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A Simple Introduction to
Organ
Transplant
Comprehend, Embrace and Make a Difference
A Simple Introduction to
Organ
Transplant
CBS Publishers & Distributors Pvt Ltd
New Delhi • Bengaluru • Chennai • Kochi • Kolkata • Lucknow • Mumbai
Hyderabad • Jharkhand • Nagpur • Patna • Pune • Uttarakhand
Gopi Ayyaswamy
MBBS, MS (ENT), DLO, PhD
Professor
Department of ENT, Head and Neck Surgery
Sree Balaji Medical College and Hospital
Chennai, Tamil Nadu
Comprehend, Embrace and Make a Difference
Disaimer
978-93-483-8557-4
First 5
Branches
th
nd
st
In Fond Memory of
Smt J Anusuyamma
and
My eternal guiding light, beloved mother
Smt Rajammal Ayyaswamy
Dedicated to
Honourable Shri S Jagathrakshakan MP
Founder, Bharath University (BIHER)
Dr J Srinisha
Chairperson, Sree Balaji Medical College and Hospital
Er N Elamaran
Managing Director, Sree Balaji Medical College and Hospital
and
My Family
Shastika Sri, Rithikka Sri and Dr Ranjani Gopi
Smt Rajammal Ayyaswamy and Shri KJ Ayyaswamy
Shri Mahendran Ayyaswamy and Shri Sanjeev Ayyaswamy
“To remember me”
The day will come when my body will lie upon a white sheet and
A doctor determines that my brain has ceased and
That, for all intents and purposes, my life has ended.
When that happens, do not attempt to instill artificial life
And don’t call this my deathbed.
Let it be called the bed of life, and let my body be taken from it
To help others lead fuller lives.
Give my sight to the man, who has never seen a sunrise,
A baby’s face or love in the eyes of a woman.
Give my heart to a person whose own heart has caused
Nothing, but endless days of pain.
Give my kidneys to one who depends on a machine
To exist from week to week.
Take my bones, every muscle, every fiber and nerve in
My body and make a crippled child walk.
Explore every corner of my brain. Take my cells,
Grow them to make a speechless boy shout and a
Deaf girl to hear the sound of rain.
Burn what is left of me and scatter the ashes to the winds
To help the flowers grow. If you must bury something,
Let it be my faults, my weaknesses
And all prejudice against my fellow man.
Give my sins to the devil.
Give my soul to God.
If, by chance, you wish to remember me,
Do it with a kind deed or word to someone who needs you.
If you do all I have asked, I will live forever.
Robert N. Test
@Organdonation.blogspot.com/2005
Foreword
vii
I
n the vast expanse of medical literature, I am delighted to introduce
a work that transcends inspiring information regarding organ
transplantation; it stands as a testament to dedication and embodies the
tireless pursuit of knowledge for the greater good of humanity. Dr Gopi
Ayyaswamy, an eminent ENT surgeon, has pushed the boundaries of
his specialization and has immersed himself thoroughly in the intricate
world of organ transplantation. His enthusiasm is truly unparalleled and
his understanding of the process is unimaginable for a non-transplant
medical professional. The outcome of his passionate work is aptly titled
A Simple Introduction to Organ Transplant: Comprehend, Embrace and Make
a Difference.
Dr Gopi Ayyaswamy’s exploration into the intricacies of organ transplant
procedure is outstanding. This book is full of compendium of medical
facts and a manifestation of an unwavering commitment to unravel the
mysteries inherent in transplant surgery. Within the carefully brainstorm
pages of this work, he skillfully navigates through the multifaceted
challenges of organ transplantation, providing a holistic perspective that
go beyond the conventional boundaries of medical disciplines.
The narrative unfolds seamlessly, covering the rich collection of the
history of Transplant Surgery with significant milestones, exploring
further into historical perspectives, and navigating the complex terrain
of ethical, religious, and sociocultural considerations. Dr Ayyaswamy
takes the reader through an enlightening experience of organ donation
and transplantation, addressing not only the medical intricacies but also
the advancements, legal considerations, and the societal recognition
that surrounds this noble endeavor. It is a literary exploration of the
challenges between intensive care, donor management and the profound
contributions of medical expertise. The depth of Dr Ayyaswamy’s
understanding becomes evident as he delves into challenging topics such
as brain stem death, maintenance of brain dead, monitoring of organ
donor, and various medical issues and management protocols. His insights
extend beyond national borders, embracing international guidelines and
legal frameworks, while also delicately outlining the meticulous processes
involved in preparing both the organ donor and recipient for this life-
Foreword
viii
A Simple Introduction to Organ Transplant
altering journey. His impassioned call for all hospitals to undertake and
execute organ transplant resonates profoundly, serving as a clarion call
for the medical community to unite in support of those in desperate need.
In extending my heartfelt congratulations to Dr Gopi Ayyaswamy,
I recognize the magnitude of his monumental contribution to medical
literature, especially organ transplant works. This book is not only an
invaluable source of knowledge for seasoned medical practitioners but also
a guiding light for the emerging generation of young medical graduates,
inspiring them to embrace the intricate practice of organ transplantation
and contribute meaningfully to the welfare of society. The triumph of organ
transplants relies on the awless coordination, resembling a melodious
life composition, among junior medical doctors, senior consultants, and
the effective support from para-medical staff. Dr Gopi Ayyaswamy has
narrated every stage with exceptional detail. I whole heartedly wish that
all his dreams come to fruition.
With profound admiration and sincere affection.
Prof Mohamed Rela
MS, FRCS, D.Sc.
Chairman & Director, Dr Rela Institute and Medical Centre
Liver Disease, Transplantation & HPB Surgery
Chancellor, Bharath University (BIHER)
Foreword
ix
O
rgan transplantation, a remarkable medical feat, involves the complex
process of retrieving organs from either living or deceased donors and
implanting them to replace dysfunctional or damaged organs in recipients.
This transformative surgical procedure has a rich history, dating back
several decades. However, a persistent challenge has marred its progress—
the rejection of newly transplanted organs by the recipients’ bodies.
The pioneering success in organ transplantation occurred in 1954 when
a kidney was exchanged between living twin brothers. This watershed
moment marked the beginning of a medical revolution. The subsequent
development of immunosuppressant drugs proved to be a game-changer,
signicantly enhancing the success rates of organ transplants. These
drugs, designed to prevent the body from rejecting the transplanted
organ, opened the door to a new era in medical science. Today, organ
transplantations have evolved into life-extending procedures, enabling
patients to gain several additional years of life with the support of proper
immunosuppressive drug therapy.
The signicance of organ transplantation is particularly pronounced
in addressing end-stage diseases, such as liver and heart failure. While
alternative treatments exist for end-stage renal disease patients, kidney
transplantation stands out as the preferred option due to its superior quality
of life and cost-effectiveness. Across the globe, kidney transplantation is
the most frequently performed type of transplant, offering a lifeline to
countless individuals.
The entangled process of diagnosing brain death and maintaining a viable
donor in intensive care demands extensive knowledge, dedication, and
untiring devotion. The author Dr Gopi Ayyaswamy, a cherished colleague
and friend, keenly felt the complexities involved in understanding and
executing the donor program.
Recognizing the challenges faced by medical faculties and paramedics
in grasping the nuances of the Cadaver Donor Program, he embarked on
a mission to create a simplied handbook. This resource aimed to provide
a comprehensive methodology for understanding the complexity of organ
donation and transplantation, ensuring that the next generation of medical
professionals could engage in these vital activities with ease.
Foreword