Brain Death and Organ Donation

What is Brain Death and how is it related to organ donation? A brain stem death or brain death results from a severe irreversible injury to the brain or haemorrhage which causes all the brain activity to stop. All areas of the brain damaged and no longer function, due to which a person cannot sustain his/her own life, but vital body functions may be maintained by an artificial support system. This maintains circulation to vital organs long enough to facilitate organ donation. Patients classified as the brain stem dead can have their organs surgically removed for organ donation.

A Brain Dead person has absolutely no chance of recovering. Brain death is a form of death and is irreversible. To know more

Once brain stems death or brain death has been declared, the person is dead, but their organs are still alive because they have been kept alive through artificial means. This means that if a person dies at home or anywhere else, and their heart stops beating, they cannot donate their vital organs, because the organs of a person who has died a cardiac death will die within minutes of the heart stopping. Therefore, the only time you can donate your vital organs is if you are in hospital and have been declared brain dead.

In case of cardiac death, it is possible to donate your corneas and tissues Such as bones, skin, veins, blood stem cells, blood and platelets, tendons, ligaments, heart valves, cartilage and even your body.

While the incidence of brain death is obviously less common than cardiac death, it is important to remember that organ donations will take place only if everyone is aware of when and how they can donate organs.

Procedures for Brain Stem Death Declaration in India

Organ donation after Brain Death is strictly regulated. According to the provisions of the Transplantation of Human Organs & Tissues Act, THOTA 1994 the protocol for declaration of brain stem death or brain death has been defined. Any organ donation process must involve the following steps before the actual transplant can occur:

• A Panel of 4 doctors, 2 of whom must be from a panel approved by the government need to declare the brain stem death. This test as per law has to be done twice, with a gap of 6 hours between the two tests. This panel needs to include:
• A Registered Medical Practitioner in charge of the Hospital where the brain stem death patient is admitted.
• A Registered Medical Practitioner nominated from the panel of Doctors who have been approved by the Appropriate Authority.
• A Neurologist/Neuro-Surgeon. (If a Neurologist/Neurosurgeon is not available to carry out the tests, then any Surgeon or Physician and Anaesthetist or Intensivist who is nominated the by Medical Administrator In-charge from the panel of names who has been approved by the Appropriate Authority can be included in the pane).
• The Registered medical practitioner treating the deceased. The results of the tests are recorded on Form 10 of the THOT Act 2014. The family's consent is obtained on Form 8.

This Organ Donation Procedure is strictly followed. The certifying clinicians must have no interest or benefit in any way from the transplantation of cadaver donor organs. The legal time of death in these circumstances is taken as the second set of the brain stems death tests. The certification should be done on laid-out forms as per the act. The medical director or medical superintendent of the hospital should finally countercheck and sign the form. It is only after these formalities have been completed, should organs be retrieved.