Organ donation witnessed a fall in the first year of the Covid-19 pandemic but recuperated in 2021. As per the Indian legislation, the Transplantation of Human Organs Act, 1994 governs the removal, storage, and transplantation of human organs for therapeutic purposes. The Act also serves as a deterrent for commercial trade in human organs.
Status of Organ Donation in India
With an organ donation rate of 0.52 per million population, India lags significantly behind countries with higher rates, such as Spain which boasts an organ donation rate of 49.6 per million population. Contrary to India where individuals need to register for organ donation and acquire family consent post their demise, Spain observes an opt-out system where one is presumed to be a donor unless specified otherwise.
Although there has been an increase in organ donation, the number of deceased donations continues to be less than the number of donations from living persons. In 2021, deceased donors, those who have suffered brain death or cardiac death, contributed only 14.07% of the total organs harvested, lower than the 16.77% in 2019.
The data collected from the year 2021 reveals a geographical skew in deceased donations. The states of Telangana, Tamil Nadu, Maharashtra, Gujarat, and Karnataka accounted for over 85% of the total deceased organ donations. The location of organ transplant and harvesting centers in these regions could be a potential explanation for this uneven distribution.
Increasing Deceased Donations: The Need of the Hour
Two major reasons highlight the need for enhancing deceased donations. Firstly, the huge gap between the demand and supply of organs remains problematic. Despite being the third highest in conducting transplants worldwide, India struggles to meet the organ requirement of its population. For instance, of the 1.5-2 lakh people needing a kidney transplant annually, only about 8,000 receive one. Similar shortages are noted in liver and heart transplants, where only a fraction of those in need receive their required transplant.
Secondly, the prevalence of lifestyle diseases has also contributed to the escalating demand for organs. Certain organs like the heart and lungs can only be retrieved from deceased donors. Nearly 1.5 lakh individuals lose their lives in road accidents annually in India, many of whom could potentially donate organs. However, most organs are currently harvested from brain-dead individuals.
Path Ahead
To ensure donated organs’ accessibility to disadvantaged sections of society, public hospitals must augment their infrastructural capacity for carrying out transplants and offer affordable treatment. A suggested measure involves cross-subsidization, where private hospitals provide free transplants for a section of the population that constitutes the majority of organ donors.
Furthermore, amendments to The Transplantation of Human Organs Act, 1994, are necessary to replace the stringent bureaucratic hospital procedures with self-declaration and mandatory verification involving civil society initiatives. By implementing these strategies, India can improve accessibility and efficiency in organ donation and transplantation.
