Q&A Organ and tissue donation

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Transplant is truly an achievement of modern medicine. But this is dependent upon a gesture of donation and families of deceased donors who are willing to make this life-enhancing gift to others. One donor can save several people, restore the sight of two people and improve the quality of life for many more. The mission is to see that more people pledge to donate their organs and tissue after their death as more people stand to benefit. By choosing to join the Organ Donation Register you can help make sure that life goes on for others. Joining the register records your wish to allow the use of your organs and tissue for transplantation after your death. To decide whether or not you wish to become a donor after you have died is something very personal and it is important that everyone makes their own decision. This list of questions contains answers to the most commonly asked questions about organ and tissue donation and hopes to resolve the doubts you may have about leaving a legacy of life when you die.


To read the answer to a particular question click on the question.

Answer.

Organ donation is a voluntary decision to give organs to help a person in need of a transplant. This generosity of donors and their families can enable saving of lives of the tens of thousands in this dire need.

Answer.
  • Cornea- 1905
  • Kidney-1950
  • Liver-1963
  • Lung-1963
  • Hand-1964
  • Heart- 1967
  • Face-2010
Answer.

Liver, kidneys, heart, lungs, pancreas and the small intestine can all be transplanted. Techniques are improving constantly and it may not be long before one can say confidently that transplant in parts of the body is possible to help even more people. Very recently in 2010, the entire face was transplanted successfully in Spain.

Answer.

Tissue donation is the gift of tissue such as corneas, skin, bone, tendons, cartilage and heart valves to help others. The first successful cornea transplant was in 1905. Every year thousands of people with a severe eye disease or injury have their sight restored by donated corneas.
Skin transplant happens on patients who are affected severely with burns.

Bone, tendons and cartilage are used for reconstruction after an injury or during joint replacement surgery. A bone transplant can prevent limb amputation in patients suffering from bone cancer.

Heart valves are used to help children born with heart defects and adults with diseased or damaged valves. Skin grafts are used to treat people with severe burns.

Most people can donate tissue. Unlike organs, it may be possible to donate tissue up to 48 hours after a person has died. Reproductive organs and tissue are not taken from dead donors.

Answer.

No. We would require specific agreement for these forms of donation – either from you during your lifetime or from your next of kin after death. Let those close to you know your wishes.

Answer.

Each year hundreds of people die while waiting for an organ transplant. There is a shortage of organs and the gap between the number of organs donated and the number of people waiting for a transplant is getting larger.

Transplants as an option have successful outcomes and the number of people needing a transplant is expected to rise steeply due to an ageing population and an increase in organ failure.

In India, there is a huge potential due to the large numbers that die due to road traffic accidents. However, out of this, only a small number of people that die due to these circumstances are able to donate their organs. As organs need to be transplanted  as soon as possible following the deceased donor’s death, they can only be donated by someone who has died in hospital. Usually organs come from people who are certified as dead while on a ventilator in a hospital intensive care unit, which can be as a result of a hemorrhage, major accident like a car crash or stroke.

Another major reason for the shortage of organs is that many people have not recorded their wishes about donation or discussed it with their families. While only a very few people die in circumstances which would enable their organs to be donated, many people can donate tissue after their death.

Answer.

Organs are only removed for transplantation after a person has died. Death is confirmed by a team of doctors who are entirely independent of the transplant team and certified by the Deceased Organ Transplant Authority (DORTA).

Most organ donors are patients who die as a result of a brain hemorrhage, severe head injury, or stroke are on a ventilator in a hospital intensive care unit. In these circumstances, death is diagnosed by brain stem tests. There are very clear and strict standards and procedures for doing these tests and they are always performed by two experienced doctors.

The ventilator provides oxygen which keeps the heart beating and blood circulating after death. These donors are called heart beating donors. Organs such as hearts, which deteriorate very quickly without an oxygen supply, are usually only donated by a heart beating donor.

Patients who die in hospital but are not on a ventilator can, in some circumstances, donate their kidneys, and in certain circumstances, other organs. They are called non-heart beating donors. Both heart beating and non-heart beating donors can donate their corneas and other tissue.

Answer.

No. The patient is dead. A ventilator keeps the body supplied with oxygen and this means the heart will continue to beat and circulate blood. This preserves the organs so they can be donated for transplant. When the ventilator is turned off the heart will stop beating within a few minutes.

Answer.

No. It is the duty of a doctor to look after a patient and make every possible effort to save the patient's life. This is their first duty. If, despite their efforts, the patient dies, organ and tissue donation can then be considered but implemented only after a family gives consent.

Answer.

Yes, in a small number of hospitals, patients who are confirmed dead on arrival or die in the emergency department can donate kidneys, which are able to tolerate a longer period without oxygen as compared to other organs.

For this to happen steps have to be taken to preserve the kidneys until the next of kin are contacted. This includes a special technique in which the organs are flushed with a cold preservative fluid. This is done through a small tube which is inserted into a blood vessel in the groin.

This must be done very soon after death to ensure the organs remain suitable for transplantation and the person who has died is not deprived of the opportunity to donate. However, organ donation itself will not take place unless you, in your lifetime, expressed a wish to donate, or the person closest to you in life gives their permission. 
You can donate tissue whether or not you die in hospital, for instance if you die at home.

Answer.

Yes, in some cases. The shortage of organs has led to an increasing number of organ donations by living people.

The most common organ donated by a living person is a kidney as a healthy person can lead a completely normal life with only one functioning kidney. Kidneys transplanted from living donors have a better chance of long-term survival than those transplanted from people who have died. There are a number of reasons for this, the main one being that the donor is alive and healthy. Majority of transplants in India are from living donors.

Part of a liver can be transplanted and it may also be possible to donate a segment of a lung and, in a very small number of cases, part of the small bowel. For all forms of living donor transplants the risk to the donor must be considered very carefully. Before a living donor transplant can go ahead there are strict regulations to meet and a thorough process of assessment and discussion.

The transplant of human organ Act 1994 is the guiding law that binds the transplant program in India.

Donors are often a close relative but may also be individuals who are not related but have an established emotional relationship with the recipient such as a partner or close friend. The Transplant of Human Organ Act 1994 established the Transplant Authorized Authority (TAA). One of the TAA’s role is to regulate living donor transplants in India.

Answer.

In India, organs and tissue from a potential donor will only be used if that is their wish. You can indicate your wishes in a number of ways such as telling a relative or close friend, by carrying an organ donor card or recording your wishes on this Organ Donor Register. Putting your name on the Organ Donor Register makes it easier to establish your wishes and for those closest to you in life to follow them.

If your wishes are not clear, the person closest to you in life will be asked what they think you would have wanted, so it is important that you make sure they are aware of your views on organ donation.

Answer.

The Organ Donor Register is, quite literally, a life-saver. It is a confidential, computerised database which holds the wishes of people who have decided that, after their death, they want to leave a legacy of life for others. The register is used to help establish whether a person wanted to donate and, if so, what.

Answer.

Yes. Cards can and do get lost or damaged and you may not be carrying yours when you are taken to hospital. Adding your name to the register is a more permanent way of expressing your wishes. You can still carry a card if you wish to. Don't forget to tell your relatives what your wishes are.

Answer.

No. This information will only be used by Deceased Organ Retrieval and Sharing Organization to register your wishes on the Organ Donor Register and by registered hospitals in the event of your death. Your details are confidential for the purpose of organ donation only.

Answer.

Write in and ask (the confidential nature of the register means that we cannot tell you over the phone) or apply to join and our system will identify if you are already on the register and update any relevant details.

Answer.

Many things need to match or be very close to ensure a successful organ transplant. Blood group, age and weight are all taken into account. For kidneys another important factor is tissue type which is much more complex than blood grouping. The best results can be achieved if a perfect match is found. Normally, priority is given to patients who most urgently need a transplant.

Tissue is very occasionally matched, eg for size and tissue type, but otherwise is freely available to any patient in need of a transplant.

Answer.

Yes. Blood is taken from all potential donors and tested to rule out transmissible diseases and viruses such as HIV and hepatitis. The family of the potential donor is made aware that this procedure is required.

Answer.

Yes, in most circumstances. Having a medical condition does not necessarily prevent a person from becoming an organ or tissue donor. The decision about whether some or all organs or tissue are suitable for transplant is made by a healthcare professional, taking into account your medical history.

There are only two conditions where organ donation is ruled out completely. A person cannot become an organ or tissue donor if they have been diagnosed with HIV or have, or are suspected of having, CJD.

Answer.

Yes. The decision about whether some or all organs or tissue are suitable for transplant is always made by a specialist, taking into account your medical history. There may be specific reasons why it has not been possible to donate blood, such as having had a blood transfusion or having had hepatitis in the past. Or there may be reasons why you could not give blood because of your health at the time – sometimes a simple thing like a cold or medication that you are taking can prevent you from donating blood.

Answer.

Everyone irrespective of age or health and who is considered legally competent can join the Organ Donor Register. Joining the Register expresses a wish to help others by donating organs for use in transplantation after death but importantly, joining the Register is a way to publically give your consent for donation to take place. In order to make it legal, however, you would need to get your witnesses to sign as evidence of your wish. These witnesses should preferably be your next of kin.

Children can register but their parents, guardians or those with parental responsibility will be asked to provide their consent should the child's death lead to donation being considered.

Answer.

Yes, in the case of cornea and some other tissue, age does not matter. For other organs it is the person's physical condition, not age, which is the deciding factor. Specialist health care professionals decide in each case which organs and tissue are suitable. Organs and tissue from people in their 70s and 80s are transplanted successfully.

Answer.

No, none of the major religions in India object to organ and tissue donation and transplantation. If you have any doubts, you should discuss them with your spiritual or religious adviser.

Answer.

No. However, organs are matched by blood group and tissue type (for kidney transplants) and the best-matched transplants have the best outcome. Successful transplants are carried out between people from different ethnic groups wherever the matching criteria are met.

Answer.

Yes and no. Any special appeal usually results in more people agreeing to become donors and can increase the number of organs available.

However, family appeals through the newspapers and television will not result in an organ immediately becoming available for the person on whose behalf the appeal was made. The patient will still be on the transplant list, just like everyone else, and the rules that govern the matching and allocation of donor organs to recipients still apply.

Answer.

Yes. You can specify which organs you would wish to donate. Simply tick the appropriate boxes on your Organ Donor Register form or on the donor card, and let those close to you know what you have decided.

Answer.

No. Organs and tissue cannot be accepted unless they are freely donated. No absolute conditions can be attached in terms of potential recipients. The only restriction allowed is which organs or tissue are to be donated.

Answer.

Yes there is a possibility. However, given the altruistic nature of this donation, families usually accept this and take it as part of the process of donation.

Answer.

Organs and tissue are always removed with the greatest of care and respect for the person. This takes place in a normal operating theater under sterile conditions by a team of specialized doctors. After wards the surgical incision is carefully closed and covered by a dressing in the normal way.

Tissue can be removed in an operating theater, mortuary or funeral home. The operation is carried out by specialist health care professionals who always ensure that the donor is treated with the utmost respect and dignity.

Only those organs and tissue specified by the donor or their family will be removed.

Answer.

Yes. Families are given the opportunity to spend time with their loved one after the operation if they wish and this is facilitated by the transplant Co-ordinator. Arrangements for viewing the body after donation are the same as after any death.

Answer.

Inform the health care professionals who are involved either with your relative’s care or are helping you in the immediate period following their death (this could be a member of the hospital staff) that they wanted to donate. The earlier you are able to tell staff, the more likely it is that donation can take place.

Answer.

Organs and tissue that cannot be used for transplant will only be used for medical or scientific research purposes if specific permission has been obtained from your family.

Answer.

Confidentiality is always maintained, except in the case of living donors who usually already know each.

If the family wish, they will be given some brief details such as the age and sex of the person or persons who have benefited from the donation. Patients who receive organs can obtain similar details about their donors. It is not always possible to provide recipient information to donor families for some types of tissue transplant.

Those involved may want to exchange anonymous letters of thanks or good wishes through the transplant co-ordinators and in some instances donor families and recipients have arranged to meet.

Answer.

So that they know what you would like to happen after your death and can confirm or help inform the hospital staff what your wishes were. If you register your wishes without telling the people closest to you, it may come as a surprise at a time when they are trying to deal with their loss.

If you think you would find it difficult to raise the subject, you could try using these questions or a TV or newspaper story about a transplant to start a discussion.

Answer.

Studies have shown that in cases families will agree to donation if they knew that was their loved one’s wish. If the family, or those closest to the person who has died, object to the donation when the person who has died has given their explicit permission, either by telling relatives, close friends or clinical staff, or by carrying a donor card or registering their wishes on the Organ Donor Register, health care professionals will discuss the matter sensitively with them. They will be encouraged to accept the dead person’s wishes. There may, nevertheless, be cases where it would be inappropriate for donation to go ahead. It is strongly advised that your wish should be discussed clearly, in your life time.

Answer.

You can join the Organ Donor Register but to fulfil your donation wishes, healthcare professionals will need to speak to someone else at the time of your death who can advise on your medical and social history. This may be a doctor or a friend close to you. It is advisable also to tell the person closest to you in life, a friend of long standing or a close colleague, about your decision.

Answer.

Where the wishes of a person who has died are not known, health care professionals will rank people who had a relationship with them. This enables specialist health care professionals to seek permission for donation to know who they should approach and in what order. This ranges from a spouse or partner (including civil or same sex partner); parent or child; brother or sister and other relatives, to a long standing friend.

Answer.

No. By the time your will is read it is likely to be far too late for you to become a donor because organs and tissue need to be removed within 48 hours of death. This is why it is so important to let those closest to you know your wishes and to record them on the Organ Donor Register.

Answer.

Yes. You can log in to www.dorso.org and update the form asking for your name to be removed. We will also request your reason.

If you have an organ donor card, tear it up. Let your family know that you have changed your mind.

Answer.

While it is possible to retrieve sperm or eggs it is illegal to store either or to create an embryo without the prior, written consent of the donor.

Answer.

No, the transplant laws in India absolutely prohibit the sale of human organs or tissue.

Answer.

Blood is needed constantly, for all kinds of things, such as cancer treatments, operations and in child birth. There are thousands of places all over the country that hold blood donor sessions and new blood donors are always welcome. Almost anyone aged 17 to 60 years and in general good health can give blood.

Answer.

Without bone marrow, blood cannot be produced. When things go wrong and the bone marrow becomes damaged, for example as a result of treatment for leukemia or a related cancer of the blood, the patient must receive a transplant to survive.

Answer.

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Answer.

Liver transplantation involves removal of the old diseased liver which is replaced with a new one. This involves the need for a donor. This procedure comes under the purview of the law governed by the Transplant of Human Organ Act, 1994. This is a law mainly for the protection of organ donors so that they are not made victims of coercion in various social circumstances.

Answer.

In adults, a key reason for a liver transplant is cirrhosis. This can be caused by various diseases that destroy healthy liver cells. Certain causes of cirrhosis are

  • long-term infection from hepatitis B and C virus
  • Overuse of alcohol over time
  • autoimmune liver diseases
  • the buildup of fat in the liver
  • hereditary liver diseases

In children, a common cause for a liver transplant is biliary atresia. This is a condition where bile ducts are missing, damaged, or blocked. These are vital tubes that carry bile from the liver to the gallbladder and small intestine. When bile ducts are blocked, bile flows back to the liver and causes cirrhosis.

  • Other reasons for needing a liver transplant include
  • sudden liver failure, called acute liver failure, most often caused by taking too much paracetamol
    liver cancers that have not spread outside the liver

Please email us if you have any other questions, we will do our best to answer them.

We acknowledge that these questions are based on what has been compiled by the NHSBT- Organ Donation Website

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