Hosps must identify brain deaths diligently: Centre

Mumbai: Failure to identify and certify brain deaths by hospitals is reducing the country’s organ donation rates drastically despite a significant number of potential donors available, the Union health ministry recently stated in a directive, asking states to insist on hospitals to document brain stem deaths meticulously. The ministry said India’s cadaver organ donation rate continues to be abysmally low——less than 1 donor per million population a year.

In a recent letter, it reminded states that as per provisions of the Transplantation of Human Organs Tissues Act, hospitals must identify each potential brain stem death case admitted in the ICU. It said is mandatory for hospitals to ask if such potential donors had pledged for organ donation, and if not, to make family members aware of the opportunity to donate organs before the heart stops. The doctor-on-duty, with the transplant coordinator’s help, is required to inquire after certification of brain stem death.

It is estimated that India sees nearly 1.5 lakh potential brain stem deaths a year due to accidents. Other causes, like strokes, could add to the numbers. However, the total number of deceased donors in India was just 1,028 in 2023, which facilitated over 3,000 transplants. This falls drastically short of the annual need for about 5 lakh organs. With barely 2-3% of the demand met, countless lives are lost to organ failure. In Mumbai alone, over 4,000 people are awaiting cadaver organs.

“We need all transplant centres and non-transplant organ retrieval centres to start declaring brain deaths. This is the crucial first step to facilitate organ donation, yet it’s not happening in most hospitals,” said Dr Anil Kumar, director of National Organ & Tissue Transplant Organisation (Notto). He said even registered transplant centres are failing to declare brain deaths.

An official from the state public health department said most institutions lack a panel to certify brain stem death which hampers identifying such cases. In Mumbai and most other urban districts, majority of brain death certifications are happening in the private sector.

Issuing protocols, the health ministry has, through Notto, urged hospitals to install ‘Required Request Display Boards’ at strategic locations conveying the message to the public that in the unfortunate event of brain death or cardiac arrest, donation of organs and tissues — like kidney, liver, heart, pancreas, eyes, skin and bones etc. — could save lives.

Notto also issued a proforma to collect information from hospitals on a monthly basis. It said the head of the institutions and respective State Organ and Tissue Transplant Organisation could analyse and take corrective action.