Body donation: Best way to remain alive after death

Dr Reeha Mahajan
Body donation or Body Bequest or Deh Dan is the supreme donation of one’s body after death. One can also donate their organs either during life (living donor) or after death (cadaveric donor). It is the best way to remain alive after death, as one donor can save eight lives through organ donation and heal fifty patients through tissue donation.
The act of body donation dates back to Vedic period, when “Dadhichi” the sage mentioned in our puranas, gave up his life so that his bones could be used to make the “Vajra”, the weapon used to defeat the Asura “Vritra”, who personified drought.
Body donation is either voluntary or by family of the deceased. In either case, the onus lies on immediate family or near relatives to decide and carry out the donation of the body of the deceased. Most important reason for less body donation in India is lack of awareness and prevailing myths regarding body donation. According to a study in India, only 22% people are aware, that the body can be donated. The general public is always in a dilemma whether they should or should not donate their body after death.
Myths & Facts
According to spiritual and religious beliefs and emotional values of some people, the dead body may not be treated with respect and dignity in the medical institution. The lack of information and willingness are major deterrents for body donation. Family and relatives of the dead person are often curious to know the events after body donation.
The department of Anatomy at AIIMS, Jammu feels the responsibility of solving the queries arising in the minds of the general public regarding body donation through this platform.
These are important facts about body donation:
1. Each donated body is treated with utmost respect and care in the medical institutions.
2. Only medical students, doctors and medical staff have access to the donated bodies.
3. The hospital and medical college abide by law which prevents the misuse of any kind.
Most common questions arising in the minds of public regarding body donation are:
Q. How can we contribute to the society by donating our body ?
Your generous donation will be used for:
Imparting education in Anatomy
Teaching and demonstrating the form and structure of the human body to undergraduate M.B.B.S. medical students, postgraduates of clinical and basic sciences and allied health care professionals.
Training health professionals
Training of surgeons, providing the opportunity for them to develop surgical skills.
Training course for doctors who work with us to develop new surgical instruments or techniques to investigate novel therapies.
Medical research
This involves scientific studies which improve the understanding of the human body and the advancement of medicine.Your donation can be valuable for research at large.
Where the anatomy is unusual, photographic/electronic images of parts of your body will be taken for educational, training and research purposes, after the approval of ethical clearance committee. Doctors find such findings extremely valuable, as they can return to them repeatedly as their learning progresses. These images will not include features which could result in your identity being disclosed.
To summarise, utilization of donated body is done for:
* Dissection
* Preparing museum specimens
* Developmental research
* Research to see variations in human body
* Surgical training –
* Postgraduate training
* Workshops
* Equipment development and training
Q. What is the procedure for consent for donation ?
As a donor, please read this section carefully as it explains what you may give consent for.
* If you wish to donate your body, you should fill in and sign the consent form in the presence of a witness in the department of Anatomy. The form must be completed in duplicate and both the potential donor and witness must sign.
* One copy of the completed form should be returned for record, while the second copy should be retained with you. It is also important to inform your next of kin and your doctor about your intention to donate.
* If the body is not accepted for scientific or technical reasons, the next-of- kin must make alternative arrangements for the funeral/burial.
Q. What all organs can be donated after natural death?
* Skin * Cornea * Whole Body Donation
Q. Which organs can be donated by living donor?
Blood o Kidney o Bone marrow o Liver o Pancreas
Q. What organs can be donated after brainstem death ( i.e. when a person has permanently lost the potential for consciousness and capacity to breathe and ventilator keeps the person alive)?
These are the organs which can be donated after brainstem death:
2 eyes 2 kidneys Lungs Heart Pancreas All bones and tendons Blood vessels Intestine Muscles and ligaments Cartilages Skin and fascia Larynx 2 hands Peni Fingers
Retrieval of organs should be done at the earliest after death to maintain the vitality of transplanted organ.
Time-period during which the organs should be transplanted are:
Heart 3-4 hours
Lungs. 3-4 hours
Pancreas 6 hours
Small intestine 4-6 hours
Liver 8 hours
Kidneys 36 hours
Q. Who all cannot donate organs?
Positive HIV, Hepatitis B and C, HTLV, Syphilis, Malaria patients etc.
Progressive neurological disease of unknown cause.
* Sepsis
* Uncontrolled hypertension and Diabetes Mellitus
* Malignancy
* Previous transplant
Q. Are all donations accepted ?
Medical institutions are not able to accept all donations and we cannot make a decision about acceptance until the time of death.
Criteria for a body donation
As donated body is used to study the normal human structure, some of the donated bodies may not be suitable for usage and hence liable for rejection. Some frequent reasons for rejection are:
* Body of a medico-legal case (e.g. suicide, homicide or accidental death etc.)
* Post-mortem bodies
* Body of a person having communicable disease e.g. HIV, Hepatitis B
* Gangrene
* Decomposed body
* Emaciated body
* Body with organ removal (except eyes)
The medical institute has a right to reject the body for any other reason and the decision for the same is to be taken by medical institution at the time of donation.
We recommend making sure that your next of kin is aware of your alternative wishes. This reduces any uncertainty at difficult times.
Q. What is the best time for body donation after natural death?
Voluntary Body donation is done in medical institutions only within 10-12 hours after natural death.
Eye donation has to be done prior to the body donation (within 6 hours)
Transportation facility will be provided by the Institution with whom you have registered.You just need to call on the contact number provided to you on the donor card.
* If the potential donor’s death has happened in the hospital or at home under natural circumstances and is not a Medico Legal Case (MLC) then following procedure should be followed for handing over the body to the medical institute.
The doctor who attended the donor during his/her last illness should be asked to provide a Death Certificate as soon as possible after death. It is important to inform the doctor that the deceased has donated his body to the Medical institution.
* At the time of a potential donor’s death, the next-of-kin should do the following:
1) Inform the Department of Anatomy as soon as possible after death. The department would be open from Monday to Saturday in a week. Relatives or attending doctors during these hours should contact the department, so that the case can be dealt immediately. After working hours, the next of kin of body donors should leave their name and contact number with the reception or casualty department along with the donor’s details, so that Anatomy department personnel can contact them at the earliest.
2) A duly signed death certificate will be issued by the doctor (either in the hospital or by the General Practitioner).
3) If the death occurs in a hospital, the body is usually kept in the hospital mortuary till a decision is made. If the death occurs at home or in a nursing home, it would be advisable to turn off all heating equipment where the body is kept and open windows if possible. Sometimes it may be necessary to have the body kept in the mortuary.
4) The doctors in the Anatomy department will scrutinize the Death certificate and make personal observations, to make a final decision of acceptance of the donated body.
5) When the body has been accepted, the next-of-kin will be required to complete the appropriate formalities with the department.
6) The department will issue a certificate of donation to the next of kin in order to pay gratitude for their generous act. The Department will ensure for the safe keeping, preservation and examination of the body.
7) The next-of-kin can then do the formalities of registration of death with the help of certificate of donation issued by the department.
Decision to pledge is a family decision.Make sure you discuss with your near and dear ones so they are aware of your pledge.The next of kin can refuse organ donation even if the deceased had pledged to donate during his/her lifetime, which is the most common cause of failure of body donation programme.
(The author is an Associate Professor in the Department of Anatomy at AIIMS, Jammu)