A team of skilled and dedicated people have made facilitating organ transplant their mission

As the evening flight from Pune to Hyderabad is about to take off, there is considerable excitement amongst the ground crew. Are they waiting to welcome a VIP? In rushes a team of people carefully bringing in, not an important person, but an unusual container. There is a flurry of activity at check-in. The paper work is done in a matter of minutes and the container immediately loaded on to the waiting aircraft. It is a cadaveric organ meant for transplantation – a liver. At the other end, at Hyderabad, is a young patient, Mohan. Within minutes of its arrival, the waiting surgeons begin the complex procedure. When it is over, Mohan and his family are deeply gratified for his new lease of life. They bless the donor, the doctors, and the many dedicated people that have made this gift possible.

Today there are many such organ transplants being performed in Pune itself. Helping to carry out this praiseworthy task are Members of the Zonal Transplant Co-ordination Centre (ZTCC), Pune. (There are also ZTCCs in Mumbai, Nagpur and Aurangabad.) The Chairman of the Pune centre is Air Marshal (Retd.) S.S.Ramdas. Here are some of the key aspects – medical, legal, and procedural – of what is known as: cadaveric organ transplant.

The word "cadaver" here specifically means a person who has suffered brain-stem death. This is an irreversible condition, not to be confused with other causes of coma, which are potentially reversible. Once a person has suffered brain-stem damage, he or she is unconscious and unable to breathe spontaneously, and therefore has to be put on artificial ventilation. In the interval between brain-stem death and inevitable death as commonly understood, the heart continues to beat and the blood continues to circulate through the organs – making them suitable for transplantation.

There are well-established medico-legal rules and procedures to diagnose brain-stem death with precision. Only once these are carried out, is the patient officially declared brain-dead and the relatives approached for permission to remove organs. Once an organ is available, the ZTCC follows a priority-based system to decide how patients are allocated organs.

Every brain-dead person can give life to many others. Several organs - kidneys, liver, heart, lungs, pancreas - can be transplanted. Currently in India, kidney transplants are the most common; liver transplantation is in its infancy here. Besides the larger organs, corneas, skin, even the three little bones inside the ears can be transplanted. While they may not be life-saving, they can certainly enhance and enrich the life of so many others.

However, there are many problems holding back this laudable effort. Many are unaware of this programme or resistant to it. At times, even after a person has expressly stated that he would like to donate his organs, his family vetoes the idea. Only better public awareness and education can help in encouraging more people to give this precious parting gift.

Honorary Secretary/Chairman, ZTCC, Pune, c/o Renal Unit Office, K.E.M. Hospital,
TDH Building 2nd Floor, Rasta Peth, Pune-411 011, Phone: 4037363 (between 9-10 am, and 12-1 pm, on all days except Sundays and holidays)

- Mita Banerjee