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.
- 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.