Organ Donation In India Research Articles

Cadaveric organ donation: Indian perspective

Cadaveric organ donation in India, although started long back; its present status is not favourable. The percentage gain is very slow in comparison to most of the country even after having proper legislation. There are many reasons for this, lack of awareness being the most common. Most of the people does not know the concept of brain death. Although government and many NGOs are attached with it and are trying their level best to communicate with people for this noble cause, they have not yet reached the expected goal.To boost up the process of cadaveric organ donation, the hospitals and their staff including doctors must play a vital role. Hence, knowledge and orientation of such potential group is important for further processing because in most of the hospitals even doctors are not well-informed about the legal and ethical aspects of organ donation. If all the weak locus are addressed properly, we can definitely achieve the goals within a short span of time.

Organ Transplantation in India: NOT for the Common Good.

Organ Transplantation in India: NOT for the Common Good.

An empirical investigation on the impact of attitudes towards organ donation in India.

Background: Organ shortage is a global issue and it is imperative to take steps to bridge this gap. In the Indian context, despite its demographic dividend, the rate of organ donation has been abysmally low. This emphasizes a need to demystify the antecedents of organ donation intention among the Indian population. Methods: Using a cross-sectional research design and adopting a post-positivism research philosophy, this study identified 259 respondents by adopting a purposive sampling approach and data on knowledge of organ donation was collected using a structured, pretested questionnaire. Results: Awareness of organ donation law in India is low on specific issues and respondents from the health science & medicine discipline scored better on knowledge about organ donation. The findings show that most participants had heard about organ donation and had a favourable attitude toward it. The primary sources of information on organ donation were television and newspapers, and healthcare service providers. A complementary partial median is established (β= .217, t = 5.889,p < .001) which implies that willingness to discuss with family significantly mediates the association between attitude towards organ & tissue donation and willingness to sign the donor card. Conclusion: This study revealed that there is a general awareness of organ and tissue donation among the Indian population, but they lack clarity on certain specific issues. Mass media has to be effectively used to build awareness campaigns revolving around enhancing knowledge on a specific issue and building acceptance of the concept of organ and tissue donation.

An empirical investigation on the impact of attitudes towards organ donation in India

Background: Organ shortage is a global issue and it is imperative to take steps to bridge this gap. In the Indian context, despite its demographic dividend, the rate of organ donation has been abysmally low. This emphasizes a need to demystify the antecedents of organ donation intention among the Indian population. Methods: Using a cross-sectional research design and adopting a post-positivism research philosophy, this study identified 259 respondents by adopting a purposive sampling approach and data on knowledge of organ donation was collected using a structured, pretested questionnaire. Results: Awareness of organ donation law in India is low on specific issues and respondents from the health science &amp; medicine discipline scored better on knowledge about organ donation. The findings show that most participants had heard about organ donation and had a favourable attitude toward it. The primary sources of information on organ donation were television and newspapers, and healthcare service providers. A complementary partial median is established (β = .217, t = 5.889, p &lt; .001) which implies that willingness to discuss with family significantly mediates the association between attitude towards organ &amp; tissue donation and willingness to sign the donor card. Conclusion: This study revealed that there is a general awareness of organ and tissue donation among the Indian population, but they lack clarity on certain specific issues. Mass media has to be effectively used to build awareness campaigns revolving around enhancing knowledge on a specific issue and building acceptance of the concept of organ and tissue donation.

A Cross Sectional Study on Knowledge and Attitude towards Organ Donation among Medical Students

Background: The organ donation in India was very low when compared to other countries. As the medical students were future health care professionals who were the first contact of potential donors family, the knowledge and attitude of medical students towards organ donation is of utmost important for the success of the organ donation program in a country. Objectives: This study aimed to assess the knowledge and attitude of medical students regarding organ donation at Government Medical College, Ananthapuramu, Andhra Pradesh, India. Methodology: This is a descriptive cross-sectional study, conducted among third year medical under graduate students of a Government Medical College between January to March 2023. Data was collected by structured, self-administered questionnaire from 141 third year MBBS students who were selected by convenient sampling. A structured, self-administered questionnaire consisting of 25 questions was used, which includes details on socio demographic characteristics, knowledge, attitude and practice towards organ donation. Results: The findings showed that a majority (90%) of the students had satisfactory knowledge regarding organ donation, 80% of the medical students expressed their willingness to donate their organs. Which implies there was a gap between knowledge and attitude. Conclusion: The study indicates that there is a need to introduce this topic into the curriculum, and by conducting frequent Continuing Medical Education (CME), they can become future donors and they motivate their patients, which can lead to an increase in organ donation rate.

Outcome of Patients Waitlisted for Deceased Donor Liver Transplantation During COVID-19 Pandemic: A Single-Center Experience

COVID-19 pandemic has strained several healthcare resources across the world. While liver transplantation (LT) is the only curative therapy for patients with end-stage liver disease, we aimed to determine the clinical outcome of patients waitlisted for deceased donor liver transplantation (DDLT) during COVID-19 pandemic. A retrospective comparative observational study of adult patients waitlisted for DDLT from January 2019 to January 2022 at our liver unit (Dr Rela Institute and Medical Center, Chennai, Tamil Nadu, India) was carried out. Patient demographics, disease etiology, Model for End-Stage Liver Disease - Sodium (MELD-Na) score were calculated for all patients listed during the study period. Clinical event was defined as number of DDLT, death in the absence of transplant, and patients awaiting LT were compared. Statistical analysis was performed with SPSS V24.0. In total, 310 patients were waitlisted for DDLT, of whom 148, 63, and 99 patients listed during 2019, 2020, and 2021 (till January 2022), respectively; 22 (53.6%), 10 (24.3%), and 9 (21.9%) patients underwent DDLT in the year 2019, 2020, and 2021 (P=0.000); 137 patients (44.19%) died on the DDLT waitlist of whom 41 (29.9%), 67 (48.9%), and 29 (21.1%) in the year 2019, 2020, and 2021 (P=0.000), respectively. Waitlist mortality was significantly higher during the COVID first wave. COVID-19 pandemic has significantly impacted patients waitlisted for DDLT in India. With limited access to healthcare facilities and decreased organ donation rates during the pandemic, there was a considerable reduction in the patients waitlisted for DDLT, lesser number of patients underwent DDLT, and higher waitlist mortality during the pandemic year. Efforts to improve organ donation in India should be strongly implemented.

Overcoming Challenges of Deceased Organ Donation in Indian Private Hospitals.

Overcoming Challenges of Deceased Organ Donation in Indian Private Hospitals.

Vision and mission of the new Editor-In-Chief

Vision and mission of the new Editor-In-Chief

Challenges and Motivators to Organ Donation: A Qualitative Exploratory Study in Gujarat, India.

Despite the global efforts to improve organ donation, there is a demand-supply gap for organs in India. The only solution to meet this disparity is to improve deceased donor transplants in the country through victims of road accidents. The government has instituted several initiatives to achieve this goal. However, challenges and barriers continue to affect the organ donation process. The present study aims to document the motivating factors and obstacles in the decision of families to donate organs in Ahmedabad, Gujarat and their suggestions to improve the processes involved in organ donation. A qualitative exploratory study (in-depth interview) of ten relatives of deceased organ donors was conducted from Oct 2021 to Feb 2022. Interviews were audio recorded, and detailed notes were taken during the interview. Thematic analysis was done using ATLAS.ti version 8 software. The significant motivators identified were family members' belief or conviction that it would help save the lives of others; a sense of moral obligation to do so as bodies of brain-dead persons can contribute to this noble goal, no use of the body after death, an extension of life, and being a role model for others. The challenges were mistrusting the organ donation process, fear of being responsible for any mishappening, and feeling of shock. The suggestions to improve organ donation included awareness creation, simplifying the legal process for accidental deaths, providing benefits to the donor family, and a system for identifying potential donors and their counselling. The present study reflects the need for a more comprehensive awareness campaign to generate awareness and remove the misconception about organ donation in India. The findings of the study can be helpful for policymakers to amend the current organ donation process in India and improve the disequilibrium of demand and supply of deceased donations in India.

Gender discrepancies in organ donation in India: The invisible road to exploitation of womanhood?

Gender discrepancies in organ donation in India: The invisible road to exploitation of womanhood?

The empathy factor: The role of empathy in knowledge, attitude, and practice of organ donation in India - A crossectional, observational study

Background: Due to the scarcity of organs available for transplantation, several patients lose their lives each year. Increased awareness and positive attitudes alone may be insufficient to increase an individual's willingness to donate (i.e., the basic tenets of the knowledge-attitude-practice/KAP model). Therefore, it is pertinent to examine other psychological determinants that are associated with engaging in the altruistic/prosocial act of organ donation. Objective: To understand the association between empathy and KAP of organ donation in an Indian population. This pilot is the precursor to a larger project which aims to develop and test an empathy intervention to promote organ donation. Methods: Using a cross-sectional design, Indians (N = 419; female = 261; mean age = 28.48 years) aged 18 years and above were recruited using convenience sampling through an online survey. Questionnaires included the Awareness, Attitudes, and Practice of Organ Donation (Chakradhar et al., 2016) and Empathy Quotient-8 (Loewen et al., 2010). Multiple regression analyses were carried out to analyze the data. Results: Results showed that empathy was related to: (i) Total KAP (β = 0.123, P = 0.014), and (ii) attitudes (β = 0.195, P < 0.001) towards organ donation. Conclusion: These pilot study findings indicate that public health messages focused on evoking empathy can use the technique of patient/donor narratives, and training clinicians on empathic communication skills can help increase individuals' KAP of organ donation. Further, this pilot elucidated the need to conduct mixed-method studies with a donor and nondonor population and clinicians prior to developing and testing a larger empathy-centered intervention aimed at promoting the KAP of organ donation.

Bold policy changes are needed to meet the need for organ transplantation in India

Twenty-five years after India passed legislation to legalize brain death, deceased donor transplantation remains underdeveloped while the country has established formidable capacity for living donor transplantation. Because of a large number of potential deceased donors, there is hope that deceased donation could help meet India's enormous need for organ transplantation. However, significant policy and practical barriers limit progress. The vast majority of potential deceased donors are poor motor vehicle accident victims who present for care in hospitals without the necessary infrastructure or expertise to support deceased donation. In contrast, transplant infrastructure and expertise are concentrated in private hospitals and are only accessible to those with the ability to pay. Given these realities, the potential of deceased donor transplantation can only be recognized if Indians who are likely to donate organs are also provided access to transplantation. In this viewpoint, we review the current status of organ transplantation in India and propose new policies to establish a national organization to oversee deceased donor services in all states, to fund resources needed to support deceased donation, to leverage the existing living donor infrastructure to advance deceased donor transplantation, and call for establishment of government policy on funding for posttransplant care and immunosuppression.

Health System Building Blocks and Organ Transplantation in India.

Health System Building Blocks and Organ Transplantation in India.

On the Way to Self-sufficiency: Improving Deceased Organ Donation in India.

On the Way to Self-sufficiency: Improving Deceased Organ Donation in India.

Organ donation in India and Nurses as a change to lead in Organ Donation: Scooping Review of Organ Donation

Organ donation is the donation of biological tissue or an organ of the human body from a living or dead person to a living recipient in need of a transplantation. Organ transplantation has made rapid strides over the last 6 decades and established its status from an experimental procedure to a well-established treatment modality. The great part of organ donation is most people can be organ donors. Nurses as being the largest part of any health care fleet can play a pivotal role in the dissemination of the right information, and nurse’s knowledge and commitment towards spreading awareness and motivating people pledging for organ donation are extremely important for the success of organ donation program.

How to set a heart transplantation unit in India - A narrative review

Cardiovascular diseases (CVDs) have become the leading cause of mortality in India. This epidemiological transition is largely because of the increase in the prevalence of CVDs and CVD risk factors in India. In 2016, the estimated prevalence of CVDs in India was estimated to be 54.5 million. Heart failure (HF) is a major health problem in India with a postadmission mortality of 20%–30%. Heart transplant is the final treatment for HF if intractable to medical management. Number of heart transplantations done in India is still very less compared to the disease burden and may be attributed to less awareness for organ donation in India. As the number of heart transplantation is increased drastically in the past decade, we need to have proper information about heart transplantation program in India. This is our attempt to simplify information regarding heart transplantation for cardiothoracic units planning to start such a program.

Perspective on organ donation in India: A comprehensive review

In twentieth century, one of the utmost wonders of medical sciences, which have saved the lives of many patients, is Organ donation. Successful recovery of life saving organs is a multifaceted process that involves a team work of specialists. The present article aimed to review the concept of Organ donation, organ donors, legal aspects, process of pledging organs by an alive person, the current perspective in India and attempts by government authorities to promote awareness about this concept.

Analysing Process of Organ Donation and Transplantation Services in India at Hospital Level: SAP-LAP Model

Organ donation and transplantation services portray a sub-system of modern healthcare organizations, which is a complex adaptive system. Across the world, there is a marked gap between the numbers of available organs for transplant and potential recipients in the waitlist. To date, researchers have struggled to comprehend the reasons for these disparities, yet the subject received relatively little attention from the system’s perspective. The outcome of organ transplantation requires the coordinated effort of many actors like donors, recipients, families, physicians, transplant coordinators and other hospital staff. They may belong to cross-functional departments and institutions, often operating with different motivations and objectives. In this study, we use Situation-Actor-Process (SAP) and Learning-Action-Performance (LAP) inquiry model, to systematically inquire the organ donation in India. With SAP-LAP, we attempt to understand the complexities and interactions among the current situation, involved actors and processes affecting organ donation at the macro- and micro-level of policy formation. The SAP part brings an insight into the present condition of the organ donation system in India. A model representing flexible interaction among situation, actors and processes is developed for a better systemic understanding. Then, LAP fetches the learning followed by the suggested actions that need to be taken for improving the performance of the organ donation system. Through a case study conducted in an Indian hospital, we explore the reasons for operational inefficiencies at the micro-level. The study identified non-value-adding activities like waiting, excess motion, inappropriate processing and defects; and value-adding activities like training intensivist, training transplant coordinator, raising awareness among family members, excess inventory and use of information and communication technology. The research brings up multiple, self-adjusting, unpredictable and interacting pathways that lead from a potential organ donor to an organ receiver, thus targeting process improvement through a holistic approach.

Deceased-Donor Organ Transplantation in India: Current Status, Challenges, and Solutions.

Tamil Nadu, Gujarat, Telangana, Maharashtra, Kerala, Chandigarh, Karnataka, National Capital Territory of Delhi, and Rajasthan are states and union territories having active deceased-donor organ transplant programs in India. Transplant data (2013-2018) have been collected by the National Organ and Tissue Transplant Organization from all states and union territories of India and submitted to the Global Observatory on Donation and Transplantation. From 2013 to 2018, 49155 transplants were reported in India, including 39000 living-donor organ recipients and 10 155 deceased-donor organ recipients. These transplants were for kidney (living donor = 32584, deceased donor = 5748), liver (living donor = 6416, deceased donor = 2967), heart (deceased donor = 895), lung (deceased donor = 459), pancreas (deceased donor = 78), and small bowel (deceased donor = 8). According to 2018 data, India was the second largest transplanting country in the world in terms of the absolute number of transplants. Here, we discuss the status, progress, challenges, and solutions for deceaseddonor organ transplantation. The plan to increase rates of organ donation in India include the following points: teamwork and focus by intensive care unit doctors; public education on organ donation using social media; professional education and family donation conversation programs for brain death declaration and donor management; organ procurement organizations; international collaboration and regular meetings and updates for organizations working in the field of organ transplantation; grief counseling and reporting of potential donation for families of recently deceased people; nonfinancial incentivization to families of potential organ donors; expert committees and standard operating protocols for use of marginal donor organs, donation after circulatory death programs, and machine perfusion; maintenance of transparency and ethics in organ donation, allocation, and transplantation as directed by governmental, nongovernmental, and intergovernmental entities; and regular audit of progress and registry data.

Analysis of Organ Utilization From Deceased Organ Donation in India

ObjectivesThis report presents an audit of utilization of various organs from deceased donors in different states of India over a 3-year period MethodsData released by the various regions on their official website was analyzed from 2015 to 2017.Regions with less than 25 donations per year were excluded while calculating utilization rates. ResultsTotal organ donation in India had increased from 570 to 843 donations from 2015 to 2017 (47.8% increase) with southern states performing exceedingly well compared with northern states. Total organs retrieved during the 3-year period were 6659 with a 54.7% increase in organ retrieval in 2017 compared with 2015 (2592 vs 1675 respectively). The net utilization rate of kidneys was 87.35%. Total liver transplants done during this period were 1894. Net liver utilization rate was 86.81% over 3 years. Total Heart transplants during this period were 641 with net utilization rate of 28.98%. An increase in utilization rates was observed from 2015 to 2017 (19.33%-34.46%). A total of 217 lung transplants were done with net utilization rate of 8.86% with an increase in yearly utilization rate from 6.5% in 2015 to 11.97% in 2017. Total pancreas transplants remained low with 48 transplants over 3 year duration with net utilization rate of 2.25% but an increase in utilization rate was observed. (0.92% in 2015 to 2.1% in 2017). ConclusionThere is a significant regional variability in organ utilization in India. Evaluating and addressing the cause of high variability can further increase the transplant activity.