Organ Donation: AIM

Organs are a National Resource,

Not even a single one to be wasted

Let The Life Bloom

Pledge to Donate Organs ≥ 18 years

• The person who donates is DONOR

• Who receives is RECIPIENT

Just One Donor can

save the lives of more

than eight people and

improve the quality of

life of many others

In case of Brain-Death

Any age group

Types of Donors

Living Donors ( ≥ 18 years)1. Near Relative - Includes grandparents,

grandchildren, in addition to spouse, son daughter, father, mother, brother or sister

2. Other than near relative (Distant relative/Friends etc)

3. Swap Translation

Cadaver/ Deceased Donors (Any Age)

Living Organ Donation

Kidney

Liver

Huge gap between demand and supply of Human Organs for Transplantation

Organs Requirement Availability

Kidney 2,00,000 6,000

Liver 30,000 1,500

Heart 50,000 15

Why We Need Deceased Donation?

Living donation alone

can not fulfill requirement

Certain organs cannot

be taken from living source

Deceased Organ Donation

Two Lungs Intestine

Heart Two Kidneys

Liver Pancreas

Organs can not be stored

Preservation Time of donated Organs

0 10 20 30 40 50 60

Kidneys

Pancreas

Liver

Intestin…

Lungs

Heart

Hours

Hours

4-6

4-8

6-10

12-15

12-24

24-48

Tissues donation

Cornea Heart Valves

Skin Bone

Tendon Cartilage

Tissues can be stored in Tissue Bank

State-wise Deceased Organ Donor

S. No State 2014 2013 2012 ODR

1 Andhra Pradesh 52 40 13 0.6

2 Chandigarh 6 N A N A 5.7

3 Delhi - NCR 20 27 12 1.2

4 Gujrat 28 25 18 0.5

5 Karnataka 39 18 17 0.6

6 Kerala 58 35 12 1.7

7 Maharashtra 52 35 29 0.5

8 Puducherry 13 2 N A 10.4

9 Tamil Naidu 136 131 83 1.9

10 U. P. 7 N A N A 0.04

TOTAL 411 313 196 0.16

0

20

40

60

80

100

120

140

160

2014

2013

2012

State-wise Deceased Organ DonorThree years trends

State-wise Organ donated in year 2014

State-wise Organ donated in year 2014

0

50

100

150

200

250

Kidney

Liver

Heart

Organ Failure

Organ failure is serious illnesses

Responsible for significant morbidity and mortality across the world.

Can be prevented: Organ transplantation

Causes of Organ Failure

Kidney

Diabetes & High B.P. common causes

Liver

Hepatitis B common cause

Hepatitis C

Alcoholic Liver disease

Cirrhosis

Liver Cancer

Heart failure

Cardio-myopathy

Ischemic heart disease

pmp-per million population

Reasons of Organ shortage

Family resistance to give consent

Negative attitude

Poor awareness

This could be due to the following reasons –

Religion

Myth & Fear

Legal aspects

Media report on Organ

Trafficking

Deceased Donation Rate per million population

World Deceased Donation Status

How can we increase the donors?

• By Giving Group talks about Deceased Organ donation

Religious Heads

School/ Colleges/ Universities Work Place/ Office etc

DO WE HAVE POTENTIAL DONORS?

YESPatients of

Stroke, Hemorrhage, Trauma etc.

According to WHO (status on road safety 2013)

In India highest absolute number of deaths

due to road accidents : 1.3 lakhs (approx 10%)

deaths out of total world’s 12.4 lakhs

Road Accident in India/year

• Approximately 1.3 Lakhs

• Which age Group majority victims ??????

• Suppose 10% are Brain Dead

• How many Organs we have ??????

Eye donation

India Total Population 118 Crore

Daily Death -- 62389

Daily Birth --86853

Total Blind --682497

If daily death people donate their eyes within 11 days all blinds will be able to see.

Then in India there will be no blinds.

Need for the Act

Gross imbalance between the new

patients being added for transplant and available donors

To protect vulnerable poor

from organ trafficking

Awareness and positive attitude

towards deceased organ donation

Organize a system of organ and tissue procurement and

distribution for transplantation

Donor

Recipient

THOA came into existence in year 1994

THOA was amended in year 2011 &

come into force with effect from

10-1-2014.

Transplantation of Human Organs and

Tissues Rules 2014 have been notified

on 27-3-2014.

Transplant of Human Organs Act

Transplantation of Human Organ Act

Purpose:

Regulation of removal, storage & transplantationof human organs/tissues for therapeuticpurposes

Prevention of commercial dealings in humanorgans

Highlight: “Brain-Stem Death (BSD)”

Highlight of Act: Recognition of BSD

“Brain-Stem Death (BSD)” means the stage atwhich all functions of the brain stem havepermanently and irreversibly ceased and is socertified

Brain Stem dead Patient can not breathe on hisown and is put on ventilator and othersupports to keep the circulation and heartmoving which maintains viability of organs

Brain Death

Punishment for Violation

Whosoever carries out removal or transplantationswithout authority is punishable for up to 5 years and a fine of

up to Rs. 10,000

Now enhanced to 10 years and 5 lacs

in transplantation of Human Organ Act

2011

As per Act 1994

Amended Act 2011

Punishment for Violation

Commercial dealings, like indulging in monetary

transaction for trading in human organs are punishable with

imprisonment ranging from 2 - 7 years, and a fine of Rs.

10,000 to Rs. 20,000

Enhanced to 5-10 years and a fine

between 20 lakhs to 1 crore in

Transplantation of Human Organ Act

2011

As per Act 1994Amended Act 2011

Establishment of NOTTO

• What: NOTTO is an Apex National Networking Organization, established under DGHS, MoHFW, GOI

• When: NOTTO was established under the aegis of DGHS in November, 2010 (EFC)

• Why: To organize a system of organ procurement & distribution & networking

• Where: 4th & 5th Floor, ICMR Building, SafdarjungHospital

Mandate of the NOTTO

To Create National Networking & Registry

To Provide a system for Procurement & Distribution of Organs & Tissues

To Promote Deceased Organ and Tissue Donation

NOTTO

National Human Organ & Tissue

Removal & Storage Network

Biomaterial Centre

National Human Organ & Tissue Removal & Storage Network

• Apex Centre for all India activities as under

– For Coordination & Networking

– Procurement, Distribution of Organs and Tissues

– Registry of Organ & Tissue donation & Transplantation

Transplant/Retrieval

Hospitals must be

registered with State

Appropriate Authority

Registration with NOTTO

Mandatory under THOA Act

to create National Networking

Creation of National Networking

SOTTO SOTTOSOTTO

T R T R T R

SOTTO

RTT R

SOTTO

ROTTO ROTTOROTTO ROTTO ROTTO

B B BB B

NOTTO

T – Transplant, R – Retrieval , B –Biomaterial Centre

Networking with Regional & State level organizations

Identified Regional & State level organizations

Procurement & Distribution Protocol

Local Level

SOTTO/ State Level

ROTTO/ Regional Level

Person of Indian Origin

Foreigner List

Availability of Donor

Check for Recipient

availability

Co-ordination from procurement to transplantation

24 X7 Helpline No.-1800-11-4770

Information to NOTTO call

centre

Brain Dead Donor available with details of

blood Group, Age

Information to State

Networking Organization or Nodal Officer

Check for availability of Recipient in

the District or State

Transport feasibility to other State

Maintain National data-bank

Waiting list Registry Patient waiting with a potential Living donor Patient waiting for Deceased Donor

Donor Pledge Registry Organ and tissue pledge through Form 7 Online & Offline Pledger demographic details

Transplantation Registry Living donor details

related donorother then near related donor

Cadaver donor details Recipient details Transplant & Follow-up details

Building a National Registry

Waiting List Registry

National Waiting List of Patients

Pledge Registry

• Pledge with NOTTO (≥ 18 Years age)

– Offline by Filling Form 7

– Online by visiting NOTTO

Website www.notto.nic.in

ONLINE PLEDGE

Mode of Pledging

OFFLINE PLEDGE

Pledging

Who has not consentedis not a donor, Choose toregister as donor

Presumed Consent i.ewho has not refused is adonor, you can registernot to be a donor

India

Spain

Transplant Registry

Transportation of Organs

Green Corridor

Organs are a National Resource,

Not even a single one to be wasted

Success Story on Green CorridorMessage from Dr. Balakrishnan,

Chief Heart Transplant Surgeon, Chennai

The recipient is the 16 years old boy from Delhi withsevere ventricular dysfunction due to dilatedcardiomyopathy and was very sick. We used a Dornieraircraft from the Indian navy coast guard. It took off fromChennai Arakkonam airbase at 4 am and reachedAurangabad by 7 am. By 9 am the organ harvest was overand the return flight landed here by 12:45 pm and theheart implant was over in half an hour by 13:15 hours. Inanother one and half hours, he was in the ICU. He is fine.This is the longest air transfer of a heart in this country of1800 kms and ischemic time of over four and half hours.We thanks NOTTO for the wonderful organization to makethis donation possible to save a young boys life. We arevery grateful.

Donor-Recipient

Donate Organs-Save Lives

Consultancy support on the legal and non-legal aspects

Capacity Building

National Biomaterial Centre

Four Tissue banks

VALVES

Four Tissue banks continued..

NOTTO Website www.notto.nic.in

NOTTO CALL CENTRE 24X7

Toll-free Helpline No. 1800-11-4770

Identifying potential donor Counseling & Motivation

Consent Brain death certification

Arrangements for organ harvesting Liasoning with the police

Arranging for the postmortem, early release of the body & transport

Recipients and arrangements for transplant

Advocacy & Awareness

IEC and information campaign for

Prevention of organ trafficking

Celebrity Pledged for Organ Donation

Promotion of organ donation

Celebrity Pledged for Eye Donation

Advocacy & Awareness Contd…

Organ & Tissue pledging programmes

–Felicitation and award for donor families and promoters

Advocacy & Awareness Contd…

I E C

Information

• Required Request Board

• Developed IEC material

• FAQs • SOPs for

Retrieval of Organs to transplant

Education

• Training of Transplant Coordinators

• National Standardized Course Curriculum for Transplant Coordinators

Communication • Competition of

LOGO, Slogan & Background of Donor Card through My.gov

• Audio Video spots script finalization

• Poster and slogan Competition at VMMC & SJH Hospital

• National advocacy Conference for sensitization of State Health Secretaries, Director Health Services and other Stakeholders on NOTP

Required Request

PM’s Mann Ki Baat

Hon’ble Prime MinisterShri. Narendra Modigave inspiring talk inMann Ki Baat on 25thOct 2015 & 29th

November, 2015 topromote OrganDonation and itsimportance from BrainStem Death Cases.

Average Calls in Call Centre

11 14 27 26 50 41

654

1867

707

976

0200400600800

100012001400160018002000

Call

Call

6th Indian Organ Donation Day on 27th

November 2015 at Vigyan Bhawan

All Religions Support Organ Donation

Exhibition at VAMSCON 29th Jan- 31st Jan

2016

Movie Making Competition on Organ Donation

at VAMSCON 2016

First Health Cricket Tournament by MoHFW to

Promote Organ Donation in 2015-2016

Sense of Urgency

Almost half a million people per year are dyingof end stage organ failure.

Only a handful of transplant are being offeredat the moment.

The focus should not be on how manytransplant are done, but how many patientsare not getting transplant done.

A sense of urgency has to develop among allof us.

Be an Organ DonorShare your life

Share your decision

Sign a Donor card

Website: www.notto.nic.in

Helpline: 1800-11-4770

Thanks

And it is expected you will Opt In

(For Organ Donation)

Any Questions are Welcome

Death is not the last sleep, It’s the final awakening

.

Don’t take your Organs to Heaven, Heaven knows we need

then Here