Organ donation: Some clarifications

Organ donation: Some clarifications

This refers to the article ‘Knowledge, attitude and behaviour of the general population towards organ donation: An Indian perspective’ (Natl Med J India 2016;29:257-61). It is a detailed article with useful results. We have a few comments:

1. The article states that the organ donation rate is ‘0.34 per 100 000 population’ with the citation, ‘Mohan Foundation. Deceased donation statistics. Indian Transplant Newsletter 2014-15;14 (43)'. The data in the referenced newsletter is ‘0.34 per million population’. On a minor note, the table appears on page 12 (the last page) and not on page 14 as cited. Moreover, the organization's name is ‘MOHAN’ (an acronym for Multi Organ Harvesting Aid Network) and not ‘Mohan’.
2. Regarding Table 2 : Participants’ knowledge about organ donation; Category ‘Knowledge of what signing a donor card means”; subsection 3: once a person has signed a donor card they cannot change their mind about organ donation. The results mentioned are true 56 (29%) and false 137 (71%). However, in the discussion, the authors state that ‘the majority (71%) of participants in our study believed that they cannot change their mind once they have signed the organ donation card’.
3. It would be useful to know what criteria were used to define the ‘lower socioeconomic status’ since an observation was made that participants from a lower socioeconomic status were unsure about signing the organ donation card. Only income (using an apparently arbitrary yardstick) has been used to describe socioeconomic status. To the best of our knowledge, income is not the sole criterion to define socioeconomic status.

It was interesting to look at the results in this article in the light of a ‘public attitude’ survey on organ donation done in 1995 and 1996 with a sample of 5008 members of the Indian public.^[1] The survey showed that 72% of the population was willing to donate eyes and carry a donor card. However, less than 50% were willing to consider solid organ donation; 74% Hindus, 72% Christians and 5 8% Muslims were willing to consider organ donation. The concept of brain death was new to most people surveyed. After this survey, a simple protocol was devised: the ‘Ramachandra protocol’, which stated that when asking for organs from relatives, eye donation would be requested first. Only if the relatives were willing for eye donation, other organs should be requested for. This approach was felt to be less likely to upset the relatives in a brain death situation. It would also give the hospital staff asking for organs an idea about the family's attitude towards the sensitive issue of organ donation in a difficult situation.

Conflicts of interest. None