In July 2017, Kartik (name changed), a 25-year-old young man from Chennai was in a road accident in Delhi. He was rushed immediately to the nearby Fortis hospital in Vasant Kunj.
He was declared clinically brain dead– meaning he was no longer alive and could not be revived, even though his heart was beating, pumping blood to keep his organs alive.
What happens to Kartik’s Organs?
When a patient is declared brain dead, time becomes crucial. Families are first informed, their grief is shared and counselors and doctors present to them the option of organ donation.
Dr Sood says Kartik’s family showed exemplary courage.
Kartik was not married and he had an elder brother. It was a huge setback for the family already reeling under the stress of his father having cancer. However, they were courageous and magnanimous enough to agree to allow organ harvesting.Dr (Col) Rajeev Sood, Director, Urology, Robotics & Renal Transplantation, Fortis Hospital
Once the family gives its permission, the process for retrieval begins. The first step is to notify the National Organ Transplant and Tissue Organisation, a national registry that decides which organ will go to whom.
As per policy, the hospital where the brain dead patient is admitted gets priority. The chosen hospitals call in the recipients, prepare them and arrange for tests to ensure a match. Simultaneously, a no-objection certificate is obtained from the police.
Till this point, the brain dead patient is maintained in the ICU and his organs are kept viable with machines. Then, transplant teams from recipient hospitals arrive.
The cadaver is maintained in the ward in the critical care setting. Once the decision is taken, the cadaver is shifted to the operation table and different teams set about harvesting the concerned organs. First organ, if it is being harvested, is the heart followed by the liver and kidney, because these are delicate organs that do not handle circulatory stress very well.Dr (Col) Rajeev Sood
The heart usually lasts for four hours– it gets priority. The blood vessels are first disconnected, the heart arteries are pumped with a cold solution, the heart is put in a bag on ice.
Ischemic period basically means that the heart is not getting any blood. So, once we stop blood circulation in the heart till it is transplanted into the patient, this period has to be minimised to prevent damage to the heart muscle.Dr Z. S. Meharwal, Director and Coordinator, Department of Cardiovascular Surgery, Fortis Escorts Heart Institute
Journey of the Organs
Is the ice box carrying cola? Chilled Beer? Nope, this picnic box is carrying the most precious cargo – the heart.
Once the heart is placed in the ice box, it must be transplanted into the patient in the shortest possible time. The transplant team carrying the heart rushes to the waiting ambulance that makes its way to the recipient hospital via what is called a green corridor.
Green corridor basically means all the street lights are turned green in the corridor. A pilot police car leading the ambulance makes its way to the recipient hospital in the shortest possible time. In this case, it took us less than 18 minutes to cover a distance that normally takes upto an hour.Dr Sidharth Yadav
Rush, rush. The clock ticks. At the recipient hospital, the transplant team waits, the recipient is on the table, ready to receive the heart.
Inside the hospital, another internal green corridor ensures that the icebox is delivered without any delay. In this case, Kartik’s heart gave a new lease of life to another 24-year-old young man suffering from a rare heart condition.
Outside the body, each organ has a life of its own.
- Heart and lungs will last upto six hours on ice
- Liver, pancreas and the intestines will last upto twelve hours on ice
- Kidneys will last upto thirty hours on ice
Liver is the only organ that can be split into two to save two lives. The smaller portion can be used in a pediatric patient and the bigger portion can be fitted into an adult patient.Dr Vivek Vij, Liver Transplant Surgeon, Fortis Hospital
Then, Begins the Second Life of the Organs
Kartik saved five lives. While his heart now beats in the body of a 24-year-old, his two kidneys went to patients at Fortis, Vasant Kunj and BLK Hospital. His liver went to a patient at Gangaram Hospital. His corneas were sent to All India Institute of Medical Sciences.
Organ donation awareness continues to be at a nascent stage in India. Over five lakh patients are waiting for an organ donor. In 2016, there were less than 750 cadaver transplants.
We are just getting started. When we talk about places like the US where nearly 20 percent of the population is organ donors, we are close to 1 percent. We are just getting started. Awareness will build as we go forward.Bhavdeep Singh, CEO, Fortis Healthcare Limited
Camera: Athar Rather
Editor: Prashant Chauhan