be Donated?

Let’s take a closer look at the different organs that can be donated by a person after death and while the person is still alive. There are eight organs that can be donated and transplanted:

1. Kidneys: Both kidneys can be donated by a deceased donor. On average the lifespan of a transplanted kidney is around nine years, but it varies from individual to individual. Of all organs in the human body, the demand for kidneys is the highest, and kidneys are the most frequently donated organs. A kidney disease most likely affects both kidneys at the same time. A living donor can easily donate one kidney to someone and function well for the rest of their lives.
2. Liver: The liver is an important organ with primary functions of bile production & excretion; excretion of bilirubin, cholesterol, hormones, and drugs; metabolism of fats, proteins and carbohydrates; enzyme activation; storage of glycogen, vitamins and minerals; synthesis of plasma proteins; blood detoxification and purification. The liver is the only organ in the human body that can grow cells and regenerate. A donated liver from someone who has died (a deceased donor) can further be split into two pieces and transplanted into two different people to save their lives. A living donor can have a portion of her/his liver removed to donate to someone, and the remaining portion will regenerate to almost its full previous size.
3. Heart: A heart is a muscular organ which pumps blood through the human body. In a person’s life, the heart will beat around 2.5 billion times on average and keep the blood running in the body. After being retrieved from the donor, a heart can survive for 4-6 hours only.
4. Lungs: Single or double-lung transplants can be performed from deceased donors. Additionally, living donors can donate a single lobe from the lungs, though it will not regenerate.
5. Pancreas: A deceased donor pancreas can be transplanted into an ailing patient. A living donor can also donate a portion of the pancreas and still retain pancreas functionality.
6. Intestine: After death, a donor can donate their intestine. Although quite rare, a living donor can donate a portion of the intestine.

In addition to organs, you can also donate tissues such as corneas, skin, bones, ligaments, heart valves etc.

Which Tissues Can Be Donated?

Layers of cells that function together to serve a specific purpose are called Tissues. Most Tissues should be donated within 6 hours of the donor’s death.

1. Cornea: Cornea donation or eye donation is the most common tissue donation. The Cornea is a transparent covering over the eye. It is also the eye’s primary focusing element. Recipients who suffer from corneal blindness can gain their sight again after a corneal transplant. These patients are those who may have been blinded by an accident, infection or disease. Either the entire Cornea can be transplanted or it can be transplanted in parts. A Corneal Transplant is does not need any anti-rejection drugs in the recipient. Corneas from all ages of recipients are effective as long as the Doctors as they are healthy.
2. Bones: Bones from deceased donors are used to replace bones of recipients whose bones are cancerous. A Bone transplant can be done instead of amputating the cancerous arm.
3. Skin: Skin can be used as grafting for burn victims, acid attack victims or for post-mastectomy breast reconstruction, amongst other things.
4. Veins: Donated veins are commonly used in surgeries for cardiac bypass.

Apart from these, other tissues that can be donated are muscles, tendons, ligaments, cartilage and heart valves.

Types of Organ Donation

There are two types of organ donations – Living Organ Donations & Deceased Organ Donations.

Living Organ Donation: This is when you retrieve an organ from a healthy living person and transplant it into the body of someone who is suffering from end-stage organ failure. This is commonly done in the case of a liver or a kidney failure (because the liver can grow back to its normal size and a donor can survive on one kidney).

Living donors are classified as either a near relative or a distant relative/friends etc.

A near-relative is spouse, son/daughter, brother/sister, parents, grandparents and grandchildren.

Those other than near-relative can be distant relatives and friends who will need the permission of the State Authorization Committee to donate organs. If the hospital refuses to entertain such cases, the patient may send a legal notice to the hospital for not following the Transplant Act.

Deceased Organ Donation: When we talk about pledging your organs for donation or about organ donation after death, we are talking about Deceased Organ Donation. This is an organ donation from a person who has been declared brain stem dead by a team of authorized doctors at a hospital. A person is said to be brain stem dead when there is an irreversible loss of consciousness, absence of brain stem reflexes and irreversible loss of the capacity to breathe.

A lot of people think that whenever and however they die, their organs can be donated. That is not true. In India, organ donation after death is only possible in the case of Brain stem death.

Donation after cardiac death is common in the West, but in India it is rare for donations to take place after cardiac death.

Although it is possible for organs such as the liver and the kidney to be easily donated from a living donor to a recipient, we should work towards an environment where everyone donates their organs after their deaths (if they can), so no living person should have to donate an organ to another.

What Organs Can Be Donated After Death?

All organs and tissues that are viable can be donated after a person dies.

The medical condition of the person at the time of death can determine what organs and tissues can be donated and what cannot be. Organs need to be removed as soon as the person is declared brain-dead. Without the necessary oxygen supply, the organs stop functioning right.

The approximate amount of time between recovering the tissues/organs and transplanting them is:

• Lung – 4 to 6 hours
• Heart – 4 hours
• Liver – 24 hours
• Pancreas – 24 hours
• Kidney – 72 hours
• Cornea – 14 days
• Bones – 5 years
• Skin – 5 year
• Heart Valves – 10 years

This is why creating a tissue bank (heart valves, skin, bones etc.) is possible but creating an organ bank is not. In case of organ transplantation, the process has to be very quick in order to save a life.

Some facts about Organ Donation

• In the case of natural death tissues of cornea, heart valves, bone and skin can be donated whereas other vital organs like heart, liver, intestines, kidneys, lungs, and pancreas can only be donated in the case of brain death.
• There is no specific age for organ donation, but the donor’s medical conditions are strictly verified and monitored.
• If someone younger than 18 wants to donate an organ, they must have consent signed by their parents or guardians.
• In 2015, an infant who donated a kidney to an adult with renal failure became the youngest organ donor. The infant lived only 100 minutes after birth.
• The oldest known donor is from Scotland, who donated a cornea after a 107-year-old woman died in 2016. The oldest known organ donor was a 95-year-old man from West Virginia who donated his liver after he died.
• India has Human Organ and Tissue Transplantation Act to regulate organ donation in the country. The law allows both dead and living people to donate organs.
• According to the World Health Organization, about 0.01% of people in India donate their organs after death.
• There is only 3% of registered organ donors in India.
• According to 2019 AIIMS data, 1.5-2 lakhs of people require a kidney transplant yearly, but only about 4% able to get it. Similarly, approximately 80,000 patients require liver transplantation yearly, but only 1,800 ultimately receive it.
• Indian Organ Donation Day is being celebrated every year on November 27 to commemorate the contributions made to society by deceased donors and their families. From 2023, the National Organ Donation day is being celebrated during August 3 to commemmorate the first successful deceased heart transplant in India on 3rd August 1994.
• The National Organ and Tissue Transplant Organization (NOTTO) has declared July as the month of Organ donation to commemmorate 8th July 1994, when Transplantation of Human Organs Act (THOA), an Act to provide the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs and tissues was enacted in India.
• India ranks third in the world only behind USA and China as per the data available on the Global Observatory on Donation and Transplantation (GODT) website.
• The total number of organ transplants done per year in the country has increased from 4990 in the year 2013 to 15,561 in the year 2022.
• As per estimates, only 0.65 organ donations per million population take place in the country.
• Around one lakh patients require corneal or eye transplants annually, but less than half of people get it.
• Even for a heart transplant, of the 10,000 who need a heart transplant, only 200 matches with donors.
• There are only three percent registered organ donors in India.
• The network of organ donation, collection and replacement through the State Organ and Tissue Transplant Organization (SOTTOs) at State-Level,  Regional Organ and Tissue Transplant Organization (ROTTOs) at Regional Level and National Organ and Tissue Transplant Organization (NOTTO) at National Level
• One person can save eight lives and enhance 75 others through organ, eye and tissue donation.
• Nearly 114,000 Americans are currently waiting for an organ transplant, nearly 22,000 live in California. An organ transplant is their only remaining medical option.
• On average, 150 people are added to the nation’s organ transplant waiting list each day—one every 10 minutes.
• Sadly, an average of 22 patients die every day while waiting, simply because the organ they needed was not donated in time.
• Approximately 98 organ transplants take place every day in the United States, that’s more than 36,000 people who begin new lives a year!
• A living donor can provide a kidney or a portion of their liver, lung, pancreas or intestine to someone in need.
• More than 1 million tissue transplants are performed each year and the surgical need for tissue has been steadily rising. Corneal transplants, meanwhile, restore sight to 50,000 people each year.
• One tissue donor — someone who can donate bone, tendons, cartilage, connective tissue, skin, corneas, sclera, and heart valves and vessels — can impact the lives of as many as 75 people.
• 1954 – First successful kidney transplant performed.
• 1966 – First simultaneous kidney/pancreas transplant performed.
• 1967 – First successful liver transplant performed.
• 1968 – First successful isolated pancreas transplant performed. First successful heart transplant performed.
• 1981 – First successful heart-lung transplant performed.
• 1983 – First successful single-lung transplant performed. Cyclosporine, the first of a number of drugs that effectively treat organ rejection by suppressing the human immune system, introduced.
• 1984 – National Organ Transplant Act (NOTA) passed ( USA ).
• 1986 – First successful double-lung transplant performed.
• 1987 – First successful intestinal transplant performed. UNOS begins collecting medical data on donor and transplant recipients.
• 1988 – First split-liver transplant performed.
• 1989 – First successful living donor liver transplant performed.
• 1990 – First successful living donor lung transplant performed.
• 1992 – UNOS helps found Donate Life America to build public support for organ donation.
• 1998 – First successful adult-to-adult living donor liver transplant performed.
• 2000 – U.S. Department of Health and Human Services publishes Final Rule (federal regulation) for the operation of the OPTN.
• 2001 – For the first time, the total of living organ donors for the year exceeds the number of deceased organ donors.
• 2014 – Vascularized composite allografts (VCAs) is added to the definition of organs covered by federal regulation (the OPTN Final Rule) and legislation (the National Organ Transplant Act). The designation went into effect on July 3, 2014.
• 2017 – The number of deceased donors top 10,000 in the United States for the first time.
• 2022 – In a historic milestone, the U.S. reached 1 million transplants, more than any other country in the world.
• Organ transplantation in the Indian state of Tamil Nadu is regulated by India’s Transplantation of Human Organs Act, 1994 and is facilitated by the Transplant Authority of Tamil Nadu (TRANSTAN) of the Government of Tamil Nadu and several NGOs. Tamil Nadu ranks first in India in deceased organ donation rate at 1.8 per million population, which is seven times higher than the national average
• The state has been awarded the ‘Best State Award’ in cadaver organ donation from the National Organ and Tissue Transplant Organisation, for five consecutive years (2015–19).
• In 1999, Uma Preman donated one of her kidneys to a stranger she met at a hospital. For 24-year-old Salil Kumar, who had all but reconciled himself to a lifetime of dialysis and an early death, this was a new lease of life. Preman had to appear in front of a medical committee in Tamil Nadu to convince them that her donation was altruistic and she had no hidden motives behind her generous act. Hers was one of the first recorded cases of altruistic donations in the state.
• In September 2008, 15-year-old Hithendran from Chennai was declared brain dead after a fatal motorbike accident. Both his parents were doctors and took the brave decision to donate all his organs. His heart was used the same day to save the life of an 8-year-old girl. Hithendran’s case became a turning point and Tamil Nadu’s high rate of organ donation is often attributed to the ‘Hithendran Effect’
• When he died in a road accident, 20-year-old Anmol Juneja gave a new lease of life to 34 people. At the time of his death, all his organs were working except his brain. Anmol’s case marked many firsts – His eyes were donated to four people as a result of India’s first such technique where an eye could be transplanted in two people. His was also the first case of a 100% liver transplant.
• In July 2010, a baby girl in Mahbubnagar, now in Telengana died just 4 days after she was born. Her uncle broached the topic of organ donation with her family and they consented. Her eyes and heart valves were harvested to save 2 other young lives, making this unnamed baby girl India’s youngest donor.
• In May 2016, the Pune Traffic Police created a ‘green corridor’ to escort an ambulance carrying the ‘heart’ of an accident victim from Pune to Mumbai in a record 94 minutes. The route usually takes anywhere between 2.5 and 3 hours.
• A “green corridor” refers to a route that is cleared out for an ambulance carrying the harvested organs to ensure its delivery at the destination in the shortest time possible
• The hospitals involved in a transplantation, city traffic authorities, and in certain cases, airport authorities collaborate to transport an organ from one hospital to the next
• The formal name of “green corridor” was given in July 2014 when a hospital and police in Chennai coordinated to transport a heart from one hospital to another in half the regular time. The system has been used effectively in cities such as Mumbai, Gurgaon, Hyderabad, Bangalore, Kolkata, and Indore.
• Green corridors are generally used for transporting heart and liver, which have the shortest preservation times of four to six and 12 to 15 hours, respectively.
• The means of transportation is often by road, but air ambulances are also employed when the organs require transportation to different cities or states

Organ Donation Process In India

In India, awareness about organ donation is a growing concern. Our country has a wide gap between patients needing transplants and the organs available through recipients. Moreover, according to a survey In India, every year, about 500,000 people die because of the non-availability of organs, 200,000 people die due to liver disease, and 50,000 people die because of heart disease. Further, 150,000 people await a kidney transplant, but only 5,000 get among them. In such a scenario, organ donation and awareness about the same can play a significant role in helping to save the lives of various individuals who need immediate transplants.

Organ transplant plays a vital role in the life of people who are suffering from genetic conditions like polycystic kidney disease, cystic fibrosis, or a heart defect. Infections like hepatitis and diabetes, physical injuries, and accidents can also raise a need for a transplant. However, the transplant process can vary depending on the organ, although the need to match a donor with a recipient is significant and critical throughout the year.

For an organ recipient, the transplant process begins when a qualified doctor puts them on an organ transplant list. For this, the doctor will need to examine the patient and diagnose them with a severe medical condition that requires them to be on the transplantation list. Overall, organ transplantation is a complex process involving many details, including blood group and other body values to match the donor and the recipient. Further, other factors may play a key role depending on the organ involved. For instance, the donor and their recipients must have compatible antibodies and similar body sizes in a kidney transplant.

Once a patient is eligible for a transplant, surgery is conducted when a matched donor becomes available. When an organ becomes available, the patient who requires a transplant must respond quickly to the call from their surgeon. Since surgery needs to occur within a fixed duration (generally four hours) as organs cannot survive for long outside the body, the patient must reply almost immediately to the call.

After understanding the importance of organ donation, here are some simple steps to help you become an organ donor in India. According to the information released on the AIIMS, there are two ways in which a person can become a donor. The first is when a person themselves pledges their organs while they are alive, and the second is after their death when the family decides to donate their organs.

Organ Donation Steps

If a person wants to become a donor, the steps that they need to follow to become include the following:

1. Download the donor form from the official website. This is free of charge and does not involve any cost. Some websites that allow you to become organ donors include National Organ and Tissue Transplant (NOTTO), Regional Organ and Tissue Transplant Organization (ROTTO), which provides for Seth GS medical college websites and KEM Hospital in Mumbai, Govt. Multispecialty Hospital in Omnadurar, Chennai, Institute of PG Medical Education and Research, Kolkata, and Guwahati Medical College in Assam, among others.
2. After downloading the form, fill out the “Organ/Body Donation” form.
3. After this, you will need two witnesses’ signatures on the donor form, one of whom must be a near relative of the person who wants to donate their organs.
4. If your request is accepted, a Donor Card with a registration number will be sent to your official address.
5. Once a person becomes a donor, they should share this decision with their family and friends.

The hospital also accepts unregistered donations if a person dies without signing up to become a donor. In that case, a family member can decide to donate the organs of the person who has died after signing a consent form.

Also you can refer the below organ donation process by AIIMS

1. Organ Retrieval Banking Organisation (ORBO) coordinates the process of cadaver organ donation i.e.organ donation after death and transplantation.
2. There are two ways to donate organs: –
   1. By pledging for organ donation when a person is alive
   2. By consent of family after death.
3. During lifetime, a person can pledge for organ donation by filling up a donor form in the presence of two witnesses, one of whom shall be a near relative.
4. The organ donor form could be obtained from ORBO either personally or through mail.  It could also be downloaded from our Website (www.orbo.org).
5. The donor form is absolutely free of cost.
6. As mentioned earlier, you need to fill up the donor form and get it signed by two witnesses one of whom shall be a near relative and send the same to ORBO.  
7. After receiving the filled in form, ORBO provides the donor with an organ donor card bearing registration number on it.
8. It is suggested to keep the donor card in your pocket and share your decision with your near and dear ones.
9. If a person expires without registration, the family members can donate his/her organs.  For this they need to sign a consent form, which is provided at that time.
10. Once, the relatives give a written consent, organs are harvested within a few hours.
11. The family of the donor does not face any difficulty or extra burden upon them.
12. The transplant coordination team carries out the entire process till the relatives receive the body of the deceased.
13. The deceased body is given back to the family in a dignified way.
14. There is no disfigurement.  The body can be viewed as in any case of death and funeral arrangements need not be delayed.

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