Organ donation in India has significantly evolved and matured in the last 25 years because the Transplantation of Human Organs Act (THOA) was passed into a law in 1994. THOA laid down the procedure for brain death declaration enabling organ donation from deceased folks. It also laid down the criteria for living donation providing a important enhance to living donor kidney and liver transplantation and prohibiting organ trading.
In an exclusive interview with TheSpuzz Online, Dr Ravi Mohanka, Chief Surgeon and Head of Department of Liver Transplant and Hepato-Biliary Surgery at Global Hospitals, Mumbai shares the evolving status of organ donation in India whilst also providing a low down on the situation of organ donation registry in India to enhance its outreach and accessibility.
How evolved is organ donation in India vis-a-vis globally?
Over the last 25 years, organ donations prices in India have enhanced from .08 PMP to .6 per million population (PMP), while there are big geographical variations across states. However, these are quite low compared to some of the major nations with organ donation prices of 25 to 35 PMP such as USA and Spain.
India at the moment performs the 2nd biggest quantity of transplants in the world, majority of them getting living donor transplants. Organ donation prices across the world are compared working with organ donations per million population (PMP).
Some of the most productive organ donation applications, such as in USA, UK, Australia, and some European nations, are enabled and supported by the government and run by pros. In India, the 2011 amendment of THOA, 1994 mandated establishing the National Organ Transplant Program (NOTP), with administrative and regulatory statuary bodies at national, regional and state levels i.e. NOTTO, ROTTO and SOTTO, respectively.
Does India have an organ donation registry?
Transplantation of Human Organs (Amendment) Act (THOTA – 2011) which came into force on January 10, 2014 mandated establishing creating a government sponsored and run organ donation registry.
National Organ and Tissue Transplant Organisation (NOTTO) maintains a pledge registry on its web-site (in addition to the NGOs). The similar could be completed in conjunction with essential identity documents such as the driving license, Aadhaar card or PAN card, one of which is usually carried by most folks, creating them out there at the time of death. Doctors and hospitals must be provided safe access to the registry to allow verification of the organ donation pledge status of any person.
Each State Organ and Tissue Transplant Organisation (SOTTO) (and their NGO partners) preserve a registry of patients waiting for a deceased donor transplant, which is utilised for organ allocation locally. A national waiting list could be maintained and utilised by different SOTTOs for organ allocation.
Each transplant hospital is mandated to send a month-to-month report of quantity of organ donations and transplants (each deceased donor and living donor transplants) to DHS. This could be complied into a registry to likely kind the most correct registry of the quantity of transplants. NOTTO and Directorate of Health Services (DHS) in distinct states also gather outcome information (survival, rejection, and so on.) from transplant hospitals at variable frequencies working with variable formats in distinct states. If the information collection formats and frequency of outcome information collection could be standardized and mandated, with a penalty clause for non-compliance or falsification, it may possibly assist establish a robust outcome registry.
What types of organ donations are productive in India?
Living donations i.e. one kidney or a aspect of the liver allow about 70% of transplants in India. The good results of these transplants is at par with international requirements. India is hence speedy becoming a hub for ethical transplant tourism.
Each deceased donation enables about 8 life-saving organ donations and donations of a lot of tissues. Most frequently donations are kidney and liver, followed by heart and lungs (as the donor choice criteria for them are more stringent) and much less frequently pancreas, intestines and hands.Tissue donations such as cornea, bones and skin are also uncommon.
What are government and private players’ interventions in assisting organ donations in India?
The government has launched the National Organ Transplant Programme (NOTP) NOTP and setup NOTTO, ROTTO and SOTTO, which in turn collaborate with state level NGOs to allow different registries, coaching applications, organ retrievals and transplants. NOTTO coordinates inter-state organ sharing.
Directorate of Health Services (DHS) is accountable for registration and regulation of transplant centres. Directorate of Medical Education and Research (DMER) is accountable for scrutiny and approval of every single living donor transplant. Mostly NGOs, have taken initiatives for organ donation awareness amongst public and pros, prominent ones getting MOHAN foundation, DONATE Life and other folks
State level NGOs have been authorized by the respective SOTTO which preserve waiting list and allocate organs for deceased donor transplants e.g. ZTCC in Mumbai, TRANSTAN in Tamil Nadu, JeevanDan in Telangana and ZCCK in Karnataka amongst other folks.
How is the regulatory and legal situation? Who are the stakeholders?
Transplants in India are regulated as per THOA, 1994 with THOTA 2011 amendment and guidelines published in 1995 and 2014. Registration, renewal and deregistration of hospitals for transplant is completed by the Directorate of Health Services (DHS) which has the powers of a civil court in these matters. Living donor approvals are completed by the Authorization Committee chaired by the DMER. NOTTO with its network of ROTTOs and SOTTOs is accountable for deceased organ donation, waiting list upkeep and organ allocation, which is most frequently completed by them either straight or in partnership with neighborhood NGOs. The penalties for any act of organ trading are fines upto 5 crores with jail and cancellation of licence for medical doctors.