More than 2.5 lakh Indians require organ transplantation annually . However, less than 10% get timely help.Although the number of organ donors and transplantations in India have increased significantly over the last decade, it is not sufficient.

To deal with this crisis, the medical experts in India are now looking at organ donation immediately after the donors' heart stops beating. Countries like Spain, UK and Australia are already doing this, said Dr Avnish Seth, director, Fortis Organ Retrieval and Transplant.

Unlike brain death cases, where a person is declared clinically dead on neurologic criteria, donation after cardiac death (DCD) is considered in cases where there is irreversible cessation of circulatory and respiratory function. It is also called circulatory death, and retrieval process has to be initiated within minutes.

According to an article published in the New England Journal of Medicine, the time from the onset of asystole--the absence of sufficient cardiac activity to generate a pulse or blood flow--to the declaration of death is generally about five minutes, but it may be as short as two minutes. This time gap can be used to recover organs, most commonly kidney and liver, and also pancreas, lungs and, in rare cases, heart. Dr Seth said initially they plan to target only those patients who have given consent for organ donation after brain death and lose cardiac functions before the retrieval takes place. “There are at least 50 such cases annually across all hospitals where retrieval could not be done since the donor suffered from cardiac death. Once the technology and Standard Operating Procedures (SOPs) are established, we can expand its scope further,“ he said. Fortis Memorial Research Institute in Gurgaon is holding an international conference on Saturday where experts from Spain will explain the procedure involved in organ retrieval in such cases.

Aarti Vij, chief of the Organ Retrieval and Banking Organisation at AIIMS, said one of the common causes for refusal of organ donation is the lack of awareness about the consequences of brain death--irreversible loss of brain functions.

“Most families think their loved ones have a chance to recover till the heart is working.But if we can evolve SOP for retrieval of organs even after the heart beat stops, many such families may agree to donate, thus adding to the organ pool,“ she said.

The experts said kidneys and liver can be retrieved even after the loss of circulatory function from patients who are on a ventilator due to devastating or irreversible brain injuries such as those caused by trauma or intracranial bleeding or end-stage musculoskeletal disease. In few cases, the doctors have also managed to successfully retrieve and transplant heart from a DCD.