2020 Feb 17
Becoming a living organ donor or making the personal but complex decision to donate one’s organs, while alive or after death, can help save and make a profound impact on someone else’s life. Figures show that a single organ donor has the life-saving potential of safeguarding up to nine other lives, while even more stand a chance in connection with procedures such as tissue donation. Consider this your definitive guide to the specifics of organ donation in Sri Lanka.
What is organ donation?
Organ donation refers to the altruistic act of giving one or more organs (or parts of organs), without compensation, to be transplanted in someone else’s body. The process has carried legal, social, cultural and ethical concerns in times past, but remains an indispensable and life-sustaining measure that has and continues to save millions of people on waiting lists every year. Due to the many concerns attached to organ donation, most countries have legal provisions set in place in order to ensure that the procedure is done consensually, ethically and effectively. Generally, the process is strictly limited to the donation and transplantation of the heart, intestines, kidneys, liver, lungs, and pancreas (e.g., the islets of Langerhans). What is more, living donors are usually able to donate a part of the pancreas, lung, liver, intestine or kidney.
Suggestively, the World Health Organisation (WHO) states that the majority of transplanted organs across the world are, in fact, by living donors. Usually, people of any age are qualified to donate their organ on the condition that they do not have certain medical conditions. Such contraindications include, but are not limited to, active cancer, systemic infection, HIV positive status, sickle cell anemia or a history of intravenous drug abuse.
The Sri Lankan context
Most organ donations in Sri Lanka (like most developing countries) are from living donors. The year 2017 shows a record of 400 kidney transplantations performed in Sri Lanka while inversely, more than 2000 patients had died due to renal failure while awaiting transplantation. The approximate ratio of organ transplantation per total population of Sri Lanka (as of 2018) stands at 1: 52, 477. Such figures illustrate a much more pressing matter, which is the dire need for more organ donations as a measure to save more lives in Sri Lanka.
In fact, the significant gap between the supply and demand of organs has resulted in overwhelmingly long waiting lists for transplants. The lack of a proper coordinating body to efficiently handle organ transplants in Sri Lanka has been identified as a barrier in both meeting the demand for organs as well as the implementation of a national transplant programme in the country. At present, there are eight kidney transplant centers attached to National hospitals with nearly 400 transplants done every year. As for liver transplants, only two programmes at the National Hospital in Colombo and the Colombo North Teaching Hospital exist at the moment. While a majority of donations are by living donors, about 95% of organs retrieved after death are by brain-dead donors.
Procedures to be followed in Sri Lanka
According to the Transplantation of Human Tissue Act of 1987, any person above the age of twenty one years may consent in writing for the donation to take effect upon their death. This may include their body or any part or tissue thereof. If consent has been given in such a manner, it cannot be revoked thereafter. In the event where the deceased had not given prior consent for organ donation, a next of kin who is over the age of twenty one years is permitted to legally provide consent on the condition that the diseased was not opposed to the donation of his/her organs when alive.
In the case of homicides where the deceased has been affected on the head and/or chest (which is the most commonly affected areas in most cases), they can still be considered as potential liver, kidney, bowel and pancreas donors. Additionally, if the cause of death is “unnatural” (i.e. a death caused by external causes such as injury or poisoning), the release of bodies are subject to an inquest followed by an autopsy examination according to the criminal code of Sri Lanka. The responsible medical practitioner checks on the possibility of organ donation once the postmortem examination is complete and consent has been previously provided by the deceased or the next of kin. A key challenge encountered here is the absence of a recognised database of potential donors or a donor card system in order to expedite the process of harvesting organs from a potential donor. This is a matter that deserves serious attention by the Ministry of Ministry of Health and Indigenous Medical Services of Sri Lanka. Mass media, on the other hand, is another influential asset in helping spread awareness on the importance of organ donation to the general public.
Donating eyes and tissues
The donation of eyes and tissues upon death is undertaken by the Sri Lanka Eye Donation Society of Sri Lanka. Eyes and tissues should be donated within 4 hours and 12 hours of death respectively. More guidelines provided by the Sri Lanka Eye Donation Society is as follows:
1. There is no age limit for donating eyes. Donors of tissues should be below 70 years of age.
2. Those with wounds in the body or those who have passed away due to an infectious disease are not eligible to donate eyes or tissues.
3. The coroner’s permission and a death certificate must be issued if a post-mortem is held.
4. The cause of death has to be mentioned.
5. Donations of eyes and tissues can either be done through prior consent of the deceased or next of kin following the death of the potential donor.
6. Priority of organ recipients will be given to Sri Lankan patients.
The Sri Lanka Eye Donation Society works around the clock to welcome such donations and trained technicians are available in order to reach the place and do the needful once they are informed. Potential eye and tissue donors can register at htb.mobitel.lk. More information can be found on their website: www.eyedonation.lk. Those interested in becoming a kidney donor can obtain more information here: www.ktsf.lk.
- You have to be in perfect health to donate an organ – False.
A common misconception is that donors are required to have a perfectly good holistic health to be able to donate an organ. While this may help in qualifying as a potential donor, it is important to keep in mind that as long as the organ you donate is healthy, there are a lot of health conditions that will not prevent you from being a donor.
- Organ donation can be costly – False.
Organ donation in Sri Lanka can only take place on a voluntary basis. Organs cannot be sold or bought according to the legal provisions of Sri Lanka.
- Living organ donation is rewarding – True.
After a successful transplant, most living donors feel a sense of accomplishment with the
knowledge that they were able to save a life.
- All major religions allow organ donation – True.
Most religions such as Christianity, Islam, Buddhism and Hindu faiths encourage organ donation or the importance of individual choice. It is recommended that you seek advice from a religious priest if you wish to become an organ donor and this matter concerns you. With a proper coordinating mechanism in place and increased awareness on the life-saving potential of organ donation, Sri Lanka can, beyond doubt, meet the increasing demand for organ transplants in the country.
Will you gift someone a second lease on life? Register as an organ donor today.