{"id":21809,"date":"2018-06-19T18:40:59","date_gmt":"2018-06-19T13:10:59","guid":{"rendered":"http:\/\/blog.forumias.com\/?p=21809"},"modified":"2018-06-19T18:40:59","modified_gmt":"2018-06-19T13:10:59","slug":"organ-donation-in-india-an-overview","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/organ-donation-in-india-an-overview\/","title":{"rendered":"Organ Donation in India: An Overview"},"content":{"rendered":"<p><span style=\"color: #ff0000;\"><strong><u>Context:<\/u><\/strong><\/span><\/p>\n<p><em>The Hindu<\/em> reported that National Organ and Tissue Transplant Organization (NOTTO) give priority to foreign patients over Indian patients waiting for a donor heart transplant.<\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>What is organ donation?<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation.<\/li>\n<li><u>Transplant<\/u>: A transplant is a medical procedure where one person\u2019s dysfunctional organ or tissue is replaced by that of a healthy person, thus restoring its function.<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Different types of organ donation:<\/u><\/strong><\/span><\/p>\n<p><strong>Living Donation:<\/strong><\/p>\n<ul>\n<li>Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person.<\/li>\n<\/ul>\n<p><strong>Deceased Cadaver Donation:<\/strong><\/p>\n<ul>\n<li>An organ or part of an organ\u00a0given at the time of donor\u2019s death. (Cadaver means corpse)<\/li>\n<li>Donated after the donor is declared brain dead.<\/li>\n<li>Brain death is the total and irreversible loss of all brain functions.<\/li>\n<li>Brain dead persons are kept on ventilators (artificial support) to ensure all organs remain oxygenated and healthy until they are harvested.<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>What organs can be donated and when?<\/u><\/strong><\/span><\/p>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-21812 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/life.png?resize=569%2C448\" alt=\"\" width=\"569\" height=\"448\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/life.png?w=569&amp;ssl=1 569w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/life.png?resize=150%2C118&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/life.png?resize=300%2C236&amp;ssl=1 300w\" sizes=\"auto, (max-width: 569px) 100vw, 569px\" \/><\/p>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-21813 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/tissue-donation.jpg?resize=353%2C333\" alt=\"\" width=\"353\" height=\"333\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tissue-donation.jpg?w=353&amp;ssl=1 353w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tissue-donation.jpg?resize=150%2C142&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tissue-donation.jpg?resize=300%2C283&amp;ssl=1 300w\" sizes=\"auto, (max-width: 353px) 100vw, 353px\" \/><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>Status of Organ Donation in India:<\/u><\/strong><\/span><\/p>\n<p><strong>Poor Organ donation Rate:<\/strong><\/p>\n<ul>\n<li>26 Per million in India as compared to 36 per million in Spain, 32 per million in Croatia and 26 per million in USA<\/li>\n<\/ul>\n<p><strong>Demand and supply gap (Annual)<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"308\"><strong>Organs Required<\/strong><\/td>\n<td width=\"308\"><strong>Organs Available<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"308\">Kidneys: 21, 000<\/td>\n<td width=\"308\">5000<\/td>\n<\/tr>\n<tr>\n<td width=\"308\">Heart: 5000<\/td>\n<td width=\"308\">70<\/td>\n<\/tr>\n<tr>\n<td width=\"308\">Liver: 20000<\/td>\n<td width=\"308\">750<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>Regional Variation:<\/strong><\/p>\n<ul>\n<li>Tamil Nadu(155 donors in 2015) has the highest number of organ donations followed by Maharashtra, Kerala, Karnataka, Telangana and Gujarat<\/li>\n<\/ul>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-21814 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/tamil.png?resize=520%2C206\" alt=\"\" width=\"520\" height=\"206\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tamil.png?w=520&amp;ssl=1 520w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tamil.png?resize=150%2C59&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/tamil.png?resize=300%2C119&amp;ssl=1 300w\" sizes=\"auto, (max-width: 520px) 100vw, 520px\" \/><\/p>\n<p><strong>Deceased Organs Donation (as of 2013):<\/strong><\/p>\n<ol>\n<li>Kidney: 548<\/li>\n<li>Liver: 257<\/li>\n<li>Heart: 25<\/li>\n<\/ol>\n<p><span style=\"color: #ff0000;\"><strong><u>Policy Initiatives:<\/u><\/strong><\/span><\/p>\n<p><strong>Transplantation of Human Organs Act (THOA), 1994 <\/strong><\/p>\n<p><u>Objective: <\/u><\/p>\n<ul>\n<li>To regulate the removal, storage and transplantation of human organs for therapeutic purposes<\/li>\n<li>To prevent commercial dealings in human organs<\/li>\n<\/ul>\n<p><u>Key features:<\/u><\/p>\n<ul>\n<li>Scope: Organs only<\/li>\n<li>Legalized the concept of brain death- Brainstem death. Brain death certification to be given by Medical Board<\/li>\n<li>Imprisonment of up to 10 years and fine up to Rs. 20 lakh for removal of organs without authority<\/li>\n<\/ul>\n<p><strong>Transplantation of Human Organs (Amendment) Act, 2011\u00a0<\/strong><\/p>\n<p><u>Key features:<\/u><\/p>\n<ul>\n<li>Scope widened: Both organs and tissues<\/li>\n<li>Brain death certification Board\u00a0simplified, more experts permitted<\/li>\n<li>Mandatory transplant coordinator- for coordinating all matters relating to removal or transplantation of human organs<\/li>\n<li>National Human Organs and Tissues Removal and Storage Network at one or more places and regional network<\/li>\n<li>National Registry of Donors and Recipients<\/li>\n<li>Provision of SWAP Donation included- A Swap transplant involves an exchange of organs between two families, who cannot donate the organ to their own family member because of blood group mismatch.<\/li>\n<\/ul>\n<p><strong>Transplantation of Human Organs and Tissues Rules (THOT), 2014<\/strong><\/p>\n<ul>\n<li>Authorised transplantation centre must have its own website<\/li>\n<li>Apex national networking organization at the centre; regional and state level organizations<\/li>\n<li>State units to be linked to hospitals, Organ\/Tissue matching Labs and Tissue Banks\u00a0within area and also regional and national networking organisations<\/li>\n<li>National Registry on Donors and recipients of Human Organ and Tissue to be accessible online<\/li>\n<\/ul>\n<p>Organizations:<\/p>\n<ol>\n<li>National Organ and Tissue Transplant Organization (NOTTO) set up under Directorate of Directorate General of Health Services, Ministry of Health and Family Welfare<\/li>\n<li>National Human Organ and Tissue Removal storage Network<\/li>\n<li>National Biomaterial Centre<\/li>\n<\/ol>\n<p><strong>National Organ Transplant Programme (NOTP)<\/strong><\/p>\n<ul>\n<li>Objective:<\/li>\n<li>To promote organ donation\u00a0in India<\/li>\n<li>To organize a system of organ and Tissue procurement &amp; distribution for transplantation.<\/li>\n<li>To promote deceased organ and Tissue donation.<\/li>\n<li>To train required manpower.<\/li>\n<li>To protect vulnerable poor from organ trafficking.<\/li>\n<li>To monitor organ and tissue transplant services and bring about policy and programme corrections\/ changes whenever needed.<\/li>\n<li>Financial support to States to set up Regional Organ and Tissue Transplant Organizations\/State Organ and Tissue Transplant Organizations.\u00a0(Note: Health is a State subject)<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td width=\"616\"><strong>Green Corridors:<\/strong><\/p>\n<ul>\n<li>Green corridor refers to a special road route that facilitates the transportation of harvested organs meant for transplantation to the desired hospitals.<\/li>\n<li>The street signals are manually operated to avoid stoppage at red lights and to divert the traffic to ensure a rapid transportation of the desired organ.<\/li>\n<li>There are many recent instances in India where organs were transported in time using this facility. Example: \u00a0In May 2018, a green corridor was created to transport heart from airport to the Max Hospital in Delhi<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"618\">\n<tbody>\n<tr>\n<td width=\"618\"><strong>The Tamil Nadu Model<\/strong><\/p>\n<p>1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Introduced Cadaver Transplant Programme in 2008<\/p>\n<p>2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Donation process and organ allocation effectively monitored by an organization- Transplant Authority of Tamil Nadu (TRANSTAN)<\/p>\n<p>Key initiatives:<\/p>\n<ul>\n<li>Focus on deceased organ donation<\/li>\n<li>Emphasis on not letting organs go waste- set of guidelines even for non-transplant centres to ensure that all organs get used<\/li>\n<li>Declaring brain death mandatory<\/li>\n<li>Training transplant coordinators<\/li>\n<li>Implementation of transplant guidelines<\/li>\n<li>Centralised waiting lists<\/li>\n<li>Free transplant in government hospitals<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"color: #ff0000;\"><strong><u>Issues and Challenges:<\/u><\/strong><\/span><\/p>\n<p><strong>Demand and Supply Gap: <\/strong><\/p>\n<ul>\n<li>Huge gap between demand and supply of organs.<\/li>\n<\/ul>\n<p><strong>Socio-cultural beliefs: <\/strong><\/p>\n<ul>\n<li>Religious beliefs hinder deceased organ donation. Superstitions prevalent such as being born (rebirth) with a missing organ (that has been donated), being tangled in the\u00a0life-death-rebirth cycle<\/li>\n<\/ul>\n<p><strong>Lack of awareness: <\/strong><\/p>\n<ul>\n<li>The concept of &#8216;brain death&#8217; and its legal implications unfamiliar to majority of Indian population<\/li>\n<\/ul>\n<p><strong>Infrastructural issue:<\/strong><\/p>\n<ul>\n<li>Limited facilities for transport of donated organs; no air ambulance facilities<\/li>\n<li>Lack of training for intensive-care unit personnel to maintain brain dead person<\/li>\n<li>Lack of awareness among doctors<\/li>\n<li>Lack of effective transplant coordinators<\/li>\n<li>Not all hospitals in India are equipped to carry out the process of organ transplantation and retrieval.<\/li>\n<li>Out of 301 hospitals equipped to handle the process, only 250 are registered with National Organ and Tissue Transplant Organisation (NOTTO)<\/li>\n<\/ul>\n<p><strong>Wastage of organs:<\/strong><\/p>\n<ul>\n<li>Organs (especially hearts and lungs) not used due to lack of suitable recipient. This leads to wastage of organs.<\/li>\n<\/ul>\n<p><strong>High Cost of transplant surgeries:<\/strong><\/p>\n<ul>\n<li>Unregulated cost of transplant surgeries; cost out of reach of poor people<\/li>\n<\/ul>\n<p><strong>Regional Variation:<\/strong><\/p>\n<ul>\n<li>All states in India do not have active organ donation programmes. Organ donation rates in North India abysmally poor.<\/li>\n<li>Further, since health is a state subject, there are issues with implementation of THOA<\/li>\n<li>There are only 5 Regional Organ and Tissue Transplant Organisation (ROTTO)<\/li>\n<\/ul>\n<p><strong>Negative propaganda by media:<\/strong><\/p>\n<ul>\n<li>False proclamation of \u201cscandals\u201d; organ rackets<\/li>\n<li>News of improper practices of organ collection breaks public trust and is impediment to the entire process of organ donation<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Best Practice: \u00a0Spain<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Spain has the highest organ donation rate in the world<\/li>\n<li>Creation of National Transplant Organization (ONT)- Coordinates transplant policies across Spain<\/li>\n<li>It has an opt-out system- organ donation is automatic unless refused<\/li>\n<li>Circulatory death (when circulation, heartbeat and breathing stop, as opposed to brain death) is also a circumstance in which donation is considered<\/li>\n<li>Designation of appropriate professionals (intensive care doctors) to ensure organ donations are fast and efficient<\/li>\n<li>More emphasis on organ donation in patients older than 65 years of age- In Spain 10% of donors are 80+<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Way Forward:<\/u><\/strong><\/span><\/p>\n<p><strong>Public awareness:<\/strong><\/p>\n<ul>\n<li>Reducing the shortage of organs by promoting deceased organ donation<\/li>\n<li>Public awareness is the most important step that can lead to improved rates of deceased organ donation<\/li>\n<li>Example: In 2017, Andhra Pradesh government had initiated the screening of \u201cPunarjanam\u201d (one -minute short film on organ donation) before starting of each show for one week.<\/li>\n<\/ul>\n<p><strong>Infrastructure:<\/strong><\/p>\n<ul>\n<li>Increasing the number of transplantation centres<\/li>\n<li>Training transplant coordinators<\/li>\n<li>Training doctors, paramedical personnel<\/li>\n<li>Improving transport of organs; developing air ambulance services<\/li>\n<li>Proper storage facilities; setting up tissue banks<\/li>\n<\/ul>\n<p><strong>Finance:<\/strong><\/p>\n<ul>\n<li>Reducing the problem of finances; reduction in cost of transplants<\/li>\n<li>Financial support for poor<\/li>\n<\/ul>\n<p><strong>Organizational:<\/strong><\/p>\n<ul>\n<li>Strengthening the role of NOTTO for coordinating the organ distribution system<\/li>\n<li>Effective centralised organ donation registry<\/li>\n<\/ul>\n<p><strong>Legislation:<\/strong><\/p>\n<ul>\n<li>Declaring brain-death should be made mandatory in all hospitals<\/li>\n<li>The Centre proposed to amend the law on motor vehicles to include a choice for voluntary organ donation in new or renewed driving licenses. The draft to amend the Central Motor Vehicles Rules, 1989 should be implemented<\/li>\n<\/ul>\n<p><strong>Ensuring zonalization of organ sharing:<\/strong><\/p>\n<ul>\n<li>To ensure more effective sharing of organs a zonalization should be done (USA has such a provision). This would help in transporting and transplantation of organs which can be preserved only for shorter durations e.g. hearts.<\/li>\n<\/ul>\n<p><strong>Process of allocation to be more transparent:<\/strong><\/p>\n<ul>\n<li>The process of allocation of organs should be made more transparent. It should be made monitored and tracked; made accessible to public.<\/li>\n<li>Further, outcome of transplantation should be properly monitored.<\/li>\n<\/ul>\n<p><strong>Responsible media:<\/strong><\/p>\n<ul>\n<li>The media should be more responsible before proclaiming scandals, rackets. Information should be properly investigated before being published.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Context: The Hindu reported that National Organ and Tissue Transplant Organization (NOTTO) give priority to foreign patients over Indian patients waiting for a donor heart transplant. What is organ donation? Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/organ-donation-in-india-an-overview\/\">Continue reading <span class=\"screen-reader-text\">Organ Donation in India: An Overview<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":21815,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[27],"tags":[],"class_list":["post-21809","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured-editorials","entry"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/iStock-160194832-2.jpg?fit=1003%2C589&ssl=1","views":{"total":373,"cached_at":""},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/21809","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=21809"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/21809\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media\/21815"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=21809"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=21809"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=21809"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}