As per data shared in Parliament by the Union Health Ministry, after a dip in 2020 owing to the pandemic, organ donations picked up again in 2021 with 12,387 organs harvested from deceased as well as living donors.

 

Details

  • After a fall during the first year of the Covid-19 pandemic, organ donation numbers bounced back in 2021.
  • However, the number of deceased donations has remained lower than the number of donations from living persons.
    • Deceased donation — organs donated by the kin of those who suffered brain death or cardiac death.

 

What is the status in India?

  • Of the 12,387 organs — kidney, liver, heart, lungs, and pancreas among others — harvested in 2021, only 1,743 (a little more than 14%) were from deceased donors.
  • The numbers harvested in 2021 were close to the highest in the last five years (12,746, in 2019).
  • The numbers are skewed in favour of living donations — organs like kidney and liver donated by living family members.
  • There is also a geographical skew in deceased donations.
    • All but two deceased organ donations in 2021 were in 15 states.
    • The top five — Telangana, Tamil Nadu, Maharashtra, Gujarat, and Karnataka — accounting for more than 85% of the total.
    • Two organs were harvested from a deceased donor in Goa.
    • One reason for the geographical skew could be that most organ transplant and harvesting centres are concentrated in these geographies.
  • India has an organ donation rate of about 0.52 per million population.
    • In comparison, the organ donation rate in Spain, the highest in the world, is 49.6 per million population.

 

Need to increase deceased donations

  • Increased demand —
    • There is a gap in the number of organs needed and the number of transplants that happen in the country.
      • In absolute numbers, India conducts the third highest number of transplants in the world.
      • Of the estimated 1.5-2 lakh persons who need a kidney transplant every year, only around 8,000 get one. And of the 10,000 who need a heart transplant, only 200 get it.
    • Demand is on the rise because of the increasing prevalence of lifestyle diseases.
    • Besides, organs like heart and lungs can be retrieved only from deceased donors.
  • Precious resources are wasted —
    • Without deceased donations, a precious resource is wasted.
    • Nearly 1.5 lakh persons die in road traffic accidents every year in India, many of whom can ideally donate organs.

 

Regulatory framework in India

  • Legislation —
    • In 1994, The Transplantation of Human Organs Act (THOA) was promulgated by the government of India.
    • The Transplantation of Human Organs Rules followed in 1995 and were last amended in 2014, increasing the scope of donation and including tissues for transplantation.
    • The act made commercialisation of organs a punishable offence and legalised the concept of brain death in India allowing deceased donation by obtaining organs from brain stem dead person.
  • Institution —
    • National Organ and Tissue Transplant Organization (NOTTO) is a national level organisation set up under Ministry of Health and Family Welfare.
    • Besides laying down policy guidelines and protocols for various functions, it coordinates all the activities associated with organ donation at national level.

 

Reasons for low organ donation rate in India

  • Existing system —
    • In India a person has to register to be an organ donor and the family has to consent to it after death.
      • Even with a donor card, the family’s consent is sought for organ donation after the death of the individual.
      • If the family refuses, the organs are not harvested.
    • On the other hand, Spain has an opt-out system where a person is presumed to be a donor unless otherwise specified.
  • Availability of transplant coordinator —
    • Having a medically qualified transplant coordinator helps in organ donation.
      • A transplant coordinator is the patient’s link to the transplant hospital.
      • They also serve as information resources for patients and families after the transplant.
    • India has smaller number of such coordinators.
  • Transport infrastructure —
    • Good transport networks between cities and states can help boost organ donation.
    • There is need to improve coordination among the Road, Railway, and Aviation Ministries to facilitate the creation of green corridors for faster transportation of organs.
  • Less awareness — There is need for more awareness about organ transplant so that people register as donors.