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In
the first half of twentieth century, a lot of
surgical research on animal organ transplantation
was done by Jaboulay, Carrel and Ulmann. Their
work contributed greatly towards the first successful
human kidney transplant performed by Murray between
identical twins, in 1954. In 1959, a group of
neurosurgeons from Lyon in France, described a
condition termed "death of the nervous system".
This was the first description of the clinical
state known as "brain stem death" today.
Subsequent research led to the successful transplantation
of functioning organs, retrieved from such brain
dead cadavers with beating hearts. Developments
in the field of immunosuppresion and human organ
preservation revolutionized the science of cadaver
organ transplantation through the last two decades
of the twentieth century. Since the late 1980s,
human organs like heart, lungs, liver, kidneys,
bowel and pancreas are being retrieved from brain
stem dead cadavers and transplanted regularly
into patients having organ failure from various
diseases. Such operations have an impressive success
rate of greater than 85% and the transplanted
organs function for several years giving new lives
to the recipient patients, who would have surely
died without the transplant.
Individual transplant organizations have been
set up throughout the western and former Soviet
block countries to coordinate the complex and
elaborate activity required for conducting cadaver
organ transplantation. Such organizations work
to facilitate the donation of cadaver organs and
ensure proper sharing of organs between the various
transplant centers on the basis of best tissue
match for recipient patients. Such transplant
coordinating organizations have a wide range of
activity including counseling of relatives of
the brain dead cadavers, contacting potential
recipients, organizing laboratory investigations
and arranging hospital operation theatre schedules
for the donor and recipient operations. The enormous
success of the transplant programme in the mentioned
countries is almost entirely due to the intransigent
endeavor of these transplant coordinating organizations.
Our organization, Ganadarpan, is in the process
of starting a transplant coordinating centre,
which will serve our state.
In the late 1990s, while I was training in liver,
pancreas, kidney and bowel transplantation, in
the University of Cambridge and University of
Leeds, ! became painfully aware of the fact that
organ donation was almost nonexistent amongst
the Asian population of Britain. In 1999, I had
the opportunity to attend The World Congress of
Transplantation in Montreal, Canada. Interacting
with delegates in that Congress, I found to my
dismay, that cadaver organ donation was extremely
unpopular throughout the Oriental World, including
Japan, China, Korea, Southeast Asia and the Indian
Subcontinent. The rest of the world has an impression
that the Oriental world is steeped in tradition
which prevents people from coming forward for
donating organs of their loved ones, even in the
event of brain stem death. With the rise of economic
prosperity in the whole of the Oriental world,
modern medical technology will become more and
more available to the population at large. With
the widespread availability of artificial life
support systems in the intensive care units of
hospitals throughout the Oriental world, even
greater number of trauma and cerebral bleed patients
will be brain dead, on such systems with there
hearts beating, blood circulating and organs functioning
for several days. Such brain dead, heart beating
cadavers form an invaluable pool of potential
organ donors. Transplant doctors and organization
like ours (Ganadarpan) involved in setting up
a transplant coordinating center, face a mammoth
task of making our society break with tradition,
in order to come forward and donate organs, for
giving fresh lease of life to patients dying from
organ failure diseases. Availability of advanced
transplant technology will ultimately help to
break the tradition of not donating organs.
Ganadarpan wants to turn this tradition of nonparticipation
to a tradition of voluntary donation in order
to save lives. |
