Organ Transplants in India

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.

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