The Post Graduate Institute of Medical Education and Research (PGIMER) claims to be the first institute in the country to perfor m organ transplants by retrieving organs from cardiac dead patients.
The practice of taking organs from cardiac dead patient (non-heart beating donor) is common in foreign, but in India, there are currently no protocols regarding organ donation following the cardiac arrest, after elective withdrawal of life support in terminal conditions.
In the country, organ transplants have been done after retrieving organs from brain dead donors or living donors, like in case of kidney transplant.
A PGIMER official says, “In first of its kind in the country, the PGIMER has established organ donation from donors with (uncontrolled) cardiac death.” Dr Ashish Sharma, nephrologist, PGIMER, said, “In the last two years or so, we came across situations where many patients in the ICU were willing to donate organs, but suffered cardiac arrest before they could be declared brain dead. A protocol was made to quickly obtain consent, retrieve organ and arrange a match with a potential recipient.”
As a result of the initiative, six such donations, after cardiac death, were accepted at the PGIMER, providing 11 donor kidneys to patients with renal failure. The first transplant using organs from cardiac dead patient was performed in 2012, while rest five transplants were performed in the last two years. “This has happened for the first time in India. All these kidneys have worked well and the recipients continue to enjoy normal kidney function after transplantation,” said a doctor. The data was presented in an annual meeting of the Indian Society of Organ Transplantation at Chennai by Dr Ashish Sharma last year, and the presentation was awarded with the ‘best oral paper’.
Highest rate of organ donation
By utilising the additional source of organs, the PGIMER claims to have achieved the highest rate of organ donation per million population in India last year.
The institute performed 50 deceased donor kidney transplantation from 26 deceased donors last year - both brain dead and after cardiac death- which yielded a rate of 24.64 organ donors per million population.The number of organ donations after brain death has increased from 2 per year in 2008 to nearly 10 per year till 2014. However, in the first six months of 2015, the donation rate was negligible. Prof Mukut Minz said, “At that time, we thought we would utilise all possible sources of donor kidneys, and made a protocol for donation after a cardiac death.”
In case of cardiac death, the heart stops beating, and circulation and blood pressure can’ t be restored despite medications or interventions. Such patients are declared dead when, even after at least 30 minutes of cardiopulmonary resuscitation, their hear t activity can’t be brought back. The organs have to be removed at a very short span of time (3060 minutes).