Incidentally Maharashtra’s SBTC (State Blood Transfusion Council) imposed fines totalling nearly Rs 13 lakh on more than 150 blood banks for failing to upload their stocks between December 2022 and April 2023. In December 2020 they had been warned that if they failed to do so they would be fined @ Rs 1000 per day.

In January 2024 the Drugs Controller General of India banned all charges on blood units except supply and processing costs. When a person donates blood this whole blood is not given directly to the person but is processed and spun in centrifuges to separate it into transferable components like red cells, platelets and plasma. More reason the donor should be asked if s/he is veg or non-veg.

Blood and Brains from a Lab

Researchers of the Boston Children’s Hospital in the US say that there is potential to have a limitless supply of blood stem cells and blood by taking cells from universal donors. For the first time scientists have generated blood forming stem cells in the lab which has brought them close to create a limitless supply of human blood.

In 2019 the University of California declared in “Cell Press” that they had come up with a better procedure to grow stem cells. They allowed adequate time for the pea-sized mini lab-grown brains called brain or cerebral organolds (derived from adult stem cells) to develop and then compared their wave patterns with those of human brains in early development stages and found that they shared a similar growth trajectory to brain waves like newborns.

In November 2022 scientists in the UK including researchers from the University of Cambridge said they had successfully produced lab-grown blood for which a clinical trial had begun. The blood cells were grown from donor stem cells after which these red blood cells were transfused into healthy volunteers. Lab-grown blood cells were expected to last longer than those that come from blood donors.

The origin of lab-grown blood can be veg or non-veg depending on whether the stem cells were taken from a veg or non-veg person.

Donating eyes or organs is allotransplantation but it is not commonly known by this name. Allotransplantation (allo means other in Greek) is transplantation of cells, tissues or organs to a recipient from a genetically non-identical donor of the same species. The transplant is an allograft, allogeneic transplant or homograft although most are allografts. Autotransplantation is from one part of the body to another in the same person whereas syngeneic transplantation is between two genetically identical individuals of the same species.

No one can ever be forced to donate the eyes of a person who has expired. Newspaper headlines have mischievously and misleadingly stated “Nod for eye donation to be made mandatory”. The fact is that in 2015 the Directorate of Health Services assured the High Court that Maharashtra’s municipalities and corporations had been told to mandatorily seek (repeat, seek) consent for eye donations while issuing a medical death certificate. In other words, it was only mandatory for the authorities to ask (not force) relatives to agree to donate the eyes of a person who had just expired. It is not at all mandatory for eyes to be donated. Relatives can very well refuse and the authorities have no right to force them to posthumously donate the eyes of their dear departed souls.

Many souls would be upset if their corneas were used by non-vegetarians who looked at meat dishes with a view to enjoying them. Years ago, someone from the Times Eye Research Foundation stated that the majority of Indian eye donors were (Jain) vegetarians, while the majority of recipients were not. It is very difficult for a donor family to find out who the recipient is and approach the family to turn vegetarian. Although in February 2015, the Desai family some how located and convinced the Gharat family to give up being non-veg. They did it as a tribute to the soul of the spiritual and vegetarian Desai family’s lady whose kidney one of the Gharat family members received.

Surprisingly (may be unsurprisingly for some people) in 2015 the Times of India stated that although over 50% of the eyes donated were not used (eyes need to be removed within six hours of death) due to infection in the body at time of death, or poor storage, they took them any way!

As regards other organ donations also (if they are usable which is known after they are removed) one can not choose the recipient, leave alone know whether the person is veg or non-veg. It is therefore extremely important not to get carried away by advertisements or requests, and persuasions from organisations and celebrities, who recommend organ donations and ask people to pledge to give after death. Interestingly, only a third of the number of people who say they support organ donation have upon death had their organs donated, hence the rise in frequent appeals.

Remember, organ donation is not a duty we are obliged to perform. In fact, organ donation refusal may save one’s own life because most organs are required to be taken from patients who are almost dead. Haste is essential to ensure healthy organs. “Brain dead” patients are therefore given paralyzing drugs to prevent reactions when organs are removed. This indicates they are not dead – one is dead or alive, not in-between. In fact, brain death is defined inconsistently. It can be synonymous with cerebral death and may or may not include the brainstem. With the aim of facilitating and promoting organ donations, in September 2012 a government resolution made it mandatory for hospitals to declare brain dead patients. It is repeatedly claimed by them that one cadaver can save as many as eight lives. There is no doubt that the rising waitlist of persons wanting organs transplants necessitates hospitals taking organs from “brain dead” and “brainstem dead” persons.

“Brain dead” certification is viewed mostly as a procedure only to aid organ donation. If the family of the patient say they don’t want organs donated, then most doctors fearing legal implications, refuse to switch off the ventilator and support systems.

Except for Kerala “brain death” is India is defined only in connection with organ donations, therefore certification by doctors to discontinue treatment can easily be seen as the underlying reason to promote organ donations under The Transplantation of Human Organs and Tissues Act, 1994 and Rules, 1995. As per law, even if the hospital is licensed to carry out organ transplants, brain death is not sufficient to withdraw treatment if the family does not opt for organ donation.

What Kerala has done is de-linked brain death from organ donation. The decision to stop treatment has been taken away from families. Doctors declare patients to be “brain dead” and they decide if treatment should be discontinued.

India has not defined “brain dead” clearly as a result of which Kerala has unfortunately allowed doctors to withdraw life support from “brain dead” patients without the family’s approval. Other states, such as Maharashtra is mulling it as well.

The Registration of Births and Deaths Act, 1969 defines death as “the permanent disappearance of all evidence of life at any time after live-birth has taken place”. Whereas the Transplantation of Human Organs and Tissues Act & Rules 1994-95 defines death as a “permanent disappearance of all evidence of life, by reason of brain-stem death or in a cardio-pulmonary sense at any time after live birth has taken place”.

A free e-book entitled The Nasty Side of Organ Transplanting available on the Organ Facts website www.organfacts.net/nso/ exposes the deception and Chapter 1 is definitely worth reading.

There are cases where people declared brain dead have woken up. Remember, where there is life, there is hope… miracles do occur. The brain typically shuts down within 20-30 seconds after the heart has stopped. Therefore, the brain stops functioning after the heart stops beating. That is when a person actually dies.

Interestingly, evidence based on research by a team of scientists of the Southampton University (UK) over four years (ending August 2015) examining 2,060 people who suffered cardiac arrests (clinical death when the heart stops beating and there is cessation of blood circulation and breathing) at 15 hospitals in the UK, US and Austria, suggests that conscious awareness continues even after the heart stops beating and brain shuts down.

In 2016 it was reported that researchers and scientists of Washington University in Seattle, USA, undertook a study to see what happens upon death and found that genes can live for up to four days after the body has died and in fact some genes, including ones that help to create an embryo and others associated with cancer even turned on or became more active after death. In short, tumour DNAs get active post demise and can be passed on in an organ transplant. (Genes are made of a chemical called DNA which is short for deoxyribonucleic acid, whereas a chromosome is a strand of DNA.)

Living donations: blood, bone marrow, kidney, a part of liver/lung/pancreas can be donated by living people. (If the need arises they should be given by way of help to relatives or close friends, not sold.)

Non-heart-beating donations: eyes, heart valves, skin & fascia, bones & tendons, cartilage, veins & arteries can be taken and re-used from dead bodies.

Heart beating donations (declared brain dead): almost all other organs such as kidney, liver, lung, pancreas, small intestine, voice box or larynx, hands, uterus, ovaries, fact, eyes, middle ear bones, skin & fascia, bone, cartilage, tendons, veins, arteries, nerves, fingers and toes can be taken from brain dead (i.e. still living with heart beating) persons and implanted into other people.

There is no need to be confused. A corpse has no rights, nor does it legally belong to any one. However, near relatives get custody over the dead body to decide upon its mode of disposal, including donation of organs. Therefore, any one desirous of donating his/her own organs should give proper thought before impulsively agreeing to donate his or her body-parts. The issue should be discussed at length with his/her family and their views respected.

In August 2015, the Rajasthan State Minister for Home, Shri Gulab Chand Kataria declared that organ donation is murder because the organs are taken away when the person is still alive; and he is not the only one among the Jain community and others to think thus. In the winter 2023 issue of Compassionate Friend we printed a synopsis of the discourse by Pranamya Sagarji Maharaj entitled “Defining Donation” which stated “when next of kin grant permission to remove organs from a “brain dead” person, in reality the organs are removed from their living relative, who then due to the lack of these organs will positively die. In short, the removal of organs “scientifically” kills the donor.”

Zoroastrianism also says organs should not be donated because the laws of keshas (karma) and reincarnation meant for spiritual evolvement of human beings are disrupted, creating chaos affecting both the giver and receiver. Upon death the ruvaan (soul) of the donor does not get its entire anasaar (subtle energy) as part of his/her physical body is in another human body and can only disintegrate on the death of the recipient, thus obstructing the soul’s progress.

Tibetan Buddhists believe the spirit or soul remains in the body up to a week after death and if organs are donated it would interfere with rebirth.

Pure Land Buddhism (a branch of Mahayana Buddhism) is also against organ donation because they do not want the soul to be disturbed when brain death is declared and feel it should be permitted to leave peacefully towards rebirth.

Since Egyptian Muslims believe organs belong to God they cannot donate an organ they themselves do not own.

In 2019 a Czech woman declared to be brain dead gave birth to a normal baby after 34 weeks. The reaction of a scientist to this news was “That means the body was working even though the brain wasn’t … the science fraternity need to rethink. Science needs to evolve. The brain dead can be saved with a better understanding although it appears impossible now. Organ donations have commercialised medical science.”

Donating body-parts is not a sublime form of charity as is being projected. Keeping the theory of karma in mind, vegetarians need to answer these questions: Now, when alive, do I eat non-veg? If not, how can my soul after death, be pleased that my donated organs are being nourished with non-veg food, and that too within the body of a flesh-eater? If the lifespan of the non-veg donee gets extended due to my donated organs, wouldn’t it mean more meat is being consumed and more cows, goats, chickens, fish, etc. slaughtered? Since all life is precious – human and animal – wouldn’t my organ donation to a non-vegetarian adversely affect the karma and spiritual progress of my soul? Lastly, would my near and dear ones feel comfortable in giving away my body-parts to some unknown, non-vegetarian person and then disposing off my lacerated and plundered body? In fact, the organs removed could be thrown away if they are not found to be healthy or fit enough for transplantation.

As per Indian culture, the living are duty-bound to give the dead a respectful and dignified end.

Gender-wise Organ Donations in India

In 2019 India ranked third (after USA and China) in the total number of transplants.

Studies undertaken showed a skewed ratio between Indian male and female donors as well as recipients: living donations were given by 37% males and 63% females; whereas 72% were male transplant recipients.

Multiple social factors for this gender disparity are responsible: attitudinal, financial, patriarchy and coercion. Living donation decisions are greatly influenced by the woman’s role within her family and society. For example, men often take a kidney from the wife even though a brother would be considered an ideal donor.

Whereas allotransplantation is the taking of living organs (cells, tissues, etc.) within the same species as in organ donations from human to human detailed above, xenotransplantation means taking a living organ from one species and transplanting it into another, like from pigs to humans or baboons to humans.

In 2019 Japan permitted implanting animals with human stem cells that could eventually help grow human organs for transplant inside animal hosts. The experiment at the University of Tokyo involves human cells to be grown in rat and mouse embryos and then brought to term in surrogate animals. However, the scientists say they plan to proceed with caution by growing hybrid mouse embryos to 14.5 days and rat embryos to 15.5 days only when the animals organs are mostly formed. The ethical anxiety even among scientists is that the human cells could stray beyond the targeted organs into other areas of the animal effectively creating a creature that is part animal, part human.

The history of xenotransplantation as documented:
17th Century: Jean Baptiste Denis began transfusing blood from animals to humans
1838: The first corneal xenotransplantation from a pig took place – 65 years prior to the first human to human cornea transplant.
19th Century: Skin grafts, mainly from frogs, from animals were used on humans in Europe.
1920s: Serge Voronoff, a Russian scientist began testicular transplants from chimpanzees to aging men but his work was later discredited.
1963: Keith Reemtsma, a US doctor, transplanted chimpanzee kidneys into 13 humans. All failed between 4 to 8 weeks except for one who lived for 9 months.
1964: James Hardy, a US surgeon transplanted a Chimpanzee’s heart into a human but the patient died in 2 hours.
1983: Leonard Bailey of the US transplanted a baboon heart in an infant called Baby Fae who survived for 20 days only. (See below.)
1992: Dr Jonathan Ho Kei-Shing fit heart valves made from ox tissue (designed by Dr Baruah) into human patients.
1997: Dr Dhani Ram Baruah of Sonapur, near Guwahati illegally transplanted a pig heart into a human. The recipient survived for a week only.
Both Dr Ho and Baruah were arrested.
2022: Doctors at the University of Maryland Medical Centre, USA, transplanted a pig heart into a patient citing organ shortage crisis due to the pandemic. The recipient survived for only 2 months post-surgery and it was suspected that the patient died of a viral infection in the pig’s heart. In June and July 2022 a team of researchers at NYU Langone’s Tech Hospital transplanted two genetically engineered pig hearts into recently deceased humans and monitored their heart function for 3 days to check for signs of early rejection.
2023: The NYU Langone’s Transplant Institute transplanted a single kidney from a genetically modified pig into a brain-dead man and it was working normally even after a month.

Humane Heart Tissue and other Transplants

In 2017 Chinese doctors grew in three months a new ear on a man’s arm and successfully transplanted it. The plastic surgeon Guo Shuzhong of the First Affiliated Hospital of Xi’an Jiaotong University and his team first stretched the man’s skin on his arm with a skin expander. Then they took a piece of cartilage from one side of his chest to carve out a new ear before planting the artificial organ on the patient’s forearm.