Organ Donation and Transplantation in India

Posted by on

 


1. Present Health Status in India

  • Current Numbers – India performed about 18,911 organ transplants in 2024, the highest ever. But the deceased organ donation rate is still less than 1 per million population (PMP), much lower than countries like Spain (~48 PMP).

  • Gap Between Need and Availability –

    • Kidneys: Around 2 lakh needed each year, but only about 13,500 transplants done.

    • Liver: Around 50,000 needed, only about 4,900 done.

    • Heart, Lungs, Pancreas: Acute shortage.

    • Over 5 lakh patients are estimated to be waiting for organ transplants at any given time.

  • Success Rates – One-year survival rates are high: 85–90% for liver, kidney, lung, and heart transplants; 95% for pancreas.

2. Medical Research and Capability

  • India has advanced surgical skills, especially in living donor transplants and even complex procedures like hand transplants.

  • Kidney swap (paired exchange) programs are growing, with Gujarat leading in this method.

  • Major hospitals like All India Institute of Medical Sciences (AIIMS) and large private centres run specialised heart, lung, and liver transplant programs.

3. Science Behind Transplantation

  • Involves matching donor and recipient tissues (HLA typing), preserving the organ in cold storage, and preventing immune rejection through medicines.

  • Organs must be transplanted quickly:

    • Heart/Lungs – 4 to 6 hours

    • Liver – 6 to 12 hours

    • Kidneys – up to 30 hours

    • Pancreas/Intestine – around 6 hours

4. Structural and Legal Framework

  • Main Law – The Transplantation of Human Organs and Tissues Act (THOTA), 1994, amended in 2011 and 2014.

    • Recognises brain-stem death.

    • Regulates living and deceased donations.

    • Prohibits organ trading.

  • Key Bodies –

    • National Organ and Tissue Transplant Organisation (NOTTO) – national level.

    • Regional Organ and Tissue Transplant Organisations (ROTTOs) – regional coordination.

    • State Organ and Tissue Transplant Organisations (SOTTOs) – state-level coordination.

  • Recent Reforms –

    • No age limit for donors.

    • Removal of domicile restrictions (One Nation, One Policy).

    • No hospital registration fees for transplant centres.

    • Standard rules for organ transport, including “green corridors”.

5. Challenges

  1. Low Awareness – Many people are unaware of organ donation or believe in myths.

  2. Cultural and Religious Beliefs – In some communities, reluctance to donate is linked to traditions or misconceptions.

  3. Low Deceased Donation Rate – Less than 1 PMP compared to over 20 PMP in developed countries.

  4. Family Refusal – Even when brain death is certified, families often refuse consent due to lack of counselling or fear.

  5. Infrastructure Gaps – Not all hospitals have transplant facilities, especially in smaller cities.

  6. Uneven Access – Most transplants happen in metro cities, leaving rural patients behind.

  7. Organ Trafficking – Illegal trade still exists despite strict laws, driven by poverty and shortage of donors.

  8. Logistics Issues – Delays in creating green corridors or transporting organs can waste viable donations.

  9. Coordination Problems – Data sharing between states and centres is often slow and unorganised.

6. Government Measures

  • National Organ Transplant Programme (NOTP) – funds infrastructure, staff training, and awareness campaigns.

  • Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) – covers certain transplant costs.

  • Rashtriya Arogya Nidhi (RAN) – financial help for poor patients.

  • National Awareness Drives – e.g., “Angdaan – Jeevan Sanjeevani Abhiyan”, pledge portals linked with Aadhaar, state-level donor registration drives.

  • Model State Programs – Telangana’s “Jeevandan” and Tamil Nadu’s mandatory brain-death certification.

7. Global Benchmarks

Country                          Deceased Donation Rate (PMP)
        Spain                                             ~48
        United States                                             ~22
        United Kingdom                                             ~15
         India                                             ~0.5–0.8

8. Way Forward (Crisp)

  • Awareness First – Nationwide education in schools, workplaces, and media to break myths.

  • Train More Coordinators – Skilled counsellors in every ICU to speak with families.

  • Strengthen Infrastructure – Equip district hospitals for retrieval and storage.

  • Uniform System – Fully digitised, real-time organ allocation across states.

  • Support Families – Recognition, incentives, and emotional support for donor families.

  • Strict Law Enforcement – Zero tolerance for trafficking with quick legal action.

  • Learn from Leaders – Replicate Telangana and Tamil Nadu’s best practices across India.

Comments

Post a Comment