• There is a huge demand supply gap between organs available for donation and the end stage organ failure patients waiting for transplant and this gap is widening every day
• Cadaver organ donation means donation of organs and tissues from a person who is brain dead due to some illness or injury. Brain dead patient means that the brain is totally & permanently dead while the function of the heart and lungs is maintained artificially by ventilator and medicines. In such a situation, one can get adequate time to discuss, plan and retrieve organs for transplantation
• The diagnosis of brain death is made only through the statutory protocol. Subsection 6 of Section 3 of the THOA 1994 states : Where any human organ is to be removed from the body of a person in the event of his brain-stem death, no such removal shall be undertaken unless such death is certified, in such form and in such manner and on satisfaction of such conditions and requirements as may be prescribed, by a Board of medical experts consisting of the following namely:
  • The registered medical practitioner in charge of the hospital in which brain-stem death has occurred;
  • An independent registered medical practitioner, being a specialist, to be nominated by the registered medical practitioner specified in clause (i), from the panel of names approved by the Appropriate authority;
  • A neurologist or a neurosurgeon to be nominated by the registered medical practitioner specified in clause (i), from the panel of names approved by the Appropriate Authority; and
  • The registered medical practitioner treating the person whose brain-stem death has occurred

As per the Transplantation of Human Organ Act two clinicians who are experts in the field (like neurologists or neuro-surgeons) are required for brain death certification. Ethically these clinicians must not have interest in or benefit in any way from transplantation of cadaver donor organs. They are expected to do two sets of tests six hours apart to certify brain death. One of these two clinicians should be a nominated member from the panel of doctors listed by the State Government for this purpose. The legal time of death in these circumstances is taken as the second set of brainstem death tests. The certification should be done on laid out forms as per the act. In a medico-legal case a forensic expert is also required for the certification. The medical director or medical superintendent of the hospital should finally countercheck and sign the form (Table-2- Form 8 THO Act). It is only after this has been done should ventilatory support be discontinued or retrieved.

The person who pledges his organs, must discuss this with his family, relatives and friends. This is for two reasons. Firstly, to stimulate them also to think on these lines, for a noble cause. Secondly, for them to know your wish & desire and to give the consent accordingly to the care givers at a time when you yourself would not be in a position to consent. It is also advisable to keep your Organ Donor Pledge card in your pocket, just as you keep your driving licence & credit cards etc.

Even if you have pledged your organs, they cannot be removed without the express & written consent of your family members, at the time of brain death.

It is important to know that any body who pledges his organs has the full freedom to withdraw his pledge at any time without assigning any reasons. This is allowed even if the pledge has been registered with the central registry.