Mr. Ashok Bhogle, a 48-year-old male patient was admitted at Apollo Hospital, Navi Mumbai, on 10th September 2018 with Intracranial Bleed. On 10th September 2018, the ICU Head at Apollo Hospitals Navi Mumbai informed me (since I am MOHAN Foundation’s Transplant Coordinator deputed to the hospital) about a potential brain dead donor in the neuro critical care unit.

A few moments prior, Mrs. Veena Ashok Bhogle had been given primary information by the ICU doctor that the patient was not responding to any stimuli and that they were suspecting that the brain functions had ceased. Even in those grief-stricken moments when she seemed to be gradually processing it all, she was anxious to know “Is there anything else that can be done now?”

Dr. Tushar Parmar, the ICU doctor, guided her that she could consider donating the organs of her husband for the larger cause of helping patients in need of organs. She requested more information on this. The doctor informed her that MOHAN Foundation’s counsellor would shortly get in touch with her.

At 1 pm I spoke to Mrs. Bhogle and the patient’s sister-in-law, in the critical care counselling room, in the presence of Apollo’s own Transplant Coordinators, Mr. Santosh Sorate and Mr. Prakash Saindane. I softly asked Mrs. Bhogle if she had understood the condition that her husband was in. She replied saying that she understood that her husband was in an irreversible condition as explained to her by Dr. Parmar. She further added that she wanted to explore the possibility of organ donation because she felt that by donating her organs her husband would be alive in many people who are desperately waiting for an organ. She then requested for more Information about the process of organ donation.

I then explained the process in great depth and also cleared her doubts such as how much time the whole process would take, who would the organs go to, would the recipient details be shared with the family, what all organs could be harvested and would the procedure cause any mutilation to the body. Having understood all that, Mrs. Bhogle was ready to go ahead.

Meanwhile Dr. Shailesh Kalamkar (Neurosurgeon) initiated appropriate monitoring and management of the patient at the ICU as per standard guidelines for a brain stem dead organ donor. Dr. Gunadhar Padhi (Intensivist) along with Dr. Shailesh Kalamkar did the first apnoea testing at 3.20 pm and the findings were recorded in the case file.

At 5.30 pm I received a call from the Mrs. Bhogle saying that she wished to meet me once again. The meeting took place in the counselling room but this time Mrs. Bhogle was accompanied by another gentleman whom she introduced as her ‘Mama’ (Uncle).

She informed me that while she was convinced about donating her husband’s organs but she wanted that the liver must be given to the accompanying gentleman, who she said, was a close family friend cum neighbour, whom she knew since 15 years. In fact, she added that she will consent to the donation only if the liver is given to the neighbour.

Along with the other Medical Social Workers I explained to her and the neighbour about the allocation process being transparently laid out in the law. They were assured that all rights of organ allocation lie only with the state allocation nodal agency i.e. ZTCC (Zonal Transplant Co- ordination Centre). As an example, the story of Shri Vilasrao Deshmukh (ex-CM of Maharashtra) was shared that when he was in need of liver and kidney, he still had to wait for his turn on the waiting list and in spite of his huge political clout, organs were not allocated to him out of turn and that organs are allocated strictly as per the waiting list only.

The neighbour started grumbling that it was unfair that in spite of him being a close family friend and in spite of the patient’s wife wanting to give him a liver, he was unable to get it. The hospital’s Medical Social Worker reiterated saying that the rules apply to all and that if the family decided not to go ahead with the donation; their decision will be respectfully accepted.

Mrs. Bhogle was told to take her time and make up her mind. She seemed satisfied with all the replies and immediately gave her consent to go ahead with the donation. The formal consent was taken and subsequently the transplant teams were intimated. Second Apnoea test was concluded at 10.50 pm and the findings were recorded in the Brain stem death certification form (Form No. 10) with the signatures of the Board of team Medical Experts namely, Dr. Prasad Muglikar, the Medical Superintendent in-charge of the hospital, Dr. Vaishali Lokhande, authorised specialist, Dr. Sunil Kutty, treating doctor and Dr. Suvadeep Sen, Neurologist.

On 12th September 2018, at 2am, the donor was shifted to the operation theatre for retrieval of organs. Finally, the donor’s body was wheeled into the ICU at 10 am for the final packing. The clothes in which the body was to be packed were given to the nursing staff of the ICU. All measures were taken to ensure that the donor’s family did not face any procedural delays in the release of the body. All the documents were handed over to the donor’s sister in law. The body was then shifted to the mortuary and from there it was respectfully handed over to the relatives at 1pm.

The heart, liver, two kidneys, two lungs, skin and corneas were donated. More than 8 lives were saved.

Mr. Ashok Bhogle, a 48-year-old male patient was admitted at Apollo Hospital, Navi Mumbai, on 10th September 2018 with Intracranial Bleed.

On 10th September 2018, the ICU Head at Apollo Hospitals Navi Mumbai informed me (since I am MOHAN Foundation’s Transplant Coordinator deputed to the hospital) about a potential brain dead donor in the neuro critical care unit.

A few moments prior, Mrs. Veena Ashok Bhogle had been given primary information by the ICU doctor that the patient was not responding to any stimuli and that they were suspecting that the brain functions had ceased. Even in those grief-stricken moments when she seemed to be gradually processing it all, she was anxious to know “Is there anything else that can be done now?”

Dr. Tushar Parmar, the ICU doctor, guided her that she could consider donating the organs of her husband for the larger cause of helping patients in need of organs. She requested more information on this. The doctor informed her that MOHAN Foundation’s counsellor would shortly get in touch with her.

At 1 pm I spoke to Mrs. Bhogle and the patient’s sister-in-law, in the critical care counselling room, in the presence of Apollo’s own Transplant Coordinators, Mr. Santosh Sorate and Mr. Prakash Saindane. I softly asked Mrs. Bhogle if she had understood the condition that her husband was in. She replied saying that she understood that her husband was in an irreversible condition as explained to her by Dr. Parmar. She further added that she wanted to explore the possibility of organ donation because she felt that by donating her organs her husband would be alive in many people who are desperately waiting for an organ. She then requested for more Information about the process of organ donation.

I then explained the process in great depth and also cleared her doubts such as how much time the whole process would take, who would the organs go to, would the recipient details be shared with the family, what all organs could be harvested and would the procedure cause any mutilation to the body. Having understood all that, Mrs. Bhogle was ready to go ahead.

Meanwhile Dr. Shailesh Kalamkar (Neurosurgeon) initiated appropriate monitoring and management of the patient at the ICU as per standard guidelines for a brain stem dead organ donor. Dr. Gunadhar Padhi (Intensivist) along with Dr. Shailesh Kalamkar did the first apnoea testing at 3.20 pm and the findings were recorded in the case file.

At 5.30 pm I received a call from the Mrs. Bhogle saying that she wished to meet me once again. The meeting took place in the counselling room but this time Mrs. Bhogle was accompanied by another gentleman whom she introduced as her ‘Mama’ (Uncle).

She informed me that while she was convinced about donating her husband’s organs but she wanted that the liver must be given to the accompanying gentleman, who she said, was a close family friend cum neighbour, whom she knew since 15 years. In fact, she added that she will consent to the donation only if the liver is given to the neighbour.

Along with the other Medical Social Workers I explained to her and the neighbour about the allocation process being transparently laid out in the law. They were assured that all rights of organ allocation lie only with the state allocation nodal agency i.e. ZTCC (Zonal Transplant Co- ordination Centre). As an example, the story of Shri Vilasrao Deshmukh (ex-CM of Maharashtra) was shared that when he was in need of liver and kidney, he still had to wait for his turn on the waiting list and in spite of his huge political clout, organs were not allocated to him out of turn and that organs are allocated strictly as per the waiting list only.

The neighbour started grumbling that it was unfair that in spite of him being a close family friend and in spite of the patient’s wife wanting to give him a liver, he was unable to get it. The hospital’s Medical Social Worker reiterated saying that the rules apply to all and that if the family decided not to go ahead with the donation; their decision will be respectfully accepted.

Mrs. Bhogle was told to take her time and make up her mind. She seemed satisfied with all the replies and immediately gave her consent to go ahead with the donation. The formal consent was taken and subsequently the transplant teams were intimated. Second Apnoea test was concluded at 10.50 pm and the findings were recorded in the

Brain stem death certification form (Form No. 10) with the signatures of the Board of team Medical Experts namely, Dr. Prasad Muglikar, the Medical Superintendent in-charge of the hospital, Dr. Vaishali Lokhande, authorised specialist, Dr. Sunil Kutty, treating doctor and Dr. Suvadeep Sen, Neurologist.

On 12th September 2018, at 2am, the donor was shifted to the operation theatre for retrieval of organs. Finally, the donor’s body was wheeled into the ICU at 10 am for the final packing. The clothes in which the body was to be packed were given to the nursing staff of the ICU. All measures were taken to ensure that the donor’s family did not face any procedural delays in the release of the body. All the documents were handed over to the donor’s sister in law. The body was then shifted to the mortuary and from there it was respectfully handed over to the relatives at 1pm.

The heart, liver, two kidneys, two lungs, skin and corneas were donated. More than 8 lives were saved.

- Jigisha Yadav

Transplant coordinator

MOHAN Foundation