The shortage of organ donations, especially deceased donations, continues to be a significant concern in India. Thousands of patients are currently on the waitlist, with many losing their lives daily due to unavailability. Recent amendments to the National Organ Transplantation Guidelines by the Ministry of Health and Family Welfare now allow individuals exceeding 65 years of age to receive organs from deceased donors for transplantation. The regulatory framework for human organ removal, storage, and transplantation is underpinned by The Transplantation of Human Organs Act, 1994, which also aims to prevent commercial dealings in human organs.
Status of Organ Donation in India
India’s organ donation status mirrors a growing demand-supply gap. The current donor list, featuring over 300,000 patients, remains insufficiently satisfied as the supply isn’t catching up with the escalating demand, causing about 20 individuals to succumb daily while waiting for transplants. Despite a rise from 6,916 donors in 2014 to approximately 16,041 in 2022, the deceased organ donation rate has stagnated below one donor per million population over the past decade. Efforts are needed to raise this rate, taking cues from countries like Spain and the United States that have achieved rates between 30 to 50 donors per million population.
Regional Disparities and Predominance of Living Donors
Living donors form the majority, constituting 85% of all donors in India, while deceased organ donations, particularly kidneys, livers, and hearts, remain significantly low. Regional disparities are also evident, with Telangana, Tamil Nadu, Karnataka, Gujarat, and Maharashtra leading in deceased organ donors, while Delhi-NCR, Tamil Nadu, Kerala, Maharashtra, and West Bengal are recognized for a high number of living donors. Especially in kidney transplants, the annual demand for 200,000 is met with only around 10,000 transplants, establishing a considerable gap.
Challenges Surrounding Organ Donation
The organ donation landscape in India is plagued by various challenges, including limited awareness and education amongst the public and medical professionals, family reluctance in providing consent, and issues relating to organ trafficking and the black market. Additionally, there are complexities related to medical compatibility and organ availability, ethical implications of financial incentives or compensation to donors, and inadequate infrastructure and resources for timely organ retrieval, preservation, and transplantation.
New National Organ Transplantation Guidelines
Eliminating the age limit for organ recipients, waiving the domicile requirement for organ recipient registration, and removing registration fees mark the highlights of the new National Organ Transplantation Guidelines. Promoting a ‘One Nation, One Policy’ approach, these guidelines enable patients to register for organ transplants in any state without any charges.
National Organ and Tissue Transplant Organization (NOTTO)
Set up under the Directorate General of Health Services, Ministry of Health and Family Welfare, NOTTO serves as the key center for all activities related to procurement, distribution, and registry of organ and tissue donation and transplantation across India.
Suggested Strategies Going Forward
To bridge the gap between demand and supply, impactful campaigns involving artists, influencers, celebrities, and religious leaders are required. Engaging medical professionals and students through seminars, workshops, interactive simulations, case studies, and talks can be an effective way to increase awareness about organ donation. Community-driven events showcasing donor and recipient success stories, honoring donors and their families, and fostering collaborations between healthcare institutions can play a crucial role in promoting organ donation as a compassionate, selfless act.