Two government orders issued last month clarify procedures for declaring brain death and make it mandatory for hospitals in the State to adopt them The government orders clarify several procedures that are ambiguous in the Transplantation of Human Organs Act, 1994. For instance, it gives the procedure for performing apnea tests, which are essential for declaring brain death } Chennai FOR the first time in the State, two government orders (GOs) that outline the procedures for declaring brain death and make it mandatory for hospitals to adopt them, have been issued. The orders came last month and are due to be implemented in all government hospitals. Add to that a third GO, which is currently being worked upon. "It deals with organ sharing and other procedures relating to this,'' Health Secretary V K Subburaj said. For doctors in the city, all this is welcome news, as declaration of brain death is the first step in the process of harvesting organs for cadaver transplants. Though the Transplantation of Human Organs Act, 1994 and the Transplantation of Human Organs Rules, 1995 provide procedures for declaration of brain death, this is the first time these rules have been elaborated upon to ensure their applicability in the State.According to Dr Sunil Shroff, managing trustee, Multi Organ Harvesting Aid Network Foundation, the government orders clarify several procedures that are ambiguous in the Act. "For instance, it gives the procedure for performing apnea tests, which are essential for declaring brain death. It also re-defines a lot of areas, including the role of the doctors in the procedure, which makes the whole process much easier,' he said. Experts are increasingly calling for more cadaver transplants to cope with the demand of organs. "Our capacity to do cadaver transplants is huge but so far, the procedures for doing them have not been clear. We have brought in these orders to clarify the procedures, so we can do more such transplants,'' said Subburaj. Procedures for cadaver transplants were first specified around the late 1970s. Yet, only around 150 cadaver transplants have been performed in the State so far. This is not only due to the absence of a proper mechanism. There is a dire shortage of counsellors to talk to the relatives of the deceased about donating organs. "For the most part, people are not against donating. If it is put to them properly and explained, they are willing. The problem is we do not have enough trained counsellors in this area,'' said Dr Shroff. He suggested that the government make it mandatory for hospitals to ask the relatives of a deceased person if they were willing to donate the organs. "Right now, many doctors shy away from asking relatives. The relatives are under no compulsion to donate, it is completely voluntary,'' he said. Prof. J Amalorpavanathan, transplant co-ordinator at the Government General Hospital, concurred. He said this was what doctors had been waiting for, for decades. "Once the orders are implemented, then we will know how well it is going,'' he said. The government is also planning to collaborate with private hospitals to create an organ-sharing network, Subburaj said. Ray of hope Demand high 70,000 people in the country need a new kidney every year. Not even a quarter of them get a transplant. Thousands of others need hearts, lungs and livers Supply low 12,000 people die in road traffic accidents in the State every year. Many of their organs could be used in cadaver transplants Problem Procedures for cadaver transplants were first specified in TN in 1970s.