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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 110-112

Impact of green corridors in organ donation: A single-center experience


Department of Hospital Administration, PGIMER, Chandigarh, India

Date of Web Publication29-Jun-2018

Correspondence Address:
Dr. Raman Sharma
Department of Hospital Administration, PGIMER, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_11_18

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  Abstract 


With the onset of 21st century, organ donation (OD) has taken a big stride, still waiting for organ transplants is higher than its availability. Donating a life after one's death to someone you even do not know is one of the noble humanity causes. In Indian scenario, with the inception of Transplantation of Human Organs Act, 1994, multiple active initiatives were undertaken time to time for promoting OD; similarly, green corridors have also come in a big way for transfer of organs for interinstitutional transplantation. The institute undertook its first green corridor for OD in 2015 when liver was sent to one of the hospitals, and till date, 25 green corridors have been established where 27 organs have been shared with other institutes nationwide besides intrainstitute transplantations. Although this noble cause has taken its initial steps, still, innovations, and opportunities for promoting OD should be explored in a continuum for foreseeable better future.

Keywords: Green corridor, Impact, organ donation, organ transplantation


How to cite this article:
Koushal V, Sharma R, Kumar A. Impact of green corridors in organ donation: A single-center experience. Indian J Transplant 2018;12:110-2

How to cite this URL:
Koushal V, Sharma R, Kumar A. Impact of green corridors in organ donation: A single-center experience. Indian J Transplant [serial online] 2018 [cited 2019 Sep 15];12:110-2. Available from: http://www.ijtonline.in/text.asp?2018/12/2/110/235585




  Introduction Top


The success of organ donation (OD) and transplantation in the 21st century has resulted in one of the biggest conundrum; waiting for organ transplants is simply higher than its availability.[1] To address this challenge of discrepancy between demand and supply in organ transplantation, a variety of approaches have been implemented, i.e., promotion of live donation, efforts to expand deceased donor donation, paired donor exchange, split OD, improved efficiency of donation process, increasing public awareness, sharing models, and greater utilization of expanded criteria donors.[2]

The pledge of OD after one's death to needy ones is Donating a Life' to someone you even do not know. An actual organ donor is a deceased or living person from whom at least one solid organ or part of it has been recovered for the purpose of transplantation, but, in brain death, though one is declared dead, organs are still alive and kept viable through artificial support system. Patients classified as brain dead can have their organs surgically removed for OD. Spain has consistently recorded the highest deceased OD rate of 35.1 per million population (pmp) followed by the USA (21.9), the UK (15.5), and Sweden (13.8).[3],[4],[5],[6] India with population over a billion lags far behind in OD campaign with a national deceased donation rate of <1 pmp.[7],[8],[9] Tamil Nadu is the only model state of India having an OD rate of 1.8 pmp, which is seven times higher than the national average (0.05–0.08) of OD.[10],[11] In India, the annual organs' requirement is about 260,000 organs every year (180,000 kidneys, 30,000 livers, and 50,000 hearts), while only 6000 kidneys, 1200 livers, and 15 hearts are transplanted annually (National Organ Transplant Program).

The Government of India (GOI) in 1994 passed Transplantation of Human Organs Act (THOA) where brain death concept was legalized and organ procurement from heart beating and brain-dead donors were facilitated. GOI undertook multiple initiatives for promotion of OD, namely, procedure adopted for cadaver transplant, criteria for nontransplant centers to retrieve organs, mandatory declaration of brain deaths, postmortem procedures, and a counseling department for all registered hospitals. The strong political commitments along with participation of nongovernment organizations have put an impetus on OD promotion. Furthermore, initiative of green corridors has come in a big way for transfer of organs for interinstitutional transplantation.


  Green Corridors Top


Green corridor is a demarcated, cleared out special road route created for an ambulance that enables harvested organ(s) meant for transplant to reach the destined hospital. It is a special corridor created without any stoppages which ensures that, during transit, organ(s) arrive at its specified destination within the shortest possible time. The prime objective of creation of these green corridors has arisen from the fact that organs have a short preservation time; henceforth, within few hours, the entire process, right from harvesting, interinstitutional transportation, and final transplantation surgery must be completed [Figure 1]. Studies suggest that the shorter the wait between harvest and transplant, the better the odds are of the surgery being successful making early transportation more important.[12],[13]
Figure 1: Time for transplantation

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The idea of setting these green corridors for organ transportation refers to corridors which are usually created in the country for safety and security of VIP motorcades to bypass traffic on heavily choked routes. At that time, street signals are manually operated to avoid red lights and to manage green corridors during peak traffic hours. In the past few years, this concept of green corridors has taken up across the nation from North to South and East to West part of India and has successfully managed to save a number of lives through timely delivery of organs. This article is an attempt to describe the light of these green corridors in propelling the concept of OD donation further to a new platform.


  Impact Top


The present study was conducted in one of the premier tertiary care multispecialty hospitals of North India providing services to states of Punjab, Haryana, HP, Uttarakhand, Uttar Pradesh, and to city itself. The institute took over the OD program in 1963 with the cornea donation. The active lead for OD program was taken on with the inception of THOA, 1994, where active measures were taken to promote the OD in the institute. Since then, there has been a significant rise in OD program [Figure 2] and [Table 1].
Figure 2: Year wise cadaver donations

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Table 1: Onset of organ donation initiation in postgraduate Institute of Medical Education and Research, Chandigarh

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The institute undertook its first green corridor for OD in 2015 when liver was sent to R and R Hospital, Delhi [Table 2]. After that, there was no look back and till date 25 green corridors have been established and 27 organs have been shared with other institutes nationwide [Table 3]. To establish a “Green corridor,” institute's security wing coordinates with police authorities, especially traffic police authorities and police control room (PCR) of the city. After, fulfillment of required documentation, a PCR vehicle is specially deputed with the institute on the specified time of organ retrieval and transportation. Moreover, needed instructions are given to traffic police for managing the said corridor. This PCR leads the ambulance till airport or the area under its jurisdiction, where, further, PCR of adjoining city/state coordinated for the same. With green corridor, the 45 min (approximately) distance is covered in minimal of 12–14 min. The establishment of “Green corridor” is a tedious process due to multistakeholders' involvement, and a coordination has to be established by the donor institute with different state police authorities, airport authorities, airport security Central Industrial Security Force, recipient institute, and that has to be executed within possible shortest duration to keep organ viable.
Table 2: Organ sharing with other institutes

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Table 3: Comparison of organ donations within institute and with other nation-wide institutes

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  Conclusion Top


There are excellent opportunities for promoting OD through education, awareness and legislation. Innovations and potential opportunities should be explored in a continuum for promoting deceased donation for promoting deceased donational for foreseeable better future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Shanmugarajesh K, Villani V, Madariags ML, Shalhoub J, Michael SG. Current progress in public health models addressing the critical organ shortage. Int J Surg (London, England) 2014;12:1363-8.  Back to cited text no. 1
    
2.
Saidi RF, Hejazii Kenari SK. Challenges of organ shortage for transplantation: Solutions and opportunities. Int J Organ Transplant Med 2014;5:87-96.  Back to cited text no. 2
[PUBMED]    
3.
Matesanz R, Domínguez-Gil B, Coll E, de la Rosa G, Marazuela R. Spanish experience as a leading country: What kind of measures were taken? Transpl Int 2011;24:333-43.  Back to cited text no. 3
    
4.
Matesanz R, Miranda B. A decade of continuous improvement in cadaveric organ donation: The Spanish model. J Nephrol 2002;15:22-8.  Back to cited text no. 4
[PUBMED]    
5.
Matesanz R. Factors influencing the adaptation of the Spanish model of organ donation. Transpl Int 2003;16:736-41.  Back to cited text no. 5
[PUBMED]    
6.
Matesanz R, Domínguez-Gil B. Strategies to optimize deceased organ donation. Transpl Rev 2007;21:177.  Back to cited text no. 6
    
7.
Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol 2009;25:348-55.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Chugh KS. Five decades of Indian nephrology: A personal journey. Am J Kidney Dis 2009;54:753-63.  Back to cited text no. 8
[PUBMED]    
9.
Making after-life a reality in India: Executive Summary of National Round Table on Organ Donation from Deceased Donors. Lucknow: King George Medical University; 2014.  Back to cited text no. 9
    
10.
Cadaveric Transplant Program. Government of Tamil Nadu, Tamil Nadu Network for Organ Sharing; 2013.  Back to cited text no. 10
    
11.
Abraham G, Reddy YN, Amalorpavanathan J, Daniel D, Roy-Chaudhury P, Shroff S, et al. How deceased donor transplantation is impacting a decline in commercial transplantation-the Tamil Nadu experience. Transplantation 2012;93:757-60.  Back to cited text no. 11
[PUBMED]    
12.
Kilic A, Emani S, Sai-Sudhakar CB, Higgins RS, Whitson BA. Donor selection in heart transplantation. J Thorac Dis 2014;6:1097-104.  Back to cited text no. 12
[PUBMED]    
13.
Walter J, Burdelski M, Bröring DC. Chances and risks in living donor liver transplantation. Dtsch Arztebl Int 2008;105:101-7.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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  In this article
Abstract
Introduction
Green Corridors
Impact
Conclusion
References
Article Figures
Article Tables

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