Time Specific Content Teaching Learning AV Aid Evaluation
Objective Activity Activity
5 Introduce Introduction: Organ donation is a Lecture Listening, PPT Why do we
min the topic voluntary process of giving one's cum questioning need organ
and organ/tissues after death or while alive to discussion donors in
explain the save another life India?
need .Need for Organ Donation: Every year,
lakhs of people suffer from end-stage
organ failure. Organ donation rate in
India: 0.5 per million population, vs. 36
in Spain.
Why India needs more donors: 5 lakh
people die due to lack of organs.
Major shortage of hearts, livers, kidneys.
Only ~10% of demand is met.
5 Highlight History of Transplantation in India: Lecture Take notes, PPT What year
min milestones 1965 – First successful kidney transplant cum ask was
and major 1994 – THOTA (Transplantation of discussion questions THOTA
transplants Human Organs and Tissues Act) enacted enacted?
1
2012 – First hand transplant
2015 – Chennai: 23 organ transplants in
36 hours
2016 – First uterine transplant in Pune
3 Discuss Organs That Can Be Donated:Heart, Lecture List along PPT Name 3
min what lungs, liver, kidneys, pancreas, intestine cum with teacher organs and
organs and Tissues That Can Be Donated: Corneas, discussion 2 tissues
tissues can skin, bones, heart valves, tendons, that can be
be donated ligaments, blood vessels Bone marrow donated
and stem cells
4 Describe Types of Transplants: Lecture Doubt PPT What is a
min types and cum clearing examples domino
Autograft
special discussion transplant?
Transplantation of tissue or organ within
transplants
the same individual.
Example: Skin grafts from one part of the
body to another in burn patients.
There is no risk of rejection since the
donor and recipient are the same person.
2
Allograft (Homograft)
Transplantation between two genetically
non-identical individuals of the same
species.
This is the most common type used in
human organ transplants, such as kidney
or liver.
It requires immunosuppressive therapy to
prevent rejection.
Xenograft (Heterograft)
Transplantation from a donor of a
different species.
Example: Pig heart valves used in
humans.
There is a high risk of rejection; usually
used temporarily or as supportive therapy.
Special Types:
Split Liver Transplant
3
A single donor liver is divided into two
portions and transplanted into two
recipients, typically one adult and one
child.
This method maximizes the use of a single
donor organ and requires advanced
surgical techniques and precise matching.
Domino Transplant
A chain of transplants in which a recipient
of one transplant becomes a donor for
another recipient.
Example: A patient with a metabolic liver
disorder receives a healthy liver, and their
own liver (which is structurally normal
but metabolically defective) is
transplanted into another patient.
This method requires ethical approval and
coordinated surgical planning.
4
4 Explain Living Donor Requirements: Age 18–65 Lecture Engage and PPT Who can
min donation Mentally sound cum discuss be a living
eligibility medically fit discussion organ
and Close relative or legal approval donor?
logistics Situations for Donation:
Brain death
Cardiac death
Voluntary donation (pledged)
4 Explain One of the major barriers to organ Lecture Express PPT List any
min organ donation in India is the widespread cum opinions two
donation presence of myths and misconceptions. discussion barriers to
shortage in Many people believe in ideas related to donation in
India rebirth, karma, and body disfigurement India
after death, which leads to resistance
against donating organs.
Family refusal is another critical factor.
Even when individuals pledge their
organs, families often refuse consent at the
time of death due to emotional distress,
5
religious beliefs, or lack of clarity about
the donor’s wishes.
There is a significant lack of awareness
among the general population regarding
the concept, benefits, and process of organ
donation. Most people are unaware of
brain death criteria or the legal and ethical
frameworks involved.
India also faces challenges related to
inadequate infrastructure, especially in
rural and semi-urban hospitals, where the
facilities for organ retrieval, storage, and
transplantation are either unavailable or
underdeveloped.
Lastly, poor coordination between
hospitals, transplant centers, and organ
allocation networks (such as NOTTO,
SOTTO, ROTTO) often results in delays
6
or loss of viable organs, reducing the
overall efficiency of the donation process.
One of the major barriers to organ
donation in India is the widespread
presence of myths and misconceptions.
Many people believe in ideas related to
rebirth, karma, and body disfigurement
after death, which leads to resistance
against donating organs.
Family refusal is another critical factor.
Even when individuals pledge their
organs, families often refuse consent at the
time of death due to emotional distress,
religious beliefs, or lack of clarity about
the donor’s wishes.
There is a significant lack of awareness
among the general population regarding
the concept, benefits, and process of organ
7
donation. Most people are unaware of
brain death criteria or the legal and ethical
frameworks involved.
India also faces challenges related to
inadequate infrastructure, especially in
rural and semi-urban hospitals, where the
facilities for organ retrieval, storage, and
transplantation are either unavailable or
underdeveloped.
Lastly, poor coordination between
hospitals, transplant centers, and organ
allocation networks (such as NOTTO,
SOTTO, ROTTO) often results in delays
or loss of viable organs, reducing the
overall efficiency of the donation process.
4 Elaborate Organ Donation Process: Lecture Take notes, PPT Write
min donation cum respond down 3
Donor Identification
process discussion steps in the
8
Potential donors are identified, usually in organ
ICU settings, based on medical criteria donation
such as brain death or impending process
circulatory death.
Consent from Family or Donor Card
Consent is obtained either through a
previously signed donor card or from the
next of kin after appropriate counseling.
Medical Evaluation
A comprehensive medical assessment is
conducted to evaluate the suitability of
organs for transplantation. This includes
blood tests, infection screening, and organ
function tests.
Brain Death Certification
A formal diagnosis of brain death is made
and certified by a panel of authorized
medical professionals, typically involving
9
two separate examinations.
Allocation through NOTTO/SOTTO
Organ allocation is done by authorized
organizations such as NOTTO (National),
SOTTO (State), or ROTTO (Regional),
ensuring fair and transparent distribution.
Organ Retrieval
Organs are surgically retrieved by trained
transplant surgeons in a sterile operating
environment, following standard
protocols.
Transport & Transplant
Organs are preserved using specialized
solutions, packed in sterile containers, and
transported—often via Green Corridor—
to the recipient hospital for
transplantation.
10
Box Used: Temperature-controlled
sterile containers are used for the safe
transportation of organs.
These boxes maintain the organ at 4°C
to slow down metabolic activity and
preserve viability.
The container typically includes
multiple layers:
➤ Inner sterile bag with preservation
solution
➤ Ice packs or crushed ice layer
➤ Outer insulated transport box
Often used during Green Corridor
transfers for quick and secure organ
delivery.
Temperature-controlled sterile
containers are used for the safe
11
transportation of organs.
These boxes maintain the organ at 4°C
to slow down metabolic activity and
preserve viability.
The container typically includes
multiple layers:
➤ Inner sterile bag with preservation
solution
➤ Ice packs or crushed ice layer
➤ Outer insulated transport box
Often used during Green Corridor
transfers for quick and secure organ
delivery.
4 Introduce Transplant Rejection Reactions: Lecture Active PPT What are
min transplant Hyperacute – Hyperacute Rejection cum listening the 3 types
rejection Occurs within minutes to hours after discussion of
and transplantation. rejection?
12
treatment Caused by pre-existing antibodies in the
recipient’s body against donor antigens.
Results in immediate graft failure.
Acute Rejection
Occurs within days to weeks after the
transplant.
Mediated by T-lymphocytes attacking the
donor organ.
Can often be managed with
immunosuppressive therapy.
Chronic Rejection
Occurs months to years after
transplantation.
Characterized by gradual loss of graft
function due to progressive fibrosis and
vascular damage.
Often irreversible and leads to the need
for re-transplantation.
13
Hyperacute Rejection
Occurs within minutes to hours after
transplantation.
Caused by pre-existing antibodies in the
recipient’s body against donor antigens.
Results in immediate graft failure.
Acute Rejection
Occurs within days to weeks after the
transplant.
Mediated by T-lymphocytes attacking the
donor organ.
Can often be managed with
immunosuppressive therapy.
Chronic Rejection
Occurs months to years after
transplantation.
Characterized by gradual loss of graft
function due to progressive fibrosis and
14
vascular damage.
Often irreversible and leads to the need
for re-transplantation.
Signs & Symptoms: Fever
Pain or tenderness over the
transplanted organ site
Swelling or localized inflammation
Reduced organ function (e.g.,
decreased urine output in kidney
transplant)
Abnormal lab markers, such as:
• Increased serum creatinine in
kidney transplant
• Elevated liver enzymes in liver
transplant
• Abnormal ECG or reduced
15
ejection fraction in heart transplant
Immunosuppressive therapy is essential to
prevent the body from rejecting a
transplanted organ. It helps suppress the
recipient’s immune response and ensures
long-term graft survival. The therapy
usually involves a combination of drugs,
tailored to the type of transplant and
patient’s condition.
• Corticosteroids
o Example: Prednisolone,
Methylprednisolone
o Used for induction,
maintenance, and treatment
of acute rejection
o Broad immunosuppressive
and anti-inflammatory effects
o Side effects: Weight gain,
16
hyperglycemia, osteoporosis,
mood changes
• Calcineurin Inhibitors (CNIs)
o Examples: Tacrolimus,
Cyclosporine
o Inhibit T-cell activation by
blocking calcineurin pathway
o Mainstay of maintenance
therapy
o Side effects: Nephrotoxicity,
hypertension, neurotoxicity,
gum hyperplasia
(Cyclosporine)
• mTOR Inhibitors
o Examples: Sirolimus,
Everolimus
o Block mTOR pathway and
prevent cell proliferation
o Used as an alternative or in
17
combination with CNIs
o Side effects: Hyperlipidemia,
delayed wound healing
• Monoclonal Antibodies
o Examples: Basiliximab,
Alemtuzumab
o Target specific immune cells
(e.g., IL-2 receptor on T-
cells)
o Mostly used during induction
therapy or for steroid-
resistant rejection
o Side effects: Risk of
infections, infusion reactions
Immunosuppressive therapy is essential to
prevent the body from rejecting a
transplanted organ. It helps suppress the
recipient’s immune response and ensures
long-term graft survival. The therapy
18
usually involves a combination of drugs,
tailored to the type of transplant and
patient’s condition.
• Corticosteroids
o Example: Prednisolone,
Methylprednisolone
o Used for induction,
maintenance, and treatment
of acute rejection
o Broad immunosuppressive
and anti-inflammatory effects
o Side effects: Weight gain,
hyperglycemia, osteoporosis,
mood changes
• Calcineurin Inhibitors (CNIs)
o Examples: Tacrolimus,
Cyclosporine
o Inhibit T-cell activation by
blocking calcineurin pathway
19
o Mainstay of maintenance
therapy
o Side effects: Nephrotoxicity,
hypertension, neurotoxicity,
gum hyperplasia
(Cyclosporine)
• mTOR Inhibitors
o Examples: Sirolimus,
Everolimus
o Block mTOR pathway and
prevent cell proliferation
o Used as an alternative or in
combination with CNIs
o Side effects: Hyperlipidemia,
delayed wound healing
• Monoclonal Antibodies
o Examples: Basiliximab,
Alemtuzumab
o Target specific immune cells
20
(e.g., IL-2 receptor on T-
cells)
o Mostly used during induction
therapy or for steroid-
resistant rejection
o Side effects: Risk of
infections, infusion reactions
1 Introduce A Green Corridor is a special traffic Lecture Discuss & PPT What is a
min Green route created by traffic police and civic cum reflect green
Corridor authorities for the rapid and discussion corridor?
system unobstructed transportation of
harvested organs from the donor hospital
to the recipient hospital.
The purpose is to minimize
transportation time, as organ viability is
time-sensitive (especially for heart, lungs,
and liver).
Traffic signals along the route are
21
manually controlled or synchronized to
ensure a non-stop journey for the
ambulance carrying the organ.
Typically, police escorts are deployed to
clear the path and monitor real-time
movement using GPS.
It has been successfully implemented in
several Indian cities including Chennai,
Mumbai, Delhi, Hyderabad, and
Bengaluru.
The concept significantly increases the
chances of a successful transplant by
ensuring the organ remains viable upon
arrival.
5 Explain • Identification of Potential Donors Lecture Observation PPT What are 5
min role of Nurses working in ICUs or cum & note specific
nurse in emergency departments play a key discussion taking roles of
22
depth role in early recognition of brain- nurses?
dead or dying patients who may be
eligible for organ donation. They
notify the transplant coordinator
and initiate evaluation.
• Emotional Support and
Counselling
Nurses are often the first point of
contact with grieving families.
They offer emotional support,
answer questions, address concerns,
and facilitate compassionate
communication, helping families
make an informed decision about
donation.
• Educating Patients and Families
Nurses educate families about the
process, legalities, myths, and
benefits of organ donation. They
23
help clarify misconceptions such as
religious objections, body
disfigurement, and concerns about
organ misuse.
• Coordinating Between Units and
Teams
Nurses serve as key coordinators
between different departments—
ICU, operation theatre, transplant
team, and hospital administration.
They ensure smooth
communication and minimize
delays in the donation process.
• Monitoring Organ Function and
Maintaining Donor Stability
Nurses in critical care continuously
monitor vital signs, organ
perfusion, fluid balance, and
laboratory parameters of the donor
24
to maintain organ viability until
retrieval. This includes ventilator
management and administration of
medications.
• Ethical Advocacy
Nurses ensure that informed
consent is taken without coercion.
They uphold ethical standards,
respect patient autonomy, and
ensure the dignity of the donor is
maintained throughout the process.
• Community Awareness and
Health Promotion
Nurses contribute to increasing
public awareness about organ
donation by organizing or
participating in health camps,
rallies, school programs, and
awareness campaigns during
25
events like Organ Donation Day.
• Assisting in Documentation and
Legal Forms
Nurses assist in preparing and
verifying essential documents such
as:
o Form 1 – Consent from a
living donor
o Form 7 – Consent for organ
retrieval from brain-dead
donor
o Form 10 – Recipient’s
consent for transplant
They also ensure that brain
death certification is properly
documented as per legal
requirements.
• Infection Control and Patient
Safety
26
During and after organ retrieval
procedures, nurses ensure aseptic
techniques, proper personal
protective equipment (PPE) use,
and maintain strict infection control
protocols to protect both donor and
healthcare team.
• Identification of Potential Donors
Nurses working in ICUs or
emergency departments play a key
role in early recognition of brain-
dead or dying patients who may be
eligible for organ donation. They
notify the transplant coordinator
and initiate evaluation.
• Emotional Support and
Counselling
Nurses are often the first point of
contact with grieving families.
27
They offer emotional support,
answer questions, address concerns,
and facilitate compassionate
communication, helping families
make an informed decision about
donation.
• Educating Patients and Families
Nurses educate families about the
process, legalities, myths, and
benefits of organ donation. They
help clarify misconceptions such as
religious objections, body
disfigurement, and concerns about
organ misuse.
• Coordinating Between Units and
Teams
Nurses serve as key coordinators
between different departments—
ICU, operation theatre, transplant
28
team, and hospital administration.
They ensure smooth
communication and minimize
delays in the donation process.
• Monitoring Organ Function and
Maintaining Donor Stability
Nurses in critical care continuously
monitor vital signs, organ
perfusion, fluid balance, and
laboratory parameters of the donor
to maintain organ viability until
retrieval. This includes ventilator
management and administration of
medications.
• Ethical Advocacy
Nurses ensure that informed
consent is taken without coercion.
They uphold ethical standards,
respect patient autonomy, and
29
ensure the dignity of the donor is
maintained throughout the process.
• Community Awareness and
Health Promotion
Nurses contribute to increasing
public awareness about organ
donation by organizing or
participating in health camps,
rallies, school programs, and
awareness campaigns during
events like Organ Donation Day.
• Assisting in Documentation and
Legal Forms
Nurses assist in preparing and
verifying essential documents such
as:
o Form 1 – Consent from a
living donor
o Form 7 – Consent for organ
30
retrieval from brain-dead
donor
o Form 10 – Recipient’s
consent for transplant
They also ensure that brain
death certification is properly
documented as per legal
requirements.
• Infection Control and Patient
Safety
During and after organ retrieval
procedures, nurses ensure aseptic
techniques, proper personal
protective equipment (PPE) use,
and maintain strict infection control
protocols to protect both donor and
healthcare team.
2 Summarize Legal Aspects of Organ Donation in Lecture Q&A and THOTA Name 2
min laws & cum review chart + legal forms
31
forms India discussion Forms used in
donation
• THOTA (Transplantation of
Human Organs and Tissues Act),
1994
o Enacted to regulate the
removal, storage, and
transplantation of human
organs and tissues for
therapeutic purposes.
o Prevents commercial
dealings in human organs.
o Applicable throughout India
and amended in 2011 and
2014 to strengthen
enforcement.
• Brain Death Certification
o Mandatory for deceased
organ donation.
o Requires a panel of four
32
independent doctors to
certify brain death on two
separate occasions, with a
gap of 6 hours (for adults).
o Doctors must be registered
medical practitioners and
include:
▪ The treating physician
▪ A
neurologist/neurosurge
on or intensivist
▪ A medical
administrator
▪ A government-
authorized independent
doctor
• Consent Rules
o For living donation: requires
written informed consent
33
from the donor.
o For deceased donation:
consent from next of kin or
via pledged donor card.
o Special scrutiny is required if
the donor is unrelated to the
recipient.
• Penalties for Organ Trafficking
o Engaging in or facilitating
commercial trade of organs
can lead to imprisonment
(5–10 years) and fines up to
₹20 lakhs.
o Hospitals must be registered
and compliant under
THOTA; violations can lead
to license cancellation.
Important Legal Forms in Organ
34
Donation (India)
• Form 1 – Consent for organ
donation by a living donor (related
or unrelated, with appropriate
approvals).
• Form 5 – Brain Death Certificate,
issued by the authorized medical
panel following all guidelines.
• Form 7 – Application for approval
of organ retrieval from a brain-
dead donor.
• Form 10 – Consent of the
recipient for undergoing an organ
transplant procedure.
3 Conclusion Organ donation is a noble and life-saving Lecture Feedback, Quote What was
min act that has the potential to give a second cum Q&A slide the most
chance at life to multiple individuals. It discussion interesting
not only benefits the recipients but also thing you
35
provides meaning and legacy to the donor learned?
and their family.
Nurses play a crucial role in this
process—not just in clinical care, but also
in advocacy, education, coordination, and
emotional support. They are often the
bridge between the grieving family and
the healthcare team, ensuring that the
process is handled with sensitivity, ethics,
and professionalism.
By raising awareness, dispelling myths,
and promoting informed decision-making,
nurses can help overcome the challenges
that contribute to the shortage of organ
donors in India.
Organ donation is a noble and life-saving
act that has the potential to give a second
chance at life to multiple individuals. It
36
not only benefits the recipients but also
provides meaning and legacy to the donor
and their family.
Nurses play a crucial role in this
process—not just in clinical care, but also
in advocacy, education, coordination, and
emotional support. They are often the
bridge between the grieving family and
the healthcare team, ensuring that the
process is handled with sensitivity, ethics,
and professionalism.
By raising awareness, dispelling myths,
and promoting informed decision-making,
nurses can help overcome the challenges
that contribute to the shortage of organ
donors in India.
37
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4. Ministry of Health and Family Welfare, Government of India. The Transplantation of Human Organs and Tissues Act
(THOTA), 1994, with Amendments. New Delhi: MoHFW; [Internet]. Available from: https://main.mohfw.gov.in
5. National Organ and Tissue Transplant Organisation (NOTTO). Guidelines and Protocols for Organ Donation and
Transplantation. [Internet]. New Delhi: NOTTO; [cited 2025 Jul 7]. Available from: https://notto.abdm.gov.in
38
6. Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol. 2009 Jan;25(3):348–55.
doi:10.4103/0970-1591.56208.
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