13th August: World Organ Donation Day
Eminent Author, Medical Biochemist and Scientist, Technical Education consultant.
AGD Biomedicals (Pvt) LTD. Andheri East, Mumbai.
An increase in the organ donors has not kept pace with demand in India and also all over the world (Ref Q2,3). There should be greater awareness among general population on how one deceased donor can save several lives. With a waiting list of over three lakh patients and at least 20 persons dying each day waiting for an organ, the number of deceased organ donations must increase (Ref Q1). Recently introduced 4th generation clinical laboratory tests and auto analyzers could be extremely useful to detect initial stage of any specific organ dysfunction (Ref Q6). With appropriate health-check examinations, preventive measures, effective treatment regimens, appropriate follow ups and diet controls, serious organ-damage episodes could be prevented (Ref Q.7).
Q1. What is the present status of number of organ donors in India (2024)?
ANS: According to the data published from the health department of India, the number of donors (including deceased) only grew from 6,916 in 2014 to about 16,041 in 2022. It is estimated that almost five lakh Indians face organ failure every year and yet less than 2-3% of them receive a life-saving transplant.
Q2. What is the prognosis of organ failures and the present rate of organ donations in India?
ANS: Organ failure is a serious condition with poor prognosis presenting a 0–7-day mortality at 11.0% for patients with organ failure at first arrival. It is estimated that almost five lakh Indians face organ failure every year and yet less than 2-3% of them receive a life-saving transplant. Lack of awareness about organ donation and also about protecting individual organs is significant.
Q3. What are the main reasons of organ failures in India and in the world?
ANS: The most prevalent organ failures observed so far are related to lung, followed by heart, brain, kidney and liver. Multiple system organ failure (MSOF) is the most common cause of death of patients who have Acute Respiratory Distress Syndrome (ARDS).
Q4. What are the main causes of Acute respiratory distress syndrome (ARDS)?
ANS: ARDS is caused mainly due to severe viral and bacterial infections, massive myocardial infarction, chronic kidney and liver diseases, severe burns, production of auto-antibodies against a specific or many organs, and major physical trauma (accident), etc.
Q5. Why there was an increase in the number of organ failures following discharge from hospitals during COVID 19 pandemic?
ANS: In studies published, it was observed that individuals discharged from hospitals after COVID-19 had increased rates of multiorgan dysfunction compared with the expected risk in the general population.
Q6. Have advancements in the IVD could be useful in the early detection of ARDS, intravascular coagulopathy and the status of lung-inflammation?
- Blood oxygen saturation (low levels indicate lung-dysfunction),
- Complete hemogram (CBC, indicate viral or bacterial infection),
- Blood sugar random (indicates if immunocompromised status is present),
- Glycosylated hemoglobin (indicate average blood glucose level),
- SGPT (indicate inflammation of the liver),
- SGOT, LDH (indicate inflammation of the lungs),
- serum procalcitonin (indicate bacterial infection),
- Serum creatinine (gives idea about the status of Kidney functions),
- Serum ferritin (high levels indicate viral or bacterial infection)
- D-Dimer, Bleeding time, Clotting time and Prothrombin time (values indication of state of coagulopathy).
- C-reactive protein, IL-6, IL-8, TNF-alpha, IFN-gamma Inflammatory markers (increased values indicate inflammatory status of the lungs).
Q7. Role of mismanaged Diabetes in an incresed incidences of kidney failures.
- Blood sugar random
- Glycosylated hemoglobin (indicate average blood glucose level)
- Serum creatinine (gives idea about the status of Kidney functions)
- Urine Microalbumin, and Urine Microprotein (Indicates damage to kidney caused due to mismanaged Diabetes)
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References
(1) Daniel Ayoubkhani, Kamlesh Khunti, Vahé Nafilyan, Thomas Maddox, Ben Humberstone, Ian Diamond, Amitava Banerjee. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ. 2021 Mar 31:372:n693.
(2) Bikram Das, Divya Joshi, V K Vineeth, A S Naveen, Ram Gopalakrishnan, V Ramasubramanian, V R Yamuna Devi, P Senthur Nambi.Post-COVID multisystem inflammatory syndrome in adults: A study from a tertiary care hospital in south India. Indian J Med Res. (2022). Oct-Nov;156(4&5):669-673.
(3) Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Mikkel Brabrand, and Annmarie Touborg Lassen. Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study. BMJ Open. 2019; 9(10).
(4) Shengnan Chen, Lei Chen, Hongli Jiang. Prognosis and risk factors of chronic kidney disease progression in patients with diabetic kidney disease and non-diabetic kidney disease: a prospective cohort CKD-ROUTE study. Multicenter Study Ren Fail (2022), Dec;44(1):1309-1318.
(5) End-Stage Kidney Diseases in Immigrant Groups: A Nationwide Cohort Study in Sweden.Per Wändell , Axel C Carlsson, Xinjun Li , Danijela Gasevic, Johan Ärnlöv, Jan Sundquist , Kristina Sundquist. End-Stage Kidney Diseases in Immigrant Groups: A Nationwide Cohort Study in Sweden. Am J Nephrol, 2019;49(3):186-192
(6) Godkar PB, Godkar DP. Text book of Medical laboratory technology (4th edition, 2024), Bhlani Publishers, Mumbai. India.