Organ Transplants in India

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    In News

    •  Government removes age cap on cadaver organ transplants.

    About

    • The Union Ministry of Health and Family Welfare has recently removed the clause that people beyond 65 years could not receive cadaver organ transplants.
    • Cadaveric donation comprises organ donation i.e., taking organs (heart, lungs, kidneys, liver, pancreas) from brain-dead people, as well as tissue donation, meaning taking tissues (skin, corneas, tendons, bone) from brain dead as well as heart dead people.
    • Certain States like Kerala and Maharashtra have been charging fees ranging from ?5,000 to ?10,000 for registering organ transplant patients.
    • Previously, the Health Ministry has proposed a ‘One Nation One Policy,’ for organ donation and transplantation.

    Major highlights

    • Registration for Organ Recipients:
      • Government removes the need for domicile registration to receive organs from a particular state/union territory
      • All states/UTs directed to not charge any fee for organ recipient registration.
      • Patient will be now allotted a unique ID by NOTTO on registering which will get carried forward even if the patient changes multiple hospitals in different States.
    • Age Bar Lifted:
      • Earlier, preference was given to younger patients below 65 years of age.
      • The government removes the age bar for organ registration in consideration of the right to life enshrined under Article 21.
    • Transplantation of Human Organs Act:
      • Organ retrieval, storage, and transplantation are governed under THOA, 1994.
      • The law has been adopted by most states but some aspects are vague, leading to confusion and different implementations.
      • The government is working on a ‘one nation, one policy’ approach to eliminate variations.
    • Awareness and Education:
      • To create awareness about organ donation, a chapter will be added to the school curriculum soon
      • Anyone regardless of age or gender can become an organ and tissue donor with parental or legal guardian consent required for minors
      • Living persons can only donate to immediate blood relations, while a brain-dead person can donate more than 20 organs and tissues
      • The Health Ministry has instructed States to stop charging registration fees from patients.
      • A chapter in the school curriculum regarding organ donation awareness for students will be introduced.

    Organ transplant: Scenario in INDIA

    • The number of organ transplants has increased by over three times from 4,990 in 2013 to 15,561 in 2022.
    • The most common organ transplant is for the kidney, followed by liver, heart, lung, pancreas, and small bowel transplants.
    •  In 2022 alone, nearly 12,791 living donor transplants and 2,765 deceased donor transplants were conducted.
    • Only 1,743 (14%) of the organs were from deceased donors, while the majority of organs harvested were from living donors, specifically kidney and liver donations.
    • Nearly all deceased organ donations in 2021 were in 15 states, with the top five accounting for over 85% of the total.

    Need for Increased Organ Donations in India

    • India conducts the third highest number of transplants in the world, but the number of organs needed is still much higher than the number of transplants.
    • Lifestyle diseases are increasing the demand for organs as heart and lungs can only be retrieved from deceased donors.
    • Nearly 1.5 lakh persons die in road traffic accidents every year in India, many of whom can ideally donate organs.
    • Organ transplantation also helps to reduce the burden on the healthcare system by reducing the need for hospitalization, repeat surgeries, and long-term treatment.
    • India has an organ donation rate of 0.52 per million population, much lower than the rate in Spain (49.6 per million).
    • Organ donation can help save the lives of multiple people, as one donor can donate several organs and tissues.

    Challenges of Organ Transplantation

    • Lack of awareness: There is a lack of awareness among people about the importance of organ donation and transplantation, which leads to a shortage of donated organs.
    • Shortage of donors: Despite increasing awareness, there is still a shortage of organ donors due to several reasons, including religious beliefs, and lack of trust in the medical system.
    • Legal and ethical issues: There are several legal and ethical issues surrounding organ donation, including consent, allocation of organs, and the fair distribution of organs.
    • Transportation and preservation: Organs need to be transported and preserved under specific conditions to ensure their viability for transplantation which has logistical challenges, especially for organs that have a short shelf life.
    • Medical suitability: Not all donated organs are suitable for transplantation due to medical conditions or other factors, which can limit the number of available organs for transplant.
    • Costs: The costs associated with organ transplantation can be high, which can limit access to treatment for some patients.

    Government Steps to facilitate Organ Transplant in India

    • Transplantation of Human Organs and Tissues Act (THOTA): It was enacted in 1994 and governs organ transplantation in India.The act also establishes the National Organ and Tissue Transplant Organization (NOTTO) and State Organ and Tissue Transplant Organizations (SOTTO) to oversee organ donation and transplantation activities.
    • National Organ Transplant Programme (NOTP): It was launched in 2014 to create a national registry of organ donors and recipients, establish more organ transplant centers, and raise awareness about organ donation.
    • Deceased Organ Donation Program:It was launched by Ministry of Health and Family Welfare to encourage organ donation from deceased individuals. 
    • National Organ Donation Day: The government of India has designated November 27 as National Organ Donation Day to raise awareness about the importance of organ donation and encourage people to pledge to donate their organs.
    • Swasth Bharat Yatra: It is a government-led campaign to promote healthy living, prevent lifestyle diseases,raise awareness about organ donation and encourages people to pledge to donate their organs.
    • National Organ and Tissue Transplant Registry: It has established a National Organ and Tissue Transplant Registry to maintain records of organ donations and transplantation in the country to help in the development of policies and strategies to promote organ donation and transplantation.
    • Organ Retrieval Banking Organization: It is a part of the All India Institute of Medical Sciences (AIIMS) in New Delhi and is responsible for the retrieval, preservation, and distribution of organs for transplantation in the Delhi-NCR region. 

    Conclusion:

    • Although organ donation numbers increased in the last decade, there is still a need to increase deceased donations in India.
    • There is a need for awareness, building trust, and increasing the number of medically qualified transplant coordinators to help increase the deceased donations.
    • Overall, organ transplant plays a critical role in the medical field by offering hope to patients suffering from organ failure and improving their quality of life. 
    • It is a vital healthcare service that requires ongoing support, awareness, and education to increase organ donation rates and help more patients in need.

    Source: HT