The Ministry of Health and Family Welfare has recently updated the National Organ Transplantation Guidelines, removing the age limit and domicile requirement for organ recipients. This new policy aims at promoting cadaver donations and offering better access to organ transplantation services across the country.
Transplantation of Human Organs Act, 1994
In India, the regulation for organ removal, preservation, and transplantation is guided by the Transplantation of Human Organs Act, 1994. This act provides a legal framework for therapeutic procedures and prevents unauthorized transactions related to human organs.
Modifications to the National Organ Transplantation Guidelines
One significant change in the policy is the removal of the upper age limit. Previously, National Organ and Tissue Transplant Organization (NOTTO) guidelines prohibited registration for organ receipt from end-stage organ failure patients who were over 65 years old. However, recognizing that people are now living longer, this restriction has been removed.
Another noteworthy change is the abolition of the domicile requirement for registering as an organ recipient in a specific state. Under the new ‘One Nation, One Policy’ framework, patients can now register to receive organs in any state of their choice, enabling them to have their surgery performed there.
Registration Fees
To register for organ receipt, states previously charged a fee. The Centre has now asked the states to stop this practice. Some of these states, including Gujarat, Telangana, Maharashtra, and Kerala, charged between Rs 5,000 to Rs 10,000 for registration on the organ recipient waiting list.
The Role of NOTTO
NOTTO, located in New Delhi, operates under the Ministry of Health and Family Welfare’s Directorate General of Health Services. Its National Network division serves as the central hub for organ procurement, distribution, and registry activities relating to organ and tissue donation and transplantation across India.
Objective of the New Guidelines
The new guidelines aim at creating a national policy for transplantation, standardizing the criteria applied throughout the country. Despite health being a state subject, and the central government’s rules not binding on states, these changes are designed to promote access to organs and cadaver donations, which currently constitute a small fraction of all organ transplants in India.
Organ Transplantation Scenario in India
India ranks third worldwide in performing the highest number of transplants. Deceased donors accounted for nearly 17.8% of all transplants in 2022. The total number of such transplants increased from 837 in 2013 to 2,765 in 2022. In comparison, organ transplants – from both deceased and living donors – increased from 4,990 in 2013 to 15,561 in 2022.
The Demand-Supply Gap
However, the need for organ transplants far outstrips the supply. Every year, an estimated 1.5-2 lakh people require a kidney transplant, but in 2022, only around 10,000 received one. Similarly, 80,000 people needed a liver transplant, yet less than 3,000 got one, and only 250 out of 10,000 who needed a heart transplant received it.
Promoting Organ Donations
Promoting organ donations is crucial in bridging this gap. By increasing public awareness, enhancing educational efforts, and improving the donation process, organ and tissue donation accessibility can be maximized, augmenting the potential donor pool. For equitable access amongst economically weaker sections, public hospitals should enhance their infrastructural capabilities for transplants and provide low-cost treatment. Cross-subsidization, where private hospitals offer free transplants for every 3 or 4 paid ones to the majority organ donor section, can also increase accessibility.
