There can be no greater human work than giving new life or new light to another human being after death. Awareness regarding Organ & Tissue Donation in India has increased rapidly in the last few years. Many people express their desire to donate organs after death in their will or will and family members also wish to donate their organs to perpetuate the memory of their deceased loved one. When a person dies at home (Natural/Cardiac Death) instead of in the ICU of a hospital, the biggest dilemma families face is which organs can now be donated. Many times people think that they can donate kidney, liver or even heart at home, whereas the rules of medical science are exactly the opposite. There is a huge biological and medical difference between death at home and 'brain death' in hospital, which is very important for every citizen to understand. Brain death vs cardiac death: What is the medical difference between the two and why does donation of solid organs stop? To understand the rules of organ donation, it is first necessary to understand the two types of death: 1. Cardiac death (death due to natural/heart attack – which usually happens at home): When a person's heart stops beating forever, the blood circulation and oxygen supply in the body stops at that very moment. Due to lack of blood, within a few minutes (3 to 5 minutes) all the major solid organs of the body get affected by 'Warm Ischemia' and get damaged forever. Therefore, in case of cardiac death at home, only tissues can be donated, not living organs. 2. Brain death (brain stem death – which occurs only in the ICU of a hospital): This condition occurs in cases of severe head injury, brain hemorrhage or stroke where the patient's brain stops functioning completely and permanently, but with the help of ventilators and life support systems, his heart continues to beat and blood and oxygen continue to reach the organs. In such a situation, solid organs (like heart, liver, kidney) are safely removed and transplanted on ventilator support in the ICU. Which organs/tissues can be donated after death at home? If a person has died at home, the following tissues and structures can be successfully donated within the next 4 to 6 hours: 1. Cornea/Eye Donation: This is the most common and simplest donation that can be done at home. Instead of removing the entire eyeball, only the upper transparent layer of the eye pupil i.e. 'cornea' is removed. Donating one person's cornea can bring vision back into the lives of two corneal-blind people. It should be taken within 4 to 6 hours (maximum 8 hours in winter) of death. 2. Skin Donation: Skin transplant proves to be life saving for severe burn victims and acid attack victims. Skin can be donated within 6 hours of death. The Skin Bank team comes to the home and removes a very thin layer (micron level) of skin from the thighs and backside. There is no bleeding and no deformity occurs on the body; Later a bandage is tied on that area. 3. Bones & Tendons (Bone & Cartilage Donation): Bones, joints and cartilage can be donated to bone cancer patients, severe bone fractures in accidents or for replacement surgeries. It is extracted by bone bank experts within 6 to 8 hours of death. 4. Heart Valves: Even if the entire heart does not function, the heart valves (Aortic/Pulmonary Valves) survive for hours even after cardiac death. These are removed and used to replace defective valves in children and heart patients. 5. Blood Vessels / Veins: Veins are used for bypass surgery and vascular reconstruction. Which organs cannot be donated at all after death at home? Donation of the following vital organs is not possible after natural death at home: Kidneys: The kidney nephrons are completely damaged within 30 minutes of cardiac arrest. Liver: As soon as the supply of oxygen stops, the liver cells start destroying rapidly. Whole Heart: After the heartbeat stops, it is not possible for the heart to beat again in any other body. Lungs: After breathing stops, the alveoli of the lungs immediately constrict and become useless. Pancreas and Small Intestine: These organs are extremely sensitive without oxygen and become ineligible for transplant within minutes. All these solid organs can be donated only when the patient is admitted to the hospital and a 4-member team of doctors declares him legally 'brain dead'. 5 important immediate steps to donate eyes or skin after death at home If the family wants to donate eyes or organs after death at home, then take these steps immediately before the medical team arrives: Switch off the room fan immediately: Running the ceiling fan dries up the cornea of the deceased and can get damaged. If there is an air conditioner (AC) in the room, turn it on so that the temperature remains cool. Keep the eyes closed and keep wet cotton: Gently close both the eyes of the deceased and place cotton soaked in clean water or rose water on them. Place a pillow under the head: Place a pillow under the head of the deceased and keep the head about 6 inches higher than the torso, so that there is no accumulation of blood on the eyes and face. Keep the death certificate ready: Make sure to get the death certificate (Medical Certificate of Cause of Death) made from a registered doctor, because without the official doctor certification no one can start the banking process. Immediately call the National Helpline or local Eye Bank: Immediately contact the National Organ and Tissue Transplant Organization (NOTTO), Government of India, toll-free number 1800-11-4770 / 1919 or call the nearest Eye Bank/Red Cross in your city. The team completes the procedure after reaching home in 15 to 30 minutes. Any organ of a person suffering from which diseases cannot be donated? Under strict safety and infection control protocols, organ or tissue donation is not accepted if the deceased has had the following diseases: HIV/AIDS Active infection with Hepatitis B or Hepatitis C Rabies or tetanus Blood cancer (Lymphoma) or active cancer that has spread throughout the body (metastasis) Brain infection (Encephalitis/Meningitis) or Septicemia (blood Donating cornea and skin even after natural death at home can brighten the dark life of a blind person and give a new lease of life to a burnt patient. Taking care of time and following the correct procedure makes this great donation successful.
