By Faranak Bakhtiari

Organ donation, a generous life-saving ‘gift’

May 21, 2021 - 16:53

TEHRAN – Organ donation is the donation of life to thousands of patients whose future is hanging in the balance, a humane and benevolent act that can prevent the death of 3,000 people annually in Iran.

The country celebrates “National Organ Donation Day” annually on May 21. The day commemorates the issuance of a decree by the late founder of the Islamic Revolution, Imam Khomeini, on May 21, 1989, authorizing organ donation.

The history of organ and tissue transplantation in Iran dates back to 1935 when a patient's cornea was transplanted in one of Tehran's hospitals. Kidney transplantation first took place in 1968 and transplantation of other organs and tissues gradually took place in the 1970s and 1980s.

According to the Iranian Society of Organ Donation, there are two types of death in the medical world; Heart death (common death), which accounts for 99 percent of deaths worldwide, and brain death, which accounts for one percent of deaths.

Organ donation is an altruistic decision that can be made by the family members after brain death. Although many organizations and medical centers have implemented various interventions and training courses to increase satisfaction with organ donation, a lack of organs for donation still is a serious problem in the world.

As a result, thousands of patients on waiting lists for transplantation die every year.

In Iran, about 5,000 to 8,000 people die each year from brain death, half of whom, or about 3,000, have transplanted organs. Unfortunately, 1,000 families, or one-third, are satisfied with organ donation.

In Iran, there are over 25,000 patients in need of transplants on the waiting lists of various organs, but unfortunately, 7 to 10 of them die every day due to the lack of a transplanted organ, accounting for over 3,000 a year.

Considering that 7,000 transplant recipients are buried annually due to family dissatisfaction and 3,000 needy patients die, on the other hand, it can be considered that if only half of the buried organs could save the lives of all.

What discourages people to save the lives of others?

But what really pushes away the people from donating their deceased beloved’s organ and save the lives of many?

It is a touchy question, as some experts believe that there is a large disparity between the number of people who only claim that they support organ donation and the number of people who actually register for organ donation cards.

So, the factor keeping people from ultimately donating an organ is something that academics, doctors, and organ donation activists are trying to figure out.

Although, for long we have heard that organ donation is a generous life-saving ‘gift’, some are still unnerved by and skeptical about the donation process.

Making positive decisions about organ donation would likely require resolving tensions between respecting the family, community, and religious values versus their individual autonomy.

Such resistance may be explained by the lack of awareness about transplantation within their communities, dominant influences of older family members, religious myths and misconceptions, fear of premature death, concerns about bodily disfigurement, distrust of the medical system, and concerns of racial discrimination in organ allocation.

Providing targeted education about the process and benefits of organ donation within the community may clarify ambiguities surrounding cultural and religious-based views on organ donation, reduce taboos and suspicion towards donation, and in turn, lead to increased organ donation rates.

Understanding the meaning of neurological death is also another factor helping families to consent for organ donation of their brain-dead member of the family.

Neurological death is defined as ‘irreversible loss of capacity for consciousness combined with the irreversible loss of the capacity to breath’. It is a prerequisite for donation, although to families the body still appears to have life.

Making families of the deceased aware of the fact that they can find a sense of meaning and creating a positive outcome of their tragic loss by organ donation is a must to promote the culture. Families should have a desire to help others and apprehend that the deceased’s legacy will continue to exist through donation.

A lack of trust in the healthcare profession is also a major barrier to deceased organ donation; fears are mainly that doctors would not try as hard to save the life of an organ donor with physicians holding the power to decide whose life to save, as well as the belief that the wealthy are more likely to obtain a transplant.

Iran tops Asian countries in organ donation

Mehdi Shadnoush, head of the Health Ministry's center for transplantation and disease management, announced in June 2020 that Iran is ranked first for organ donation among Asian countries.

“The country’s organ donation rate is 14.34 per one million people,” he noted.

In February 2019, Shadnoush said that the organ donation rate has increased by 60 times over the past 18 years. Although Iran ranks 26 in organ donation in the world.

Organ donation of brain death has reached up to 60 percent, he said, lamenting that the country ranks 21st regarding organ donation from brain dead patients in the world while ranking 14th regarding organ transplant from alive patients.

According to the figures revealed by the International Registry in Organ Donation and Transplantation (IRODaT), Spain leads the world in organ donation.

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