ORGAN TRANSPLANTATION – SCIENCE
News: India
saw record over 15,000 organ transplants in 2022: Union Health Secretary
What's in the news?
● India
has witnessed a fast resurgence in organ transplant activities post COVID-19
and, for the first time, achieved more
than 15,000 transplants a year in 2022.
● Along
with this, there was an annual increase of 27% in the transplant numbers.
Organ transplantation in India:
● The
number of organ transplants has increased by over three times from 4,990 in
2013 to 15,561 in 2022.
● The
most common organ transplant is for the kidney, followed by liver, heart, lung,
pancreas, and small bowel transplants.
● In
2022 alone, nearly 12,791 living donor transplants and 2,765 deceased donor
transplants were conducted.
● Only 1,743 (14%) of the
organs were from deceased donors, while the majority of organs harvested were
from living donors, specifically kidney and liver donations.
● Nearly
all deceased organ donations in 2021 were in 15 states, with the top five
accounting for over 85% of the total.
Need for Increased Organ Donations in India:
● India
conducts the third highest number of
transplants in the world, but the number of organs needed is still much
higher than the number of transplants.
● Lifestyle diseases
are increasing the demand for organs as heart and lungs can only be retrieved
from deceased donors.
● Nearly
1.5 lakh persons die in road traffic accidents every year in India, many of
whom can ideally donate organs.
● Organ
transplantation also helps to reduce the
burden on the healthcare system by reducing the need for hospitalization,
repeat surgeries, and long-term treatment.
● India
has an organ donation rate of 0.52 per million population, much lower than the
rate in Spain (49.6 per million).
● Organ
donation can help save the lives of
multiple people, as one donor can donate several organs and tissues.
Challenges in Organ Transplantation:
1. Lack of awareness:
● There
is a lack of awareness among people about the importance of organ donation and
transplantation, which leads to a shortage of donated organs.
2. Shortage of donors:
● Despite
increasing awareness, there is still a shortage of organ donors due to several
reasons, including religious beliefs, and lack of trust in the medical system.
3. Legal and ethical issues:
● There
are several legal and ethical issues surrounding organ donation, including
consent, allocation of organs, and the fair distribution of organs.
4. Transportation and preservation:
● Organs
need to be transported and preserved under specific conditions to ensure their
viability for transplantation which has logistical challenges, especially for
organs that have a short shelf life.
5. Medical suitability:
● Not
all donated organs are suitable for transplantation due to medical conditions
or other factors, which can limit the number of available organs for
transplant.
6. Costs:
● The
costs associated with organ transplantation can be high, which can limit access
to treatment for some patients.
Measures taken by Government:
1. Transplantation of Human Organs and Tissues Act
(THOTA):
● It
was enacted in 1994 and governs
organ transplantation in India.
● The
act also establishes the National Organ
and Tissue Transplant Organization (NOTTO) and State Organ and Tissue
Transplant Organizations (SOTTO) to oversee organ donation and
transplantation activities.
2. National Organ Transplant Programme (NOTP):
● It
was launched in 2014 to create a national registry of organ donors and
recipients, establish more organ transplant centers, and raise awareness about
organ donation.
3. Deceased Organ Donation Program:
● It
was launched by the Ministry of Health and Family Welfare to encourage organ
donation from deceased individuals.
4. National Organ Donation Day:
● The
government of India has designated November
27 as National Organ Donation Day to raise awareness about the importance
of organ donation and encourage people to pledge to donate their organs.
5. Swasth Bharat Yatra:
● It
is a government-led campaign to
promote healthy living, prevent lifestyle diseases,raise awareness about organ
donation and encourage people to pledge to donate their organs.
6. National Organ and Tissue Transplant Registry:
● It
has established a National Organ and Tissue Transplant Registry to maintain
records of organ donations and transplantation in the country to help in the
development of policies and strategies to promote organ donation and
transplantation.
7. Organ Retrieval Banking Organization:
● It
is a part of the All India Institute of Medical Sciences (AIIMS) in New Delhi
and is responsible for the retrieval, preservation, and distribution of organs
for transplantation in the Delhi-NCR region.
Recent Changes in Guidelines:
1. Registration for Organ Recipients:
● Government
removes the need for domicile
registration to receive organs from a particular state/union territory
● All
states/UTs directed to not charge any fee for organ recipient registration.
● Patients
will now be allotted a unique ID by NOTTO on registering which will get carried
forward even if the patient changes multiple hospitals in different States.
2. Age Bar Lifted:
● Earlier,
preference was given to younger patients below 65 years of age.
● The
government removes the age bar for
organ registration in consideration of the right to life enshrined under
Article 21.
3. Transplantation of Human Organs Act:
● Organ
retrieval, storage, and transplantation are governed under THOA, 1994.
● The
law has been adopted by most states but some aspects are vague, leading to confusion
and different implementations.
● The
government is working on a 'one nation,
one policy' approach to eliminate variations.
● The
Health Ministry has instructed States to stop
charging registration fees from patients.
4. Organ donor:
● Anyone
regardless of age or gender can become an organ and tissue donor with parental
or legal guardian consent required for minors.
● Living
persons can only donate to immediate blood relations, while a brain-dead person
can donate more than 20 organs and tissues.
5. Awareness and Education:
● To
create awareness about organ donation, a chapter
will be added to the school curriculum soon.
● The
Ministry of Health and Family Welfare suggests wide orientation and
re-orientation through training
programmes, newly-designed courses and digital interventions for healthcare
professionals and domain knowledge experts.
● It
also pushed for a multi-stakeholder
exercise such as partnerships with NGOs for communicating effectively and
making people realize their contributions towards a greater good.
● The
Health Secretary also suggested that consultations and discussions can lead to
memoranda of understanding (MoUs) and consequently, creation of centers of excellence at the State and regional levels
where these specialized services can be provided to the needy.