Organ Donation and Transplant Coordinator

Rajeev Maikhuri –Transplant Coordinator , AIIMS

There is lack of awareness about deceased organ and tissue donation except corneas in the society. Acute shock due to the sudden loss of near and dears, non-acceptance of brain death as death, religious myths, fear of disfigurement and divided opinion are some of the conflicting factors which prevent people from donating organs and tissues after brain death.
There is a huge gap between demand and supply of human organs and tissues. In our country, 1-1.5 lac patients require kidney transplantation but only 3500-4000 patients receive it. Similarly, 1 lac patients are in need of corneal transplantation but only 25000 patients undergo corneal transplant. In case of heart transplantation, the scenario is much more dismal in our country.

However, organ donation is an activity, which, apart from involvement of health care professionals, requires active support of society at large, without a donor there can be no transplantation.

Medical advances in the field of transplant immunology, surgical management and techniques of organ preservation have made the transplantation of human organs a viable approach for the treatment of end stage organ diseases. When vital organs like heart, lungs, liver, pancreas etc. suffer a functional damage that cannot be repaired by drugs or any kind of conventional surgical treatment, organ transplant is often the only solution to the problem. Procurement of human organs, however, has been the biggest challenge to the success of transplant programme in the country. Although the removal of human organs for therapeutic purposes has been legalized by the government, it has not yet received social sanction to facilitate cadaver transplant in our country. Professionally qualified Transplant Coordinator (TC) play a crucial role in procurement of human organs for transplantation.
Several TCs have a responsibility for both organ donation and transplantation but in some areas, the role has been split and there are both procurement and recipient TCs, both providing a 24h service for their speciality. A recipient TC is the named person who coordinates the care of patients who are referred to a transplantation service or programme, with a view to transplantation, and thereafter, until discharge. The main responsibilities of the Procurement TCs are twofold:
1 To increase the number of organs and tissue made available for transplantation
2 To facilitate the process of organ donation and transplantation

Therefore a major role of the TC is one of education. Appropriate education programmes are provided for both the general public and health care professionals, particular emphasis being placed on the education of health care professionals who work in the critical care areas where most of the donors are identified. Another important aspect of the TC role is to facilitate
the organ retrieval process. At the time of a donation the TC works closely with the medical and nursing staff on the referring unit, as well as with the donor's family. The TC always remains the central point during the retrieval process, thus ensuring minimal disruption to the referring unit. Follow up information regarding the outcome of the donation is provided for both the donor hospital staff as well as the donor's relatives.