Becoming A Donor
The Donation Experience

The removal, storage and transplantation of human organs for therapeutic purposes is regulated by the Transplantation of Human Organs Act, 1994. As required by this Act, the TMH Tissue Bank is registered with the Maharashtra State Health Authorities.

The tissues are recovered from deceased donors, or living donors who donate unwanted surgical residues. All donated tissues are processed, sterilised and preserved after appropriate screening and consent of the donors.

BECOMING A DONOR

A single organ and tissue donor can potentially help up to 50 (often more) people to live more functional lives. Hundreds of thousands of patients can benefit from tissue transplants.  At TMH, thanks to the generosity and goodwill of our donors and the support of the staff of our donor hospitals, over the years, donated skin and amnion have helped save the lives of critically burned patients. Donated amnion has also helped patients recover their sight. Donated bone has benefited thousands of children and adults crippled by congenital defects or disfigured and disabled by accidents or disease.

The availability of safe and clinically effective grafts has also stimulated a radical change in the approach to surgical treatment resulting in innovative techniques with enhanced health benefits to patients. This has been reflected in the increasing demand for grafts. In the past two decades patients in 106 hospitals in Mumbai and 31 hospitals from 11 other States in India have benefited from TMH grafts.

To meet this growing need it has become necessary to expand our donor services, and YOU can help us.

You can help to put a stop to unnecessary pain and despair and save lives. You can help us improve the quality of life for someone recovering from cancer or incapacitated with burns. You can help the blind to see and those crippled by disease to lead more productive lives.

All it takes is a personal choice to be a donor.

To facilitate the donation of tissues during surgical procedures do consider the following:

  • When you or a relative/friend undergo a hip or knee replacement surgery talk to the surgeon about the possibility of donating the discarded bone.  Although the bone is no longer useful for the patient, other people may benefit from it. Volunteer to send it to the tissue bank.

  • As you or a relative/friend welcome a newborn into this world, remember to gift life to another by donating the unwanted amnion along with a blood sample for the necessary tests.

Consider the possibility of donating tissues after death.  Since donating the tissues of a family member who has died can be a difficult decision especially when the wishes of the deceased with regard to such a donation are not known, it is important to:

  • Discuss the possibility of such a donation with your family members.

  • Share with them why you believe that tissue donation is consistent with your life values and feels like the right thing to do. 

  • Explain how tissue donation can help to put a stop to unnecessary pain and despair and improve the quality of life for someone recovering from cancer or incapacitated with burns, blindness or disease.

  • Have at least one family member witness your signature on an organ/tissue donation card.

After death your body becomes the property of your legal next-of-kin. The ultimate decision to donate the tissues of the deceased remains with the next-of-kin even in the presence of a signed tissue donor card. Knowing how you feel however, makes it easier for them to reach beyond their own suffering to say that “yes” at the moment of your death.  Evidence shows that up to 96% of relatives agree to donation if they already know the individual’s wishes, compared to only 58% when the family has not previously discussed the issue.

Remember, your generosity could even save a life.

To help you make an informed decision and discuss tissue donation with your family, here are some facts about becoming a donor:

1.
 Is there a difference between tissue and organ donation?
 

Tissue donation is a simpler process than organ donation. Organ (heart, liver, kidney, etc.) donation is possible only after brain death, which is defined as the complete cessation of all functions of the brain. Brain death is a medical diagnosis which can only be ascertained by a team of certified doctors. In brain dead donors, mechanical support (i.e. ventilator) is required so that the circulation of blood is maintained to continue the viability of the organs for a short period of time after the death of the patient. The donor is usually kept in the intensive care unit. As such the death must occur in a hospital where the necessary support systems are in place. The donor and recipient must be carefully matched according to their blood type, and the transplant must take place within a few hours.

Tissue donation from non-living donors may occur either after brain death, or cardiac death (the cessation of the heart).  It does not require the donor to be on mechanical support systems and consequently any death is an occasion for potential donation. The time factor too is not as critical as for organ donors as tissues may be recovered within 15 hours after death, or longer if the body has been refrigerated. Blood-typing is not required for tissue transplants. There are no problems of rejection and anti-rejection drugs are not required to be used in tissue recipients.
   
2
 Will the donation of tissue / refusal to donate tissue alter my medical treatment?
 

In the case of a living donor, only tissue that would ordinarily be removed and discarded is banked.

For deceased donors the doctor who declares death is not a member of the tissue recovery team and is different from the transplant surgeon. Organs and tissue donation occurs only after all efforts to save life have been exhausted and the patient is declared legally dead.
   
3.
 What are the kinds of tissues that can be donated?
 

Living donors can donate amnion after the birth of their babies. Skin may be donated after certain surgeries like abdominoplasties. Bone can be donated after hip and knee replacement surgeries where the osteoarthritic bone is removed and replaced with a metallic implant.

Deceased donors can donate tissues such as bone, cartilage, ligaments, tendons, fascia lata (the thin covering of the muscles), heart valves, blood vessels and skin.
   
4.
 What will tissue donation entail?
 

In the case of a living donor, if your tissue is suitable for donation and the hospital is a participant in our tissue donation programme, you will be asked questions on your past and present medical history.  This will include questions about HIV/AIDS.  Your blood will be tested for HIV/AIDS, Hepatitis B and C, and Syphilis at the time of your surgery. A second blood test may be required six months later. You will also be asked to sign a consent form for your permission to bank your tissue and to perform the blood tests.

If you are donating tissues after your death you can fill a donor card available with the Tissue Bank preferably in the presence of a relative. At the time of your death your family will be asked questions about your medical and social history.  This will include questions about HIV/AIDS and high risk behaviour.  Your blood sample will be tested for HIV/AIDS, Hepatitis B and C, and Syphilis and your next-of-kin will be asked to sign a consent form for banking the necessary tissues and to perform the blood tests.

   
5.
 Will tissue donation disfigure the body of the donor?
 

The donor is respected at all times. Tissues are procured in a manner similar to that used during surgery. The procedure can take anywhere between 1-6 hours and must occur within 24 hours of the time of death. Care is taken to reconstruct the body after retrieval of tissues and visible areas are left unmarked as far as possible to enable an open coffin funeral.
   
6.
 When is the donor’s blood tested?
 

When living donors donate their bone, a small sample of blood is taken during the operation.  A second blood test may also be requested six months after the surgery. When women donate their amnion, a blood sample is taken within seven days of the delivery.

In the case of a deceased donor, the blood is tested at the time of tissue retrieval.  

   
7.
 Are there any costs involved in tissue donation?
 

No, there is no charge to the donor's family. The cost of the blood tests is borne by the Tissue Bank.
   
8.
 Is there any payment for donation?
 

No, The Transplantation of Human Organs Act, 1994, makes it illegal to buy and sell human organs and tissues. Tissue donation is similar to any donation. It is inspired by the desire to benefit people in need.
   
9.
 Can anyone be a tissue donor?
 

All potential tissue donors have to be medically screened and undergo blood tests prior to acceptance to rule out infectious diseases. The majority of deceased donors are otherwise healthy and relatively young people who have died in accidents or as a result of a heart attack or stroke.
   
10.
 Can organ donors also donate tissues?
 

Yes, organ donors can also be tissue donors and help many more people. In these multiple donors the organs are recovered first. If the eye is being donated this is retrieved next followed by the other tissues.
   
11.
 Is the identity of the donor made known to the recipient?
  The identity of the donor is kept confidential at all times.
   
12.
 Can one change one’s mind about donation?
 

Yes. Since in India, the next-of-kin gives the final permission for tissue donation, it is necessary to inform your family of your change of mind, and revoke any written statement indicating consent to donate tissues.

   
13.
 Are there any age limits or medical conditions that can prevent one from being a donor?
 

The surgeon or recovery team decides at the time of tissue recovery whether the tissue can be banked. The age limit is different for different tissues. All donors are screened to rule out infectious diseases, and tissues will only be procured if the donor meets the tissue bank criteria.
   

THE DONATION EXPERIENCE

In the case of living donors, the Tissue Bank's Transplant Co-ordinator or the attending surgeon makes them aware of the benefits of donated tissue and offers them the opportunity of donating their discarded tissue.

In the case of a deceased donor, the Tissue Bank's Transplant Co-ordinator contacts the family of the person who has recently died, within a few hours, since the time limit for tissue retrieval is limited.  The next-of-kin are made aware of the possibility of donating tissues. This interaction is conducted with the utmost tact and consideration, as potential donors usually die in unexpected and tragic ways (accidents, heart attacks), and this is an extremely stressful time for the family. Whatever the decision, it is respected, and at no time is there any attempt to coerce the relatives.

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