On January 16, 2015, MOHAN Foundation in partnership with Gurgaon Critical Care Forum and Medanta - The Medicity organized the first ever Deceased Organ Donation Stakeholders Meeting of Haryana at Hilton Garden Inn Hotel, Gurgaon.
Health being a state subject, each state has to deliberate upon its own initiatives and Haryana is fast emerging as a significant transplant state with many leading hospitals like Medanta, Artemis, Fortis, Paras and Alchemist undertaking transplants. Out of these- Medanta, Fortis and Artemis are looking at deceased organ donation and have enabled a few donations. The Stakeholders' Meeting was the first initiative of its kind in Gurgaon that was organised with an overarching objective of giving an impetus to the deceased organ donation scenario in the state by bringing together medical professionals from Government hospitals, corporate hospitals, policy planners, police officers, forensic experts, media and NGO's to discuss and debate and lay out a road map to give an impetus to deceased organ donations in Haryana.
The following were the panelists:
The discussion was moderated by Dr Arvinder Soin (Chairman, Liver Transplant, Medanta Hospital).
A vibrant discussion followed and various issues were discussed. One of the biggest roadblocks to organ donation is the identification and declaration of 'brain death.' However brain death is the only situation in which solid organs can be donated. Yet hospitals shy away from declaring brain death fearing public backlash as it is a concept not very well understood by the general public. The panel debated if brain death declaration could be made mandatory by the government and it was felt that while there was nothing illegal about doing so, it would be perhaps better if individual hospitals could themselves put systems in place to conduct audits as to the number of brain deaths each month, how many were certified, if families were spoken to, how many agreed to donation, reasons for refusal etc.
Another important point of discussion was the provision of ancillary tests especially in cases where apnoea test cannot be performed. Though cases where apnoea test cannot be done are very few and rare, the board of experts certifying brain stem death could collectively take the decision of performing ancillary tests after reaching a consensus. Since the law (THO Act) only recognises apnoea test as the final test for certifying brain stem death, the panel did not agree to it.
Other issues, such as the role of the government and the media in creating public awareness were discussed. It was unanimously agreed that while NGOs like MOHAN Foundation do significant work in this direction, what is really needed are large scale campaigns that could only be taken by the government and media houses.
Many brain death cases are medico legal cases and the support of the police and the forensic becomes paramount. It was discussed that efforts would be made (as in some states like Tamil Nadu) to pass government orders to streamline these processes so that timely action can be taken and organs can be retrieved with minimum discomfort to the donating families. Dr Deepak Mathur expressed that he would be happy to support this noble program. He said that if all the paperwork were in order and the police NOC has been obtained, the forensic department would gladly give permission for organ retrieval in such cases as long as the said organs are not required in forensic investigations.
Need for training for the medical professionals was also felt, as many doctors themselves remain unaware about brain death. It was also felt that there is a need for a continuous dialogue of such nature and cooperation between all the stakeholders if a robust state organ donation program has to be initiated.
The meeting was attended by more than 70 doctors, transplant coordinators, forum members, trainees and other medical professionals.
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