Organ Transplantation
(Representation Only)

What is Organ Donation?

Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. A transplant is a medical procedure where one person’s dysfunctional organ or tissue is replaced by that of a healthy person, thus restoring its function. Lungs, kidneys, liver, heart, kidney, intestine, thymus, tissues etc can be transplanted or donated. It can be Living Donation or Deceased Cadaver Donation. Living donation takes place when a living person donates an organ for transplantation to another person. An organ or part of an organ given at the time of donor’s death in Deceased Cadaver Donation. Spain has the highest organ donation rate in the world. Circulatory death (when circulation, heartbeat and breathing stop, as opposed to brain death) is also a circumstance in which donation is considered

Scenario in India

  • There is Poor Organ donation Rate. 26 Per million in India as compared to 36 per million in Spain, 32 per million in Croatia and 26 per million in USA.
  • Tamil Nadu has the highest number of organ donations followed by Maharashtra, Kerala, Karnataka, Telangana and Gujarat


 Protocol of Organ Transplantation in India

  • First it should be given to an Indian
  • If no Indian is present, it should be given to NRI.
  • If both Indian and NRI decline it, then the question of foreigner comes up.
  • Wealth, gender, race has no bearing when it comes to a person who is receiving a donated organ.
  • The medical condition of the recipient and date of registration is also taken into consideration.

Pros

  • It can help save lives of many needy people who are in need of organs.
  • It will solve cost and exchequer.
  • If done properly, it will prevent scandals and rackets.
  • It is practiced successfully in many countries like Spain, Germany, US etc

Cons

  • Ethical issues are involved.
  • Finding a donor is the main issue in India.
  • There might be trafficking and misuse of the same.
  • Religious sentiments of many people are violated.
  • It will be costly and poor people cannot afford it.
  • Organs (especially hearts and lungs) not used due to lack of suitable recipient. This leads to wastage of organs.
  • There is lack of infrastructure facilities.
  • Awareness is very low in India regarding organ transplantation.
  • The Universal Declaration of Human Rights is violated.
  • There is lot of regional variations.
  • Since health is a state subject, there are issues with implementation of THOA
  • There have been concerns when without the patient and his/her family consent, a brain dead patient’s organs are transplanted.
  • There is no centralized registry for organ donation.
  • The hospitals and institutes have become commercialized.

Policy Initiatives:

1. Transplantation of Human Organs Act (THOA), 1994- It included only Organs and legalized the concept of brain death. Regulation of transplantation regarding therapeutic purposes and preventing commercial dealings in human organs was focused. Imprisonment of up to 10 years and fine up to Rs. 20 lakh for removal of organs without authority was imposed.

2. Transplantation of Human Organs (Amendment) Act, 2011 –Both organs and tissues are included and Brain death certification Board was simplified. National Registry of Donors and Recipients was brought about and Provision of SWAP Donation and Mandatory transplant coordinator was included.

3. Transplantation of Human Organs and Tissues Rules (THOT), 2014- It authorized transplantation centre must have its own website and online accessibility. Apex national networking organization at the centre; regional and state level organizations was focused upon.

4. Different Organizations like National Organ and Tissue Transplant Organization (NOTTO), National Human Organ and Tissue Removal storage Network, National Biomaterial Centre, National Organ Transplant Programme (NOTP) also exist.

 Way forward

  • Strict action should be taken against hospital authorities and institutes who are involved in misuse of organs and exploiting patients
  • Follow up with the organ recipients after transplantation should be conducted.
  • Transparency and accountability should be there.
  • Strict guidelines should be there when foreigners are given organs.
  • Enrolling all domestic patients through State registries should be the priority for the National Organ and Tissue Transplant Organisation.
  • There should be financial support for those who really need organs.
  • There should be proper legislation.
  • Declaring brain-death should be made mandatory in all hospitals.
  • Green corridor refers to a special road route that facilitates the transportation of harvested organs meant for transplantation to the desired hospitals. Example: In May 2018, a green corridor was created to transport heart from airport to the Max Hospital in Delhi
  • The media should be more responsible before proclaiming rackets.
  • Awareness should be there.
  • Government, civil society organizations, NGO should work together.

Ipsita Mishra BA, LLB

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