Why kidney rackets thrive

News: Last week, a network of kidney traffickers was busted in Delhi. This is the 3^rd such scam in the last 15 years in Delhi.

The trafficker involved doctors and other healthcare personnel, hospital administrators. They catered to patients that have end-stage kidney diseases and cannot be treated with medicines or dialysis and require a transplant.

The Transplantation of Human Organs and Tissues Act, 2011

The act was amended in 2011 and 2014

The Transplantation of Human Organs and Tissues Act, 2011 recognizes 3 kinds of donations by living organ donors:

1. by near-relatives (parents, siblings, and spouses)
2. by altruistic donations
3. by swap donations

Swap transplant is allowed when a near relative is medically incompatible with the recipient. It allows swapping with another related, unmatched donor-recipient pair.

Altruistic donations are those donations where someone donates an organ, usually a kidney or part of the liver, to someone they are not related to or, in some cases, even to a complete stranger.

The act allowed donations from cardiac dead patients (earlier, organs could be donated only by brain-dead patients).

The law prohibits any financial exchange for donations.

All cases of living donations have to be scrutinised by an in-hospital committee to ensure no commercial dealing happens. In cases of unrelated donors or any case flagged by hospitals, an external panel examines all papers.

What are the reasons behind the prevalence of organ trafficking in India?

More than 1.5 lakh people in the country require kidney transplants every year. But the number of organ donors is a small fraction of this requirement.

The black market in the organ trade flourishes by disguising illegal trafficking as “altruistic donation”.

Medical authorities have ignored suggestions to increase the transparency in the work of committees that scrutinise organ donations.

Unlike some western countries, India does not have a “opt-out” system. This system assumes all citizens to be willing organ donors after death unless they “opt-out” of it.

India’s organ transplant law recognises cadaver (after death) donations with family approval. However, declaring a person brain-dead in time for the organs to be harvested is very difficult in India. Most hospitals lack the expertise and facilities required for this purpose.

Why Kidney trafficking is most prevalent among organs?

In 2020, there were 7,443 transplants in the country, of which 5,486 or nearly 74% were kidney transplants. Thus, the demand for transplants is high.

The kidney can survive longer outside the body — 24 to 36 hours — than the lungs (4-5 hours) and the liver (8-12).

There is a severe shortage of Kidneys and the quality of life after transplant is quite good.

India has expertise in kidney transplantation and the procedure is standardized. So patients face low risk.

With changing life styles, diseases like diabetes and hypertension are increasing. These diseases can go undetected for years and causes kidney diseases.

What can be done?

Increase donations from the dead. In 2020, of all the transplants, only 9.4%, used organs from deceased donors.

Source: This Post is created based on the articles:

1) “Explained: Why kidney rackets thrive” published in Indian Express on 6^th June, 2022.

2) “Busting illicit organ trade is imperative” published in Indian Express on 6^th June, 2022.