‘If cadaver donations are high, there would be no need for live donations’
While the kidney racket busted in 2017 slowed down the process of organ donation & transplants, the process has picked up pace again with Maharashtra conducting 50 heart transplants in 2017.
5 min read
Dr Gauri Rathod. Janak Rathod
How has the situation in organ donation changed over the past few years?
Earlier, organ transplant figures were in two digits across the state. We pushed for awareness drives, trained counsellors, created specific groups to raise awareness. These groups like kidney sub-committee, heart sub-committee, liver and so on would do focussed intervention to boost organ donation. The transplant program has picked up in Maharashtra due to that. There were only 26 non-transplant organ retrieval centres when I joined two years ago, now there are 58 centres. These centres do not conduct transplants, but can facilitate in harvesting an organ from a donor. The transplant centres have risen to 162. For heart transplant, even Aurangabad has an hospital now. We recently had one heart transplant there. In Nagpur, one hospital will soon be given permission. Last year, Maharashtra conducted 50 heart transplants, the highest so far for us.
What are the major challenges in convincing people about organ donation?
Religious sentiments play a big role. Donor families sometimes have superstition that if an organ is donated, the deceased will be born without that organ. But think about it, instead of wasting a cornea if that is donated, it could give vision to a blind person. We try to make people realise that if they donate, their child’s heart will beat in someone else’s body, which otherwise could burn to ashes or get buried.
Mumbai seems to be the only city doing extremely well in donations and transplants. How can we ensure a similar push in towns and smaller cities in Maharashtra?
That is actually a misconception. Data we analysed showed most families who donate in urban areas are actually from rural background. They are more open to the concept of organ donation. About 60 per cent of our donor families are from rural areas. They are quick to understand that an organ donation can help save life of someone. It is more difficult to convince affluent section than a middle and lower-middle class family.
Has the kidney racket busted in 2017 hampered organ donation?
If cadaver donations are high, there would be no need for live donations. In several countries, a brain stem dead person is declared a national property and state can harvest organs for transplant unless the family ‘opts out’ of donation. In India, there is no such law. We have an ‘opt in’ option if the family wants to donate. The national policy should have an ‘opt out’ model. This would reduce live donations, and scope of illegal rackets. Live donation after all also affects a donor’s health. The latest verdict on euthanasia is also important. Brain dead patients will not be kept on a ventilator for prolonged duration, which can also give way to easy facilitation of organ donation.
But did the racket impact transplants?
It did for a while. But hospitals have again started conducting regular transplants. As per Tissue and Organ Transplant Act, hospitals that conduct more than 25 organ transplants in a year must have their own authorisation committee. They can approve transplants if a donor and recipient is closely related. For unrelated or distant relatives, the case is referred to state authorisation committee.
Limb donation is still not a reality in Maharashtra, even though southern states have started such transplants.
We attempted one limb transplant in Pune last year but the transplant failed. The limb was rejected by recipient’s body. In case of organs such as kidney or liver, there is no physical mutilation to deceased’s body. But when we harvest a limb for transplant, there is disfigurement in body. Even though hospitals put a prosthetic limb, it is difficult to convince a family. In Mumbai, Global hospital and KEM hospital have been given permission for hand transplant but are yet to conduct one.
The Central government has launched national, regional and state bodies for organ transplant. Has that made the process smooth?
These bodies are yet to become fully functional. The final aim is to facilitate organ transplant amongst patients through a national registry. If there is an organ available and there is no matching recipient in the same city, the organ should not go to waste. We will look for a compatible match in the state and then in the country. This year we started transporting organs to other states. Recently a heart was transported to Chennai for a recipient under National Organ and Tissue Transplant Organisation (NOTTO). We are gradually spreading to cover all hospitals so that maximum brain-dead patients’ families can be reached out. A counsellor can also be provided to hospital by government for this purpose.
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