organ donation in sri lanka essay

• Sci & Tech
• Biz & Economy

Giving the Gift of Life: Shedding Light on Organ Transplantation in Sri Lanka

Consultative workshop on organ transplantation at teaching hospital peradeniya.

In the face of untimely deaths, a glimmer of hope emerges through the selfless act of organ donation. While the loss of a loved one is immeasurable, the potential to save numerous lives through organ transplantation offers solace to grieving families. However, due to prevalent myths, negative connotations, and a fundamental lack of information about the delicate procedure of organ transplantation, the reality of organ donation falls short of its promise globally.

While the concept is relatively new in Sri Lanka, a recent workshop held at the Teaching Hospital Peradeniya aimed to raise awareness and dispel misconceptions about this life-saving practice.

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Recognizing the need for greater awareness, a group of dedicated individuals, including Dr. Arjuna Thilakaratne, Director of Teaching Hospital Peradeniya, Dr. Amali Jayasinghe, Organ Transplant Co-ordinator – Teaching Hospital Peradeniya, Professor Arinda Dharmapala, Professor in surgery – University of Peradeniya, Professor Rajitha Abesekara, Consultant Nephrologist – Teaching Hospital Peradeniya, Professor Bandula Samarasinghe, Consultant Surgeon – Teaching Hospital Peradeniya, Professor Saman Nanayakkara, Consultant Anaesthesiologist – Teaching Hospital Peradeniya, Professor Shenal Thagahagoda, Paediatric Nephrologist -, Teaching Hospital Peradeniya, Dr. Senani Samarasinghe, Consultant Anesthetist in transplant Anesthesia and intensive care – Teaching Hospital Peradeniya, Dr. Buddhika Dasanayake, Consultant hepatobiliary surgeon – Teaching Hospital Peradeniya organized a consultation workshop on organ transplantation on January 4, 2024, at the Peradeniya Teaching Hospital auditorium. The workshop, brought together experts in the field to share their knowledge and experiences.

Dr. Arjuna Thilakaratne, Director of Teaching Hospital Peradeniya, in his welcome address, set the tone for the workshop, emphasizing the urgency of dispelling misconceptions surrounding organ transplantation. He highlighted the workshop’s focus on elucidating the intricacies of the process, fostering a deeper understanding, and encouraging a shift in public perception.

“While organ transplantation may be a relatively new concept in Sri Lanka, the need for it is undeniable. Workshops like this play a crucial role in raising awareness and demystifying this life-saving practice. By educating the public on the transplant process, its benefits for recipients, and the post-operative journey, we can dismantle prevalent misconceptions and ideologies that hinder organ donation. This program holds immense potential to encourage understanding and foster a more positive attitude towards this selfless act of giving.”

Professor M. D. Lamawansa, the Vice Chancellor of the University of Peradeniya and a pioneer in organ transplantation at Teaching Hospital Peradeniya, shared his invaluable experiences. He highlighted the critical need for organ donation, noting that many lives are lost due to a lack of available organs. Despite witnessing the positive impact on recipients’ lives, he lamented the low levels of organ donation, due to prevailing misconceptions and a general lack of understanding about the concept of brain death.

He disclosed the disparity in Sri Lanka’s approach to organ donation. While practices like cornea donation and bequeathing bodies for medical study are relatively common, organ donation after death remains significantly lower. He attributed this to two key factors: a lack of public understanding about brain death (the crucial neurological state when organs can be ethically harvested) and limited knowledge about the organ donation process itself.

He then contrasted this with the profound gratitude and joy expressed by transplant recipients, a sentiment echoed by his own satisfaction as a physician witnessing these life-saving outcomes. In light of this transformative potential, Professor Lamawansa expressed his sincere appreciation for the workshop and its aim to raise awareness and encourage participation in this selfless act of giving.

The workshop unfolded with enlightening sessions, starting with Professor Arinda Dharmapala who provided a historical context to organ transplantation and an introduction to it.

Professor Dharmapala went into the extensive history of organ donation, including artwork from the 1400s. He cited a well-known 1495 piece depicting Saints Cosmas and Damian undertaking an organ transplant to demonstrate the concept’s prevalence in Western art history. He also showed comparable depictions in Sri Lankan art, where several pieces depict animals with switched body parts, implying a parallel cultural connection with the notion of organ donation even in ancient Sri Lanka.

He elaborated on the range of organs and tissues suitable for donation. Among organs, he listed hearts, lungs, kidneys, livers, intestines, and pancreas. Additionally, various tissues can be donated, including corneas, skin, heart valves, bones, blood vessels, ligaments and tendons, cartilage, and nerves.

While kidney and liver transplants are prioritised in Sri Lanka, it is worth noting that the country’s first heart operation was successfully completed in 2017 at the Kandy National Hospital.

Sri Lanka currently witnesses roughly 5 – 10 patients, seeking organ transplantation procedures abroad. These overseas ventures incur enormous expenditures, ranging between 100 and 150 lakhs, reflecting a significant financial outflow from the country. This highlights the potential economic benefits of increasing domestic organ donation, as a robust supply within Sri Lanka could eliminate the need for costly foreign procedures. Fortunately, the nation has already established a strong legal framework that readily facilitates seamless organ transplantation processes.

Despite having the necessary legal framework, readily available specialists, and dedicated transplant centres (such as MOH Ragama, Colombo, Kandy, Peradeniya, and the proposed North Colombo Liver Centre), DDT (deceased donor transplantation) remains significantly lower than live donations, according to Professor Dharmapala. While live donation is a vital alternative, it involves inherent danger to the donor, making DDT preferable from an ethical and safe aspect. As a result, considering the enormous advantages and low donor risk, raising awareness and promoting DDT should be a key emphasis of Sri Lanka’s organ donation initiatives.

Dr. Buddhika Dasanayake, Consultant Hepatobiliary Surgeon at Teaching Hospital Peradeniya, shed light on the complex and delicate process of liver transplantation. From the initial diagnosis to post-operative recuperation, he informed the audience that every precaution is taken to protect the safety and well-being of both the donor and the receiver. This includes the initial diagnosis of transplant need, as well as open communication with patients about both the advantages and potential hazards. The thorough method covers the whole recovery trajectory for live donors. In the event of a dead donor, the legal framework and ethical factors are given careful consideration. Organs are obtained only when a panel of independent physicians confirms brain death and with the informed agreement of legal guardians.

Professor Rajitha Abesekara, Consultant Nephrologist at Teaching Hospital Peradeniya emphasized the critical need for organ donation in Sri Lanka.

Sri Lanka faces a significant public health challenge with the high prevalence of Chronic Kidney Disease (CKD). Aside from Chronic Kidney Disease, Sri Lanka faces a grim reality in terms of liver and lung failures, which are mostly due to the increased incidence of smoking, alcohol, and drug addiction.

When it comes to CKD, this progressive and irreversible decline in kidney function severely impacts lives and demands effective treatment options. While dialysis, in its hemodialysis and peritoneal dialysis forms, provides temporary relief, kidney transplantation is a better option. Prof. Rajitha Bandara emphasises the benefits of transplantation in terms of cost, patient mobility, and overall quality of life, stating that it has the potential to provide a thousand fold improvement over dialysis.

As a result, increasing organ donation becomes critical to meet the demands of these patients and provide them with a much better life.

Two primary pathways exist for organ donation: live donation and deceased donation. While live donation, often involving family members, is more common, it poses unique challenges. Compatibility issues or pre-existing health conditions in potential donors may limit its feasibility. Ethical dilemmas can also arise, particularly in situations involving altruistic donations where motivations and potential risks to the donor require careful consideration.

Given these constraints, a deceased donor (brain death) donating appears to be the best option. Organs extracted from brain-dead patients with the legal approval of their families by certified medical experts provide a conveniently available supply for transplants while minimizing dangers to living persons.

The workshop also addressed the ethical considerations surrounding organ donation. Dr. Senani Samarasinghe, Consultant Anesthetist in Transplant Anesthesia and Intensive Care at T.H. Peradeniya, discussed the care provided to organ donors in the ICU, emphasizing the importance of a transparent and respectful process.

Dr. Senani went through the complexities of caring for organ donors in the ICU. She highlighted the painstaking labour of committed medical experts who operate under strict legal guidelines to get the best possible results. Whether for live or deceased donors, their focus is on upholding donor welfare and maintaining open communication with families throughout the process.

She emphasized the crucial fact that not all deceased people are qualified to donate their organs, highlighting the significance of careful medical evaluations and formal legal processes. This transparent approach fosters trust and ensures ethical practice in this life-saving field.

A pivotal aspect introduced by Dr. Amali Jayasinghe, Transplant Coordinator at Teaching Hospital Peradeniya, was the establishment of an organ donor register. The goal of this project is to simplify the legal procedure and increase the effectiveness and accessibility of organ donation. She highlighted the current limitations of organ donor registration, noting that it is primarily facilitated at Sri Jayawardenapura Hospital. However, she expressed exciting news that with this workshop, Teaching Hospital Peradeniya will be establishing a dedicated organ donor registry. This means individuals over 21 years old can now register as organ donors at either hospital.

In her explanation of the benefits of maintaining an accurate organ donor registry, Dr. Jayasinghe emphasised that a centralised system would speed up legal processes and reduce waiting periods for patients in urgent need of transplants. Donor data that is easily accessible makes the matching process more effective and, eventually, saves more lives.

She then focused on the potential of deceased donor (brain death) donations, urging the audience to move beyond negative misconceptions and consider the immense benefits this option offers. She underlined the need to treat those who have been deemed brain-dead by strict rules with the highest respect and care. Two senior specialists independently assess and confirm brain death before any further discussion takes place. The transplant coordinator then acts as an impartial mediator, openly discussing the situation with the family and the medical staff to come to a mutual decision about organ donation. This careful procedure guarantees moral behaviour and fosters confidence among all parties involved.

The event’s climax witnessed notable figures, including Rev. Wellawatte Seelagaveshi Thero, Dr. Arjuna Thilakarathna, and Prof. Arinda Dharmapala, symbolically registering as organ donors. This inspiring gesture prompted many attendees to follow suit, signifying a collective commitment to the cause.

Lending further credence to the workshop were esteemed guests like Dr. Kumudu Bandara, Deputy Director of Teaching Hospital Peradeniya, and Prof. Wasanthi Pinto, Dean of the Faculty of Medicine, University of Peradeniya. Adding gravitas were luminaries like Prof. Bhadra Hewawitharana, Prof. Udaya Ralapanawa, Dr Thilak Abesekere, Consultant Nephrologist, Consultant Dr. Jeewantha Rathnayake and Consultant Dr. Chulanga Wickramasinghe, and Consultant Psychiatrist Dr. W.A.L. Wickramasinghe, President of Nivahana Society of Kandy.

Death is unfortunate and unexpected, yet we all know that to be born is to die. This workshop resonated with the poignant message that, though death is inevitable, the act of organ donation can extend a lifeline to those in need. Organ donation is a gift, that can be a final act of generosity upon deathbed even. By raising awareness, dispelling myths, and encouraging people to register as donors, Sri Lanka can make a significant difference in the lives of countless individuals facing organ failure. More importantly, humanity can embrace the generosity of organ donation and collectively strive to make the world a better place, one life at a time. Organ donation where the donor is both treated with the utmost respect and blessed and the receiver feels saved and relieved to be able to live another day without less struggle is truly a feat humanity has achieved and it is best to support it as humans with conscience.

-Sachinthani Ketakumbura-

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8th June, 2024

A brief overview of organ donation and transplantation in Sri Lanka

23 May 2022

• To make all health care personnel more aware as to how they can help to increase the options for organ donation while engaging in ordinary duties as a “community service” (but a health worker should not promote such to individuals while they are on duty, as it is not ethically accepted). 
• To include at least one lecture with well-organised learning outcomes (and in turn assessments) in the medical curriculum in order to provide an overview of organ transplantation in our country and around the world.  
• To make all students in a suitable grade aware about organ transplantation, the relevant knowhow and what to know by introducing a chapter in a textbook. 

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NATIONAL TRANSPLANT PROGRAMME

MORE INFO DOWNLOAD NOW -->

Organ donation in Sri Lanka was ratified by the Human Tissue Transplantation Act No. 48 of 1987. Fist live donor organ transplant was conducted in 1985 by Dr. Rezvi Sheriff and currently a living donor transplant is the most popular, frequently performed transplant surgery in Sri Lanka (R Sheriff et al.,1992). The first cadaveric kidney transplant took place in Sri Lanka in 2004 in Teaching Hospital Kandy (Harrischandra et al., 2017). Director General of Health Services (DGHS) issued DGHS Circular No: 01-37/2010 with necessary guidelines to establish National decease donor transplantation programme in Sri Lanka. Currently the National Transplant programmes is under the Deputy Director General Medical services 1 and the administrative head of the programme is the National Transplant Cooridnator

National Transplant Advisory Council

National transplant advisory council is established under the provisions of the human tissue transplantation act no. 48 0f 1987..

Dr.Asela Gunawardena

Dr.Lal Panapitiya

Dr.Sudath Dharmaratne

Dr.Hemantha Herath

Dr.Ajith Thennakoon

Dr.Ramya Amarasena

Prof.Asitha De Silva

Prof.Rohan Siriwardana

Dr.Ruwan Dissanayake

Dr.Udana Ratnapala

Dr.Charitha Fernando

Dr.Jeewaka Galhenage

Dr.Ayanthi Karunarathne

Dr.Avanthi Rupasinghe

Dr.Anushika Abeynayake

Past national transplant coordinators.

Dr.Rathnasiri Hewage

Dr.Ashani Rathnakeerthi

Transplant coordinators.

National Policy

National Policy on Organ Tissue and Cell Transplantation 2022-2026 (health.gov.lk) Download

Strategic Plan

National Strategic Plan on Organ Tissue and Cell Transplantation 2022-2026 (health.gov.lk) Download

Transplantation Of Human Tissues (lawnet.gov.lk) Link

Circular No 01-09/2015

National Transplant Programme: Streamlining Deceased Donor Organ Transplantation (Issued Date 2015-03-09) Link

Circular No 01-37/2010

Implementation of the National Organ Donor Programme for Deceased Donor Organ Transplantation (Issued Date 2010-10-14) Link

Circular No 01-39/2021

Conformation of Brain Death and Promote National Deceased Donor Organ Transplantation Programme (Issued Date 2021-10-28) Link

Not Given Link

Training Materials Link

Tissue And Organ Transplant Programme In Sri Lanka

Sri lanka’s actions to date.

• Organ donation in Sri Lanka was ratified by the Human Tissue Transplantation Act No. 48 of 1987. Fist live donor organ transplant was conducted in 1985 . The first cadaveric kidney transplant took place in Sri Lanka in 2004 in Teaching Hospital Kandy
• Director General of Health Services (DGHS) issued Circular No: 01-37/2010 with necessary guidelines to establish National decease donor transplantation programme in Sri Lanka.
• Establishment of Transplant Advisory Council according to Human Tissue Act ,No 48,of 1987
• Development of guidelines to establish Transplant Ethics Review Committees
• Established a National Transplant Policy
• Appointing and training, of institutional Transplant coordinators
• Collaborating with WHO, affiliated data bases GODT (Global Observatory Data on Transplant) to share transplant activity in Sri Lanka
• Strengthening transfusion services and establishment of National Tissue Bank at National Blood Transfusion Services

Current Situation And Challenges

Despite the range of activities developed by the Ministry of Health and other stakeholders since the adoption of resolution WHA63.22, there is still insufficient growth in development of transplantation in Sri Lanka. Notwithstanding the differing capabilities and priorities of health care systems, common national and regional barriers persist as a result of:

• Low organizational and political commitments, and therefore lack of significant funding, human resources, or infrastructure.
• Lack of understanding of the burden of disease in order to escalate interventions for preventing end-stage organ failure
• Limited community awareness and knowledge, as well as cultural resistance
• Deficiencies in deceased donor identification and donation management.
• National and regional data collection is not performed in a uniform manner to accurately capture donation, processing, distribution, and use, and to monitor outcomes.

Despite These Challenges

We were managed to

• Highest number of Deceased donors ever in 2022
• Highest number of live and deceased donor transplants ever 2022, in government hospitals

National Transplant Information System (NTIS) is Web based applications that facilitate the Notification pathway of donor availability. Transplant coordinators are authorized to access this system using provided credentials

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Enhancing organ transplantation in Sri Lanka

In the framework of a 4-years collaboration through the ISN-TTS sister transplant center program, a team of donation and transplantation experts visited Sri Lanka, with the primary objective of advancing and enhancing pancreas transplantation and organ donation practices within the country.

The team visited the Sri Jayewardenepura General Hospital in Colombo, assessing their program and providing with valuable insights and recommendations. Afterward, they visited the Sri Lanka Human Tissue Bank and Sri Lanka International Eye Bank, one of the leaders in their region, to share experiences and future collaborations.

The organization of a joint symposium on pancreas transplantation, conducted in collaboration with the Sri Lanka Society of Nephrology and the Sri Lanka College of Endocrinologists, served as a platform to exchange knowledge and expertise. The collaborative discussions aimed at bridging gaps in understanding pancreas transplantation and its implementation in Sri Lanka.

DTI professionals also participated in a National Workshop on Multi-Organ Procurement and Transplantation organized by the Sri Jayewardenepura Transplant Unit. This workshop attracted more than 120 professionals from the whole country, creating a dynamic environment for in-depth discussions on the latest techniques and methodologies in deceased donation and multi-organ transplantation.

To strengthen ties with local authorities and ensure the sustainability of advancements, the visiting healthcare professionals engaged in a strategic meeting with authorities from the Ministry of Health. This meeting was instrumental in aligning strategies and building a collaborative framework for ongoing support.

As part of the 40th Annual Congress of the College of Anesthesiologists & Intensivists in Sri Lanka, the team held a post-congress specialized “Workshop on Deceased Multi-Organ Donation and Transplantation”.

In summary, the exchange of knowledge, experiences, and best practices through symposia, workshops, and strategic meetings laid the foundation for a strengthened healthcare system in Sri Lanka, ultimately benefiting patients in need of organ transplants.

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Tissue donation and transplantation program in Sri Lanka : a medico-legal point of view

• P.B. Dassanayaka
• D.H. Edussuriya
• M.J.F. Rukshana
• P.B. Dassanayaka , Colombo South Teaching Hospital, Kalubowila, Colombo, Sri Lanka JMO”s Office
• D.H. Edussuriya , Faculty of Medicine, University of Peradeniya, Sri Lanka Department of Forensic Medicine
• M.J.F. Rukshana , Faculty of Medicine, University of Peradeniya, Sri Lanka Department of Forensic Medicine

Tissue donation and organ transplantation plays a key role in the management of the critically ill patient.

The harvesting of organs for transplantation is done according to the legal framework of the country and based on circulars, protocols and guidelines of health and legal authorities. Clear knowledge regarding medico-legal issues and ethical aspects are mandatory for an effective transplantation program.

The authors attempt to critically evaluate the medico-legal and ethical aspects pertaining to the existing system for tissue donation and transplantation in Sri Lanka and compare the local provisions with those existing in other countries. It is envisaged that this would enable identification of amendments required.

• Page/Article: 23-32
• DOI: 10.4038/sljfmsl.v9i1.7803
• Peer Reviewed

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Public knowledge on brain death and organ donation in Sri Lanka

Sri Lankan Journal of Anaesthesiology

Related Papers

NITIKA SHARMA

Introduction: Awareness about brain death influences organ donation behaviour of community. There is huge gap in the demand and availability of organs in India. This study was carried out with the objective of assessing awareness about brain death and attitude towards organ donation in a rural community. Material and Methods: A community based cross-sectional study was carried out among 1050 adults in a rural area of district Faridabad, Haryana. Data were collected through a pre-tested interview schedule and analysed using SPSS v17. Results: 80% of the study participants had heard about organ donation. Among them, about 40% were aware of brain death. Majority of the study participants (71.5%) were willing to donate organ irrespective of circumstances. Totally, 94.6% participants had the perspective that special facility should be there for organ donors and their families. Awareness was significantly more among men and among those educated above primary level. Conclusion: Knowledge a...

Liver Transplantation

PANKAJ JOSHI

Organ donation following brain stem death is infrequent in India. There is no prospective study on prevalence of brain stem death and causes of non-donation. Consecutive patients admitted to intensive care unit from Sep 2006 to Sep 2008 were studied prospectively. Families of those with brain stem death were approached for organ donation by transplant coordinator. Extensive awareness drive was launched. Reasons for non-donation, if any, were documented. Of 2820 patients admitted, 994 (35%) were on mechanical ventilator and 657 (23%) died. Brain stem death could be diagnosed in 55, 37 males, median age 46 years (range 7 to 87 years) i.e., 1.9% of all admissions and 8.3% of all deaths. Among neurology and neurosurgery patients brain stem death was seen in 45 of 1037 (4.3%) admissions and 45 of 161 (27.9%) deaths. Complications of brain stem death were hypotension in 49, diabetes insipidus in 17 and hypertension in 5 patients. Of 33 families counselled, 16(48%) consented to organ donation. In 14(42%), organs and tissues retrieved and transplanted included 13 livers, 23 kidneys, 25 corneas and 5 cardiac valves. Consent was more likely in females (10 of 14 as compared to 6 of 19 males, p = 0.037). Consent did not correlate with age of donor or medico-legal issues (p = 0.227 & 0.579 respectively). Trained staff with requisite systems in place produced significant organ donation rates. Religious issues and medico legal concerns were not a major hurdle towards organ donation. Female patients with brain stem were more likely to become organ donors. Liver Transpl 15:1443–1447, 2009. © 2009 AASLD.

britzer paul

BACKGROUND: Organ donation is considered to be a noble act. Medical and nursing students will be the major healthcare providers in this field in the future. Hence, their knowledge, attitude, and perception toward organ donation are essential to improve this field in the future. OBJECTIVE: The objective of this study is to assess the knowledge, attitude, and perception on organ donation among undergraduate medical and nursing students. This study brings forth the basic understanding level of the medical and nursing students on the concept of organ donation. METHOD: A cross-sectional descriptive study was conducted among the first 4 academic years of medical and nursing students in a tertiary care teaching hospital using convenient sampling. A total of 620 students participated in this study. They were assessed using a pretested semi-structured self-administered questionnaire. The data were analyzed using Statistical Package of the Social Sciences version 19. RESULTS: The median score on knowledge, attitude, and perception among the medical students was 16 (14-17), 25 (23-28), and 41 (38-45), respectively, and among the nurses, the scores were 14 (12-16), 25 (22-27), and 39 (33-42), respectively. Almost half (46.9%) of the study participants knew the definition for brain death. Twenty-nine percent of the study participants knew about the existence of law toward organ donation; more than half of those participants (52.7%) mentioned few rules and regulation involved in the laws pertaining to organ donation. CONCLUSION: Media is the major source for information. Only less than half of the study participants were knowledgeable on the definition of brain death and existence of organ donation law. Although they are in favor of organ donation, doubts still exist among few of the participants which could be understood through further research in this field.

Amrita Journal of Medicine

Zubair Mohamed

Review Article Religion plays a major role in the life of most people from the Indian subcontinent. Although religions originated many centuries years ago, the concepts of brain stem death and organ donation are less than a 100 years old. While acknowledging that religions have various denominations and may have varying opinions within them, this article attempts to provide a balanced view of how the major religions in India view these concepts of modern medicine.

Journal of the Neurological Sciences

Marwan Othman

Background: Deceased organ donation rates are extremely low in India. As future physicians, medical students can advocate organ donation in society. However, their knowledge, attitudes, and practices regarding organ donation remain understudied in India. Therefore, the present study aimed to assess the knowledge, attitudes, and practices related to deceased organ donation among undergraduate medical students in India using a mixed methods approach. Materials and methods: This is a mixed-method study with a cross-sectional survey conducted among 400 randomly selected medical students at a medical college in India using a pretested questionnaire. Additionally, 20 in-depth interviews were conducted to gain qualitative insights. Results: Knowledge was high regarding organ donation (90%) but lower for brain death (27.5%). Most had positive attitudes, but only 11% were registered donors, and 10% had discussed organ donation with family. Multivariate regression revealed that having third-and fourth-year-old students, urban upbringing, good knowledge, and positive attitudes were associated with increased willingness to donate. Qualitative findings revealed gaps in brain death understanding, religious myths, lack of conviction, and family disapproval as barriers. Conclusion: Despite good awareness, gaps in the comprehension of brain death persist among students. However, the registration and family discussion rates are very low. Targeted strategies such as integrating ethical issues into medical curricula, public awareness campaigns busting myths, simplifying donor registration, and promoting family conversations are strongly recommended. This can empower students to become physician advocates driving organ donation uptake in India.

Transplantation Proceedings

International journal of health sciences

jalpa desai

Introduction: Organ transplantation provides benefits to society as a whole as well as to the individuals who receive transplants. However, the success of transplantation for end-stage organ failure is limited due to the availability of suitable organs for transplant Public awareness is critical for the development of donation program. Methods: Total 200 adult participants were included in the studies from outpatient department by consecutive sampling method. A self-administered semi structured questionnaire was filled by participants in the presence of researchers. Results: Awareness of organ donation (67.5%) was higher than awareness of body donation (34.5%) and cadaveric dissection (32.5%). About 28% and 24% participants were aware of live organ donation and brain death. Willingness for organ donation was observed 21.5% participants, unwillingness in 51.5% of participants and 27.0% in undecided state of mind. Conclusion: Knowledge level regarding organ donation was found sufficie...

Indian Journal of Critical Care Medicine

Sushma Gurav

Electronic Physician

Sima Hejazi

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Public knowledge on brain death and organ donation in Sri Lanka

• Makarim Mohamed
• Krishakeesen Kamalanthan
• Edirisooriya Maddumage Manoj
• Makarim Mohamed , National Hospital of Sri Lanka, Colombo, Sri Lanka Senior registrar, Critical Care Medicine
• Krishakeesen Kamalanthan , National Hospital of Sri Lanka, Colombo, Sri Lanka Senior registrar, Critical Care Medicine
• Edirisooriya Maddumage Manoj , National Hospital of Sri Lanka, Colombo, Sri Lanka Consultant, Critical Care Medicine

Introduction : Brain death is defined as irreversible and complete cessation of the functions of the brain and brain stem. The awareness of brain death and organ donation is still questionable among the public and the data on this aspect is lacking in Sri Lanka.

Objective : To assess public knowledge on brain death and organ donation in Sri Lanka.

Methods : 2 public surveys were performed using two questionnaires during two consecutive medical exhibitions held at Colombo during 2017 and 2018. People less than 16 years of age were excluded. No ethical approval was required, and participation was entirely voluntary with responses kept anonymised.

Results : A total of 179 and 203 participants answered the questionnaire in survey 1 and 2 respectively. More than 80% of participants have heard of brain death. From the participants, 175 (97.8%) knew donating organs can save lives and 162 (90.5%) were willing to carry an organ donor card and expressed a desire to donate organs. Furthermore, 19% of the participants had at least one relative who has donated organs. Only 78 (43.5%) knew that all the listed organs (eye, kidney, liver, lung, heart, pancreas) could be donated.

Only 88 (43.3%) knew brain death is considered legal as an individual’s death in Sri Lanka. Interestingly, 24 (11.5%) and 44 (21.7%) said ‘yes’ or ‘don’t know’ to the question on the possibility of returning to life in people with brain death respectively.

Conclusion : This shows the need of education programmes, information campaigns and public media on this aspect.

• Page/Article: 157-159
• DOI: 10.4038/slja.v27i2.8446
• Peer Reviewed

• DOI: 10.4038/SLJA.V27I2.8446
• Corpus ID: 201168127

Public knowledge on brain death and organ donation in Sri Lanka

• D. Priyankara , Makarim Mohamed , +1 author E. M. Manoj
• Published in Sri Lankan Journal of… 25 July 2019
• Medicine, Sociology

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What You Need to Know About Organ Donation in Sri Lanka

2020 Feb 17

Becoming a living organ donor or making the personal but complex decision to donate one’s organs, while alive or after death, can help save and make a profound impact on someone else’s life. Figures show that a single organ donor has the life-saving potential of safeguarding up to nine other lives, while even more stand a chance in connection with procedures such as tissue donation. Consider this your definitive guide to the specifics of organ donation in Sri Lanka.

What is organ donation?

Organ donation refers to the altruistic act of giving one or more organs (or parts of organs), without compensation, to be transplanted in someone else’s body. The process has carried legal, social, cultural and ethical concerns in times past, but remains an indispensable and life-sustaining measure that has and continues to save millions of people on waiting lists every year. Due to the many concerns attached to organ donation, most countries have legal provisions set in place in order to ensure that the procedure is done consensually, ethically and effectively. Generally, the process is strictly limited to the donation and transplantation of the heart, intestines, kidneys, liver, lungs, and pancreas (e.g., the islets of Langerhans). What is more, living donors are usually able to donate a part of the pancreas, lung, liver, intestine or kidney.

Suggestively, the World Health Organisation (WHO) states that the majority of transplanted organs across the world are, in fact, by living donors. Usually, people of any age are qualified to donate their organ on the condition that they do not have certain medical conditions. Such contraindications include, but are not limited to, active cancer, systemic infection, HIV positive status, sickle cell anemia or a history of intravenous drug abuse.

The Sri Lankan context

Most organ donations in Sri Lanka (like most developing countries) are from living donors. The year 2017 shows a record of 400 kidney transplantations performed in Sri Lanka while inversely, more than 2000 patients had died due to renal failure while awaiting transplantation. The approximate ratio of organ transplantation per total population of Sri Lanka (as of 2018) stands at 1: 52, 477. Such figures illustrate a much more pressing matter, which is the dire need for more organ donations as a measure to save more lives in Sri Lanka.

In fact, the significant gap between the supply and demand of organs has resulted in overwhelmingly long waiting lists for transplants. The lack of a proper coordinating body to efficiently handle organ transplants in Sri Lanka has been identified as a barrier in both meeting the demand for organs as well as the implementation of a national transplant programme in the country. At present, there are eight kidney transplant centers attached to National hospitals with nearly 400 transplants done every year. As for liver transplants, only two programmes at the National Hospital in Colombo and the Colombo North Teaching Hospital exist at the moment. While a majority of donations are by living donors, about 95% of organs retrieved after death are by brain-dead donors.

Procedures to be followed in Sri Lanka

According to the Transplantation of Human Tissue Act of 1987, any person above the age of twenty one years may consent in writing for the donation to take effect upon their death. This may include their body or any part or tissue thereof. If consent has been given in such a manner, it cannot be revoked thereafter. In the event where the deceased had not given prior consent for organ donation, a next of kin who is over the age of twenty one years is permitted to legally provide consent on the condition that the diseased was not opposed to the donation of his/her organs when alive. In the case of homicides where the deceased has been affected on the head and/or chest (which is the most commonly affected areas in most cases), they can still be considered as potential liver, kidney, bowel and pancreas donors. Additionally, if the cause of death is “unnatural” (i.e. a death caused by external causes such as injury or poisoning), the release of bodies are subject to an inquest followed by an autopsy examination according to the criminal code of Sri Lanka. The responsible medical practitioner checks on the possibility of organ donation once the postmortem examination is complete and consent has been previously provided by the deceased or the next of kin. A key challenge encountered here is the absence of a recognised database of potential donors or a donor card system in order to expedite the process of harvesting organs from a potential donor. This is a matter that deserves serious attention by the Ministry of Ministry of Health and Indigenous Medical Services of Sri Lanka. Mass media, on the other hand, is another influential asset in helping spread awareness on the importance of organ donation to the general public.

Donating eyes and tissues

The donation of eyes and tissues upon death is undertaken by the Sri Lanka Eye Donation Society of Sri Lanka. Eyes and tissues should be donated within 4 hours and 12 hours of death respectively. More guidelines provided by the Sri Lanka Eye Donation Society is as follows:

1. There is no age limit for donating eyes. Donors of tissues should be below 70 years of age. 2. Those with wounds in the body or those who have passed away due to an infectious disease are not eligible to donate eyes or tissues. 3. The coroner’s permission and a death certificate must be issued if a post-mortem is held. 4. The cause of death has to be mentioned. 5. Donations of eyes and tissues can either be done through prior consent of the deceased or next of kin following the death of the potential donor. 6. Priority of organ recipients will be given to Sri Lankan patients.

The Sri Lanka Eye Donation Society works around the clock to welcome such donations and trained technicians are available in order to reach the place and do the needful once they are informed. Potential eye and tissue donors can register at htb.mobitel.lk. More information can be found on their website: www.eyedonation.lk. Those interested in becoming a kidney donor can obtain more information here: www.ktsf.lk.

Busting myths

• You have to be in perfect health to donate an organ – False. A common misconception is that donors are required to have a perfectly good holistic health to be able to donate an organ. While this may help in qualifying as a potential donor, it is important to keep in mind that as long as the organ you donate is healthy, there are a lot of health conditions that will not prevent you from being a donor.
• Organ donation can be costly – False. Organ donation in Sri Lanka can only take place on a voluntary basis. Organs cannot be sold or bought according to the legal provisions of Sri Lanka.
• Living organ donation is rewarding – True. After a successful transplant, most living donors feel a sense of accomplishment with the knowledge that they were able to save a life.
• All major religions allow organ donation – True. Most religions such as Christianity, Islam, Buddhism and Hindu faiths encourage organ donation or the importance of individual choice. It is recommended that you seek advice from a religious priest if you wish to become an organ donor and this matter concerns you. With a proper coordinating mechanism in place and increased awareness on the life-saving potential of organ donation, Sri Lanka can, beyond doubt, meet the increasing demand for organ transplants in the country.

Will you gift someone a second lease on life? Register as an organ donor today.

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Live Donations

Those who donate lead a normal life. There are no side effects. However if you have any concerns regarding your health AFTER donation, it could be ascertained from past live Donors. It is vital that your family supports your donation.

Please ensure that you get their blessings to avoid potential problems to both you and the patients.

Kidney Transplant Support Foundation Organ Donation Registration Form

(Under the Transplantation of Human Tissues Act No. 48 of 1987)

Email address

Telephone No.

Blood Group

Married Yes No

If Married, No. of children

Gender Male Female

Contact : Spouse / Next of Kin Spouse Next of Kin

Name of Spouse / Next of Kin

Medical History

Have you ever had any of the following illnesses? Diabetes? Hypertension? Hepatitis of any type? Known Kidney or Heart Disease? Any Psychiartic history? If so, please furnish these details when filling your Organ donor Form.

Description of Medical Issues, if any

Download the complete donation form after filling the above

As a LIVE Donor, please fill ALL the details, and ensure that the 2 witnesses required are those of your immediate family. Completed forms should be posted to the address given.

Cash donations

Help sustain the KTSF. Contribute generously.

The KTSF is currently sustained with personal funds from the Founder. Due to the increased difficulties in doing so, we appeal to well wishers to donate whatever amount, to help sustain this life saving endeavor.

Ajit F. Perera, Commercial Bank, Kollupitiya

After death donations

Even after death, your Organs matter

After an accident, if a patient placed on a hospital ventilator is declared “brain dead”, the heart, 2 Kidneys, Liver, Pancreas, Lungs and Intestines can be harvested. Natural deaths allow the Eyes & Tissues, etc to be harvested.

A Single death can save upto 8 lives and help 50 other patients to become healthy again.

After Death Donations are currently directed to the Human tissue Bank

click here to visit the human tissue bank