SURVEY BY: HANSEL MISQUITTA & DR. ANMOL SHARMA
Kindly select the correct options and fill in the blanks wherever necessary.
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Email address *
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Name *
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Sex *
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Age *
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Religion *
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Occupation ( If studying, please mention ‘student’) *
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Number of family Members *
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Medico/Non-medico? *
Medico
Non- Medico
If Medico,
MBBS
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Have you heard about Organ Donation? *
NO
YES
If YES, what is the source of your knowledge?
Your answer
Who can donate their organs? *
LIVING
DEAD
BOTH
Which organs can be donated? *
Your answer
Upto what time can the organs be donated after death?
Your answer
What is the minimum age of donation of organs in India?
Your answer
Can someone with HIV donate their organs? *
Yes
No
Maybe
Which organisation/s is/are responsible for organ collection/organ donation?
Your answer
Do you think our country has a law for Organ Donation? *
Yes
No
Maybe
If YES, what is/are they?
Your answer
If anyone in your family has an illness, would you donate? *
Yes
No
Maybe
If YES, to whom?
STRANGER
FRIEND
FAMILY MEMBER
If NO, why?
Your answer
Would you donate your organs when you die? *
YES
NO
Would you donate a family members’ organ/organs after their demise? *
Yes
No
Maybe
Most organ and tissue donations occur after the donor has died. But some organs and tissues can be donated while the donor is alive. Nearly 6,000 living donations take place each year. That’s about 4 out of every 10 donations.Most living donations happen among family members or between close friends. Some people become altruistic living donors by choosing to donate to someone they don’t know.Live Donation is from a healthy and living person. This can only be done in the case of a liver or a kidney (because the liver can grow back to its normal size, and a donor can survive on one kidney). So if a near relative of yours needs a liver or a kidney, anyone in the immediate family can donate to them.
Are you aware of complications of living/live donation?. *
YES
NO
IF YES, Describe
Your answer
Which organs can be donated?
Your answer
Do you know what is consent? *
Yes
No
Do you know what is ‘cross- matching’? *
Yes
No
IF YES, write something about pre-donation check up?
Your answer
When we talk about pledging your organs or about organ donation, we are talking about Deceased organ donation or cadaver organ donation. This is organ donation from a person who has been declared brain dead by a team of authorized doctors at a hospital. A person is said to be brain dead when there is an irreversible loss of consciousness, absence of brain stem reflexes and no spontaneous respiration.
Would you/family member receive organ from a deceased person? *
Yes
No
Maybe
Which organs can be donated?
Your answer
Do you know the life-span of donated organs? *
Yes
No
IF YES, describe
Your answer
What are the associated complications?
Your answer
What do you understand by the term ‘Brain dead’?
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Do you know the steps for organ donation before the actual transplant occurs? *
Yes
No
IF YES, describe
Your answer
Which Act states provisions for Organ donation in India?
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What is the current situation of Organ donation and transplantation in India?
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Would your like to have more knowledge about Organ donation? *
Yes
No
Maybe
If you have knowledge about OD, would you help create awareness among the masses? *
Yes
No
Maybe
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