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Organ transplants - The Indian overview
On a daily basis, the increase in organ damage or failure due to disease and accidents leave families devastated and in pain. However, with the development of medical science in the country, the potential of organ transplant has given great hope to those who had lost all.

India is rapidly becoming one of the chief centers of organ transplants including kidney, liver, cornea and heart and not just in the private sector but government hospitals are also creating new milestones each day. India has become a hub for medical tourism in the last few years.

However, organ transplant is not that easy and requires strict legal formalities to be fulfilled before the procedure can be undertaken. The first condition is the doctors to determine that no more medication or surgical procedures or partial organ extraction would comfort the patient. This has to come from a panel of senior doctors who determine this based on their experience.

Next is the search for a willing donor in case of organs that can be transplanted without posing a threat to the life of the donor like kidney or liver. In such a case generally, the doctors prefer the family members. However if the donor is an outsider then legal formalities bide the transplant. The approval from the donor is legally mandatory and this includes financial or other compensations. The hospital is bound to extract only the organ that the donor has given acceptance for. Any other procedure beyond the one signed for would be treated as a criminal offence and results in legal action.

In the case of organs that need to be donated immediately after death including cornea and heart the legal procedures are a little different. First of all to extract any organ from a dead person the donor must be declared brain dead ie when the brain of the person fails to function in medical language and results in the stopping of necessary life procedures like respiration and heart beating. In such a situation the doctor would declare the person dead and only upon the consent of the family members would the organs be extracted. In a case where the dead person had committed his organs to an organ bank or an agency working in the same capacity, then the consent of the family members is not a compulsion, however ethically, a request is put forward.

In the case of medical tourism, the embassies of the concerned country are also brought into the loop.

The following are some of the formalities that need to fulfilled before a transplant procedure can take place:

Form 1: Near-relative consent

Form 2: Spouse consent

Form 3: Other than near-relative donor consent

Form 4: Psychiatrist evaluation of the donor

Form 5: HLA DNA profiling report

Form 7: Self-consent for deceased donation

Form 8: Consent for organ donation from family (also applicable for minors)

Form 9: Consent for organ donation from unclaimed bodies

Form 10: Brain death declaration form

Form 11: Joint transplant application by donor/recipient

Form 12: Registration of hospital for organ transplantation

Form 13: Registration of hospital for organ retrieval

Form 16: Grant of registration

Form 17: Renewal of registration

Form 18: Decision by hospital authorisation committee

Form 19: Decision by district authorisation committee

Form 20: Verification of Domicile for non-near-relative

Form 21: Letter from Embassy

Only a hospital which is authorised to undertake organ transplant surgeries can conduct such a procedure.

Some key issues that people face are the availability of the donor, matching organ nomenclature, consent of families to donate organs, time to transfer the organ as sometimes distance can be a big hurdle, financial costs, and legal procedures. However, the governments are working hard to reduce these hurdles as far as possible.

One of the biggest challenges as highlighted above is the demand and supply gap. The number of patients in need of the organs is very high but in most cases, the availability of organs is very limited and mostly restricted due to religious, social and causes concerning the lack of awareness and will to help others. Till the awareness is not increased the condition is far from getting better. The governments at both Central and state levels need to take this initiative very seriously and make sure that more and more organs banks are promoted and also private sector is not only promoted but regulated in the act as well.

Organ donation is motivated by all and thus here is a list of the major organ donation banks in India along with their web links.

1. NOTTO (National Organ and Tissue Transplant Organisation)

notto.gov.in/

2. Organ Retrieval Banking Organisation

notto.gov.in/

3. Organ India

organindia.org/

4. Mohan Foundation

mohanfoundation.org/

5. Kidney Foundation of India

kidneyfederationofindia.com/

A message for humanity is that regardless of which religion you belong to, organ donation is the biggest donation that human being can give to the society.

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