FAQ's on Organs & Tissues Transplant

What is Transplantation?

Transplantation is the act of surgical removal of an organ from one person and placing it into another person. Transplantation is needed when the recipient's organ has failed or has been damaged due to illness or injury.

What are the end stage diseases that can be cured by transplantation?

Here are some end stage diseases which can be cured by the transplantation:

Who will tell me about the Transplant process?

Transplant Coordinator and Treating Registered Medical Practitioner will explain you about the process of Transplant.

Who is transplant coordinator?

Transplant Coordinator means a person appointed by the hospital for coordinating all matters relating to removal or transplantation of Human Organs or Tissues or both and for assisting the authority for removal of human organs.

Though their work is more related to deceased organ donation, they are responsible for living organ donation also. The current Transplantation of Human Organ Act envisages that every hospital doing transplant activity, whether retrieval or organ transplantation must have a transplant coordinator in the hospital before the center is registered for transplantation under the act. Transplant coordinator is a pivot of the organ donation and transplantation.

What is the role of a transplant coordinator in Organ & Tissue Transplant?

The transplant coordinator has to counsel the grieved family, make them comfortable and approach the subject of eye donation and later on solid organ donation.

If the family gives consent for organ retrieval, then the coordinator has to inform the Nodal Officer and coordinate with the ICU staff to maintain the patient on ventilator and organize organ retrieval. The coordinator has to ensure that all paperwork is correctly done and that the family receives the body as soon as possible.

Is there any insurance cover for organ transplant costs?

Till few years back, transplant cost both for donor as well as recipient was not covered by most of the insurance companies. Now a day many insurance companies are covering cost related to transplant. It will be better to be sure when you are going for insurance.

Is there any age limit to be registered for transplant?

Yes, patient should be fit for transplant and age is one of the criteria for assessing fitness of patient for transplant.

What is waiting list for Organ Transplant?

A list of people waiting for receiving an organ.

How does someone get on the waiting list?

The patient can register for inclusion in the waiting list through a registered transplant hospital. The treating physician of the hospital shall make an evaluation (based on medical history, current condition of health, and other factors) and decide if the patient needs a transplant and meets the criteria to be listed. Like for kidney transplant, other than blood group, main criteria is time since patient is on regular dialysis. Similarly, for other organs, criteria are different based on medical history, current condition of health, and other factors.

How can I know that I am fit to be listed for organ transplant?

Every patient who has developed end stage organ failure may not be fit for organ transplant. Basic principle is that patient must be screened on medical grounds (based on medical history, current condition of health, and other factors) for the development of end stage organ failure. Your treating doctor will decide whether you are medically fit for transplant and other issues before listing in the wait list.

How long will I have to wait?

Once you are added to the national organ transplant waiting list, you may receive an organ on the same day, or you may have to wait many years. Factors affecting are how well you match with the donor, how sick you are, and how many donors are available in your local area compared to the number of patients waiting.

Why waiting list is so long?

There is a huge disparity between demand and supply for transplant. There are more numbers of patients requiring different organs as compared to number of organs available for transplantation. That is why there is urgent need to create awareness about organ donation. As more persons decide to take the pledge and donate organs, the waiting list will go down.

What is the process to find a right donor?

When a transplant hospital adds an individual to the waiting list, it is placed in a pool of names. When any deceased organ donor becomes available, all the patients in the pool are compared to that donor. Factors such as medical urgency, time spent on the waiting list, organ size, blood type and genetic makeup are considered.

How long it will take to get a cadaver's organ?

There is no time line on how long one will have to wait for an organ that the individual requires. This depends on his/her medical situation and how frequently organs are becoming available in a city or state.

Do I have option other than organ transplant? 

This query can only be answered by the treating doctor depending upon medical condition and stage of damage of the organ. For example in a case of kidney failure, dialysis is an alternative treatment and for kidney failure patient transplant is usually not an emergency. Also, for a heart failure patient, some patients can be maintained on artificial cardiac assistive devices. Similarly for other organs criterias are different, that can be maintained on medical therapies for the time being.

Is it possible to know my status in the waiting list?

Yes, you may know your status in the waiting list as this is a quite transparent system. But this will not help you significantly as getting an organ depends on many other factors other than just waiting list number.

Do I need to be always prepared to receive call for transplant?

Yes, it may be better to be mentally prepared and have some funds for an urgent organ transplant. Cadaver transplant is mostly on urgent basis. That is why it is better that your investigations for cadaver transplant are updated all the time so that whenever you receive a call, you can get the organ. Getting a cadaver organ is a gift and one should not miss it.

If I get a calll for transplant, will I definitely get the organ?

No, getting a call for transplant does not mean that you will definitely receive an organ. The transplant team will examine your immediate fitness for transplant. There is possibility that the tests done just before possible transplant may not be normal to make you fit for transplant. Further, more than one patient is called for possible transplant and it may be a chance that someone else will be more fit than you for that particular organ transplant.

Would a donor's or recipient's family ever know each other?

No, in Cadaver Organ Donation Programme confidentiality is always maintained, unlike in the case of living donors who usually already know each other.

If the family wishes, 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 who have wish to exchange anonymous letters of thanks or good wishes they can do it through the transplant coordinator. In some instances donor families and recipients have arranged to meet.

What is the protocol to maintain waiting list?

As per protocol, patients who require cadaver organs are put in the waiting list. But in India, number of patients requiring organs are more as compared to number of organs available.

There are two types of waiting list; one is urgent waiting list and another one is regular waiting list. Urgent listing of patients for cadaver organ transplant is primarily based on medical criteria, i.e. patient needs organ on urgent basis otherwise he/she may not survive. 

Regular waiting list is also based on medical criteria and these criteria are different for different organs. Like for kidney transplant, main criteria is time spent on regular dialysis. Similarly, for other organs, criteria are different.

What is the protocol for organ distribution?

The organs would be distributed locally within the State first, and if no match is found, they are then offered regionally, and then nationally, until a recipient is found. Every attempt would be made to utilize donor organs.

How are donated organs matched with patients?

Many medical factors need to match to ensure a successful organ transplant. Blood group is one of the major factors taken into account. Organ size of the donor & recipient is also considered. For kidneys another important factor is tissue matching which is more complex than blood grouping matching and also takes more time. The best results can be achieved if there is a perfect kidney match.

There is a local, regional and national computerized list of patients waiting for an organ transplant. Most of the time, computer will identify the best matched patient for a particular organ and organ is offered to the transplant unit who is treating that patient. Also, priority is given to patients who most urgently need a transplant. NOTTO operates the waiting list and organ allocation system. It works round the clock, every day of the year. In case of tissues, matching is usually not required.

Can my Organs be given to a foreigner also?

As per the Transplantation of Human Organ Act 1994, sequence of allocation of organs shall be in the following order: State List-Regional list-National List-Person of Indian Origin-Foreigner.

Source : NOTTO