Reform can address India’s kidney transplant deficit

Source: The post is based on the article “Reform can address India’s kidney transplant deficit” published in “The Hindu” on 29th September 2023.

Syllabus: GS2- Governance- Issues relating to development and management of Social Sector/Services relating to Health

News: This article talks about the severe kidney shortage in India, where laws make kidney swaps and chains hard, leading to few transplants. It explains that swaps and chains could increase transplants, but strict rules and lack of coordinating authority limit them. The article suggests India should adapt successful international practices to help its citizens and reduce illegal kidney sales.

What are the ways a patient can obtain a kidney?

Deceased Donor: A patient can receive a kidney from someone who has died, but limitations like the scarcity of donations and suitable infrastructure make this challenging.

Relative/Friend Donation: A patient can receive a kidney from a compatible relative or friend, but finding a compatible donor is often problematic.

Kidney Swaps: Swaps occur when two incompatible donor-recipient pairs exchange kidneys. For example, Sunita and Zoya, incompatible with their respective spouses, can swap donors if compatibility is found, allowing transplants to occur.

Kidney Chains: A kidney chain begins with an altruistic donor. This donor gives a kidney to a compatible recipient, whose incompatible donor gives to another compatible recipient, creating a chain of donations. The constraints in the current system, however, prevent the formation of such chains in most parts of India.

What are the reasons for kidneys shortage in India?

High Demand: In 2022, over two lakh people in India needed a kidney, but only about 7,500 transplants were done, showing a stark shortage.

Prevalence of Chronic Diseases: Chronic Kidney Disease (CKD) affects about 17% of India’s population, mainly due to widespread diabetes, malnourishment, and poor living conditions, raising the demand for kidneys.

Stringent Regulations: Strict laws in India limit kidney swaps to near-relatives in most states and prohibit kidney chains, except in Kerala, restricting the availability of kidneys for transplants.

Lack of Donations: There is a scarcity of kidney donations from deceased donors due to specific conditions on the nature of death and the lack of infrastructure needed to collect and store kidneys.

Limited Compatibility: Even when willing donors are available, like friends or relatives, often they are not a match in terms of blood type and tissue type, limiting the successful transplants.

Absence of Coordinating Authority: The lack of a national authority for managing and coordinating swaps restricts the potential to find compatible matches and facilitate more transplants.

What should be done?

Reform Regulations: Laws limiting kidney swaps and prohibiting kidney chains need to be relaxed to enhance kidney availability.

Promote Swaps and Chains: Encourage the implementation of kidney swaps and chains to maximize the utilization of available donors.

Altruistic Donations: Permit altruistic kidney donations to initiate kidney chains, providing more patients access to compatible kidneys.

Enhance Infrastructure: Improve the infrastructure to collect and store kidneys, making donations from deceased individuals more feasible.

National Coordinating Authority: Establish a central authority for coordinating swaps and chains, allowing a more extensive and diverse pool for compatible matches.

Adopt International Practices: Learn and incorporate successful regulations and practices from countries like Spain and the U.S. to facilitate more kidney exchanges and transplants.