World Organ Donation Day is observed on August 13, every year to raise awareness about the importance of organ donation and to motivate people for donating organs after death. Donating an organ is highly valued, as it is gifting and saving the life of someone, as one organ donor can save up to eight lives.
Organ Donation is retrieving a donor’s organ like heart, liver, kidneys, intestines, lungs and pancreas, after the donor is deceased, transplanting into another person who is in need of an organ. Also Read: World Organ Donation Day: Debunking The Popular Myths Of This Noble Act
As per the reports, the number of transplants done annually in India has been rising slowly around 5000 kidneys, 1000 livers and around 50 hearts. However, the current organ donation rate is very poor in India - 0.86 per million when compared to 46.9 Spain’s and America’s 31.96 per million. If India reaches a 1 per million donation rate, it would almost meet current demands for organs.
Who Can Be An Organ Donor?
All people should consider themselves as possible organ and tissue donors-irrespective of age, health and race. No individual is too old or too young to be a deceased donor. New-borns and even senior citizens into their 90s have been potential organ donors as the health of the organ is more vital than age. Even a person with an illness would be able to donate organs or tissues upon death, where the doctors would examine the organs and determine whether they are suitable for donation. However, a few conditions may totally inhibit a person from becoming a donor such as active cancer or systemic infection.
COVID-19 And Impact Of Organ Donation
With the COVID-19 Pandemic, organ donation and transplant surgeries and the need for donors have come to a halt. The cost of coronavirus disease is huge and has badly affected ailing patients who are in need of organ transplants. The organ transplantation programme was temporarily suspended during the lockdown as a measure to avert the spread of COVID-19.
Patients with end-stage diseases- kidney, liver, heart and lung failure are worried following the COVID 19 pandemic. While kidney failure patients can improve their health condition with continued dialysis, although are at a slightly higher risk of contracting Covid19. However, the ray of hope for a patient with a failing liver, heart or lung disease is now a question. The impact of COVid19 and delaying transplant has now become catastrophic. Also Read: Coronavirus: Causes, Symptoms And Treatment
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Are Tissue And Organ Transplant Patients At Higher Risk Of COVID-19?
As per the Global Alliance for Eye Banking (GAEB), currently, there is no evidence that SARS-CoV-2 viruses can be transmitted via blood transfusions or tissue transplants. While there is no report till the date of spreading the virus with organ transplant, however, it has been shown that coronavirus has a higher stimulus for the kidney, where it has been shown to replicate in almost 30%of patients. With regard to cornea transplant recipients, there is no risk, as they do not need blood group matching or oral medication to lower their immunity to avert rejection.
Apparently organ transplant recipients need a high dose of immunosuppression during the initial 3 months and a lower dose for a lifetime. It is felt that the infuse size of COVID- 19 required to infect a transplant patient may be lower and progression to life-threatening pneumonia are more prone.
The Indian Society of Organ Transplant (ISOT) suggests that living donor kidney transplantation may be best delayed during coronavirus period. However, living donor liver transplant may be considered in patients with acute life-threatening forms of liver failure.
Transplantation of heart, lungs, liver and kidneys following cadaver donation may be allowed to continue depending upon the stage and number of COVID-19 patients treated at the hospitals.
The National Organ And Tissue Transplant Organisation (NOTTO) Transplant Recommendations
- Transplant amidst COVID 19 is considered risky in view of the issues related to donor selection, recipient selection, and infection control risks.
- A transplant can only be considered in emergency cases in the hospital which has dedicated facilities to guarantee the safety of the recipient and team.
- The preoperative, perioperative and post-transplant areas, including the operation theatres, need to be particularly reserved for this purpose
- Staffs involved in the care of transplant patients should not be involved in the care of other patients
- Adequate availability of PPE, masks, disinfectants should be made available and reserved for patients care.
- The hospital should not be the one reserved for the treatment of COVID-19 patients and needs to have protocols for patient movement around the hospital to prevent hospital-acquired infection of COVID.
- A transplant procedure may be considered safe only after providing proper counselling on the risks involved due to COVID- 19 to the recipient and donor.