| ‘Take steps to encourage organ, tissue donation from road accident victims’ | | | New Delhi, Nov 9:
Training first responders, designating special teams in hospitals, upgrading trauma centres and registering them as organ retrieval centres are some of the steps suggested by the Centre to states to encourage organ donation, which is less than one deceased donor per million population in the country.
The central government has asked all states to organise state and district-level training programmes for first responders in emergencies, such as police personnel, ambulance drivers and para-medical staff, to facilitate organ and tissue donation from road accident victims.
In a letter, Dr Anil Kumar, Director of the National Organ and Tissue Transplant Organization (NOTTO), which is under the Union Health Ministry, said that India faces a critical shortage of organs for transplantation, with thousands of patients on the waiting list for different organs.
A large number of deaths occur due to road traffic accidents (RTAs), especially involving young and otherwise healthy individuals. According to the report titled “Road Accidents in India 2023” of the Ministry of Road Transport and Highways, around 1.7 lakh people were killed in road accidents in the year 2023 who could have been potential organ donors, the letter said.
“Many of these potential organ donors are lost due to lack of timely identification and referral,” it said.
While all efforts will be made to save the lives of accident victims, organ donation may be considered in identified brain stem death cases as per the procedures laid down in the Transplantation of Human Organs and Tissues Act, 1994 and its rules.
“The first responders in emergencies, namely police personnel, ambulance drivers, emergency medical technicians (EMT), para-medical staff, etc, can play a vital role in identification of potential donors and timely referral and harvesting of organs from those who give consent for donation,” Kumar said in the letter.
Kumar said that mechanisms should be in place for the flow of information from the first responders to the transplant coordinators available in the nearest trauma centres or hospitals or medical colleges.
The letter suggested organising training programmes by ROTTOs/SOTTOs, in coordination with the state government authorities for the first responders, incorporating basic knowledge about organ donation, identification and maintenance of potential donors, counselling and consent of the family members etc.
The timely and appropriate referral to designated trauma or organ retrieval centres can significantly enhance the rate of deceased organ donation in the country, it said.
According to the suggested action plan for implementation by the states and UTs, state-level and district-level training programmes should be organised for police personnel, ambulance drivers and emergency medical technicians (EMTs) under government and private ambulance services. It can be a cascading mode of training through training of trainers.
There should be integration of basic modules on organ donation awareness, brain stem death identification and standard operating procedures (SOPs) for trauma referrals into the training curriculum.
Necessary directions should be issued to State Ambulance Services (including 108, 102, and private operators) to ensure participation of all first responders for attending the training sessions.
The letter called for upgrading and strengthening all trauma centres with the necessary infrastructure and manpower required for organ harvesting from deceased organ donors.
Further, they may be registered as organ retrieval centres by the State Appropriate Authority as per the provisions of the Transplantation of Human Organs and Tissues Act.
In a separate letter, the NOTTO has also sought support in promoting tissue and bone donation, in addition to organ donation in the states and UT and in establishing robust systems for counselling, retrieval of tissues and their linkage with tissue banks.
“As you may be aware, there exists a significant gap between the number of patients requiring human organ and tissue transplants and the availability of donors in our country.
“While largely, there are systems in place for organ procurement and distribution, however, it is noted that many times tissues are not being harvested from deceased donors,” the letter said.
There is a substantial national requirement for tissues. For instance, India requires nearly one lakh corneas annually, yet only about one-third of this demand is being met. Bone donation, in particular, plays a vital role in the treatment of patients with trauma, non-union of bone fractures, congenital abnormalities and other bone-related disorders.
Tissues such as corneas, skin, bones and heart valves can be donated from cases of brain-stem-death and cardiovascular deaths happening within hospitals/natural death cases, the letter noted.
Tissues can be harvested up to six to ten hours after death. Therefore, it is essential that hospitals should constitute an organ and tissue donation team by involving brain stem death committee members and transplant coordinator/counsellor and establish a system for mandatory notification of cases of deaths happening in the hospitals to this team.
All deaths happening in any area of hospitals, like the ICU, ward and emergency, should be notified and efforts should be made for timely counselling of family members of potential donors for encouraging organ and tissue donation.
Even if the family does not agree to organ donation, the option for tissue donation must be given to the family, the letter said.
Hospitals should also make proper arrangements for tissue retrieval, processing and storage through linkages with registered tissue banks.
“Besides organ donation, by promoting tissue and bone donation also, we can significantly transform lives and improve the quality of life for many patients,” the letter stressed. |
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