Organ donation: Clearing cobwebs
To reduce the demand-supply gap, we need intensified awareness campaigns. Just taking an oath for organ donation is not enough. People must pledge their organs and keep their families informed about their decision. Organ donation is altruistic, not a taboo
Recently, a string of welcome measures has been taken to boost organ donation in the country. The signing of a bilateral agreement with Spain on cooperation in organ transplantation is one of them. Spain is a world leader in organ donation and while the nitty-gritties of the agreement are being finalised, the move aims to push the number of organs available for transplants in India.
The green signal to our long pending proposal wherein motorists are being given an option to pledge for organ donation while applying for a driving licence is timely. This will help in harvesting organs from victims of fatal road accidents.
Another major development in the sector has been the granting of license to the national tissue bank to deal with donation, storage, distribution and transplantation of tissue like skin graft, corneas, bone and bone products, heart valves and vessels and cartilage. It will primarily meet the demand of the Delhi-NCR region.
Though the tissue bank was to be set up in 2014 when National Organ Tissue Transplantation Organisation (NOTTO), India’s nodal organ transplant centre, was formed, it could not take off immediately due to delay in registration a
There are many hopes from NOTTO too. It is an apex national body under the Transplantation of Human Organs Act which came into existence in 1994. The legislation was further amended to Transplantation of Human Organs & Tissue Act in 2011, strengthening the system and plugging the gaps.
Established in 2010 under the aegis of Directorate General of Health Services (DGHS), the Union Ministry of Health, the NOTTO aims to create a national networking and registry of the organs in demand and supply. It started functioning from January 2014, with its headquarter in at Safdarjung Hospital Campus in New Delhi.
One of its main mandates is to create awareness among people on deceased organ donation. In this regard, Jagdish Prasad, Director General, DGHS has been emphasising the need for public awareness and training the intensive care physicians across the country. Presently, the deceased organ donation numbers are not impressive.
As of now, each year about one to two lakh new patients are added to the list of those seeking kidney transplant. Similarly, about 50,000 persons are waiting for heart and liver transplants.
But the supply side has failed to keep up with the growing demand. The rate of transplant surgeries is not impressive. It is 7,500 for kidney, 1,500 for liver and merely 200 for heart. As against one lakh cornea requirements annually, we are able to procure just 25,000.
In order to reduce demand-supply gap, we need intensified awareness campaigns, as has also been stressed by the Union Minister for Health JP Nadda at various forums, when he said that just taking an oath for organ donation will not help — people need to pledge their organs and keep their families informed about their decision.
“Donating organs is a gift of life and an altruistic, egalitarian and essentially moral act. Organ donation can benefit the recipient largely by improving health, quality and span of that person’s life and even save the person from death or other critical conditions,” said the Health Minister who has been rightly pitching for making organ donation a national movement and has pledged his own organs.
Till date, overall, we have received organ donation pledges from 13 lakh people, but this nothing when compared to the country’s population of 125 crore.
While the general public is yet to come forward to pledge for organ donation, it is a matter of pride that we have received approximately 15,000 pledges from the officers and jawans of the Border Security Force. We have been receiving pledges from the BSF on a regular basis. Similarly, the Central Reserve Police Force has shared approximately 4,000 pledges with the NOTTO.
We must admit that we have not been able to reach out to the rural population. In this direction, however, we are now collaborating with various non-govermental organisations.
The NOTTO is also in the process of setting up a retrieval centre at each district hospital and all the medical colleges in the country. To achieve this, workshops are being conducted to sensitise retrieval surgeons.
The NOTTO has also trained around 1000 transplant coordinators with the collaboration of NGOs like MOHAN Foundation and more such training is in the pipeline. Till date, the NOTTO has coordinated around 110 retrievals from various cities in India for distribution and subsequent transplantation of organs in various States.
As of now, in India, approximately 301 centres are performing transplant activities, out of which 185 centres are actively engaged in this task. However, just 13 States Union Territories are active in the job.
At the regional level, the NOTTO has five ROTTOs (regional centres) — one each at KEM Mumbai, Guwahati Medical College, Guwahati, PGI Chandigarh, PGIMER-Kolkata and Medical College Chennai.
Also, at the State level, the NOTTO has six identified designated SOTTOs in, which are newly established institutes such AIIMS at Raipur, Bhubaneswar, Jodhpur, Bhopal and Rishikesh. Indore and Bhopal are emerging cities for retrieval and transplant in their respective areas. In the next fiscal, plans are afoot to open SOTTOs (State centres) in the capital of each State.
An Allocation Policy of Heart, Liver, and Pancreas has already been finalised and placed on the official website of the NOTTO. We are also in the process of digitising the allocation policy, sensitising the ICU staff and conducting workshops at different places.
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