by Dr. Sumana Navin on March 4, 2015 at 5:10 PM
Tamil Nadu continues to lead the country in the deceased organ
donation and transplantation programme, thanks to two decades of collective
effort from the government, transplant centres and NGOs.
The state has helped thousands of patients by facilitating organ and tissue donation for transplantation.
However, unfortunately, the recent trend in Tamil movies especially
Ajith's - Yennai Arindhaal and Sivakarthikeyan's - Kakki Sattai has brought
disrepute to the programme by depicting what is unthinkable. What they show
also has no scientific, medical or moral basis.
Administering carbon monoxide and making a person brain dead to
harvest organs to sell them abroad is the theme of Kakki Sattai. In Yennai
Arindhaal the plot revolves around organ trafficking that is untenable.
Stealing organs from cadavers, kidnapping people and killing them for organs.
The ace victim is supposed to be the heroine, whose heart is to be sold to an
ailing man for a hefty sum of money.
Both the plots are ludicrous as far as organ donation is concerned
and even if for some reason doable would not work out. The important questions
that need to be asked:
- Can you give carbon monoxide and make a person brain dead?
No, if you administer carbon monoxide not only the brain but also
all the organs will die. The plot tries to replicate the theme from an old
English movie Coma.
- Can you steal kidneys from a living person?
No, kidneys can be only removed by a highly qualified surgical team
of experts (at least 5 members of surgical team and nursing team) in a sterile
operation theatre with proper lights and anaesthetist who requires a machine to
For the removed kidney to be useful it needs blood cross match to
make sure that the kidney is not immediately rejected. To make sure that the
results of the transplants are good in the long term it requires a HLA matching
with the recipient. The person who donates needs to fast overnight before they
can be given anaesthesia. The person donating needs to give consent for
donation to take place.
As per India law this can be only first relative, which includes
mother, father, brother, sister, son or daughter. It also includes spouse and
grand parents. Minors cannot donate. Anyone other than first relative needs to
apply through the hospital to authorization committee and needs to convince the
authorities that the donation is happening out of true altruism and not for
money. Violation can lead to fines up to Rs 1 crore or imprisonment for 5 to 10
- Can you steal organs from cadavers?
No organ that is removed from cadaver can be useful. Only tissues
can be removed within 6 to 24 hours like corneas, skin, heart valves (not the
whole Heart - 'the pump' itself) and bones. Tissues unlike organs are not
critical for life. In the movie plot it is not tissues that are talked about
but organs. If they had used tissues stealing, at least then the plot would
have been medically possible.
Again for the organs to be useful certain requirements need to be
met. Organ donation is possible only in brain death. Brain death happens in
head injury in road traffic accidents or due to stroke or brain hemorrhage. It
requires a sophisticated intensive care unit and a specialist to take care of a
brain dead patient as this is a highly unstable condition.
Two sets of tests are required six hours apart and four doctors
need to sign a certificate before brain death can officially be declared. This
panel of experts needs to be certified by Government authorities.
Multiple tests must be done on multiple occasions on the brain dead
patient and only if the next of kin gives permission, the organs can be removed
for transplantation. In medico- legal cases police permission is required
before any retrieval surgery is performed.
- Can heart be removed as shown in the plot of the movie?
It is the most ludicrous angle of the plot and storywriter has let
his imagination run riot in a manner that is an insult to the intelligence of
any cinema-goer. Heart transplantation requires even stricter norms than that
of kidney and liver donations. The brain death maintenance needs to be done
within strict norms of how much medication one can administer to maintain the
The heart has to be transplanted within 4 hours of retrieval and
this means both donor and recipient surgery has to start almost simultaneously.
This is the reason why fewer heart transplantations are done in the world
compared to other organ transplantations.
India is not a banana republic. We are governed by laws and
regulations. In 1994 the Government of India passed a law called
'Transplantation of Human Organs Act', which was further amended in 2011, that
governs all transplantation activity.
Medical themes can create very powerful human dramas and many of
these themes have won the Oscars and the movies have gone to create history.
Starting from 'A Streetcar Named Desire' poignantly depicting the protagonist's
mental/nervous breakdown to movies such as 'The Beautiful Mind' depicting
schizophrenia, and 'The King's Speech' based on a speech impediment. This year
the Oscar for Best Actor - went to Eddie Redmayne in 'The Theory of Everything'
for his portrayal of Stephen Hawking living with Motor Neuron disease and the
Best Actress award went to Julianne Moore in "Still Alice" for her sensitive
portrayal of a person with early onset Alzheimer's disease.
In India too medical themes are easy to pick and make. In the last
few years deceased donation transplantation has been in the news for all the
right reasons because of the altruistic nature of donations that comes from
ordinary people who perform extraordinary deeds. Each donation helps five to
seven people get a new lease of life.
Since organ donation is so popular in the Tamil Nadu, the directors
have wanted to ride this wave but seem to have not looked at the facts and how
this programme actually works. At least the Malayalam movie "Traffic" and to
some extent its remake in Tamil called "Chennaiyil Oru Naal" got the plot
There are still almost 4345 people waiting for kidneys in the state
and many others for liver, heart and lung transplant. Both Yennai Arindhaal and
Kaaki Sattai have brought disrepute to the act of organ donation, which could
be extremely damaging to the deceased donation programme as a whole.