Organ donations rise after 2020 dip, close to pre-pandemic high

According to the government’s data, the number of organs donated by the kin of those who suffered brain death or cardiac death (deceased donations) has remained lower than the number of donations from living persons over the last five years. But its proportion worsened in 2021 — just over 14 per cent of the total donated organs came from deceased donors, as against the to pre-pandemic high 16.8 per cent figure seen in 2019.

Also, almost all of the organ donations in the country come from just fifteen states, with those in the south and the west taking the lead. In terms of only deceased donations, five states made up the bulk of the numbers in 2021.

During the first pandemic year, 2020, the total number of donations dropped to 7,519.

“When it comes to living donors, the numbers increased quickly as Covid-19 restrictions were eased and hospitals started doing routine surgeries. These people were, in fact, waiting for surgeries. Deceased donations, on the other hand, are slowly increasing again. Of course, our aim is to reverse the current trend of nearly 80 per cent transplants using organs from living donors,” said Dr Krishan Kumar, director, National Organ and Tissue Transplantation Organisation, which comes under the Health Ministry.

He said the organisation is focusing on creating awareness among people, especially school children, and improving connectivity for transporting organs to ensure more deceased donations.

With fewer living donor transplants, the proportion of deceased organ donations was higher in 2017 and 2018, standing at 22.5 per cent and 23.6 per cent of the total organs donated in those respective years. “It is not the capacity, we already have many centres doing organ transplants. In fact, we transplant the third highest number of organs in the world. We need better awareness and counselling of people to increase the number of deceased donations,” said Dr Kumar.

At present, he said, only 2.6 organs are used on an average from every deceased donor. “We are trying to bring this number as close to 8 as possible (the number of organs each person can donate, apart from tissues such as eyes and skin).”

Stressing on the need for awareness, Dr Anupam Sibal, Group Medical Director of Apollo Hospitals, said: “Recently we saw a case where a 13-year-old child passed away after falling from the roof and sustaining a head injury. The parents immediately agreed for organ donation because during some discussion the child himself said that he wanted to donate organs.”

The country-wide network set up by NOTTO has been working to ensure the use of all organs that can be used, he said. Apollo Hospitals, which carry out nearly 14 per cent of the country’s total transplants, will see nearly 1,600 transplants in 2022, after a dip from the usual 1,400 to 814 in 2020 and 1,220 in 2021, according to data provided by the hospital.

Dr Sibal said the numbers dipped during the pandemic because of the travel restrictions and precautions such as quarantine before surgery had to be followed.

“Within a few weeks to a month, we knew that Covid-19 did not impact the outcome of the transplant surgeries. There were guidelines developed on how to do it fairly quickly. So we did lose out on some time in 2020, but not much,” he said.

Unequal numbers

The southern states of Telangana, Tamil Nadu and Karnataka and the western ones of Maharashtra and Gujarat have largely taken the lead in organ donations.

These five states accounted for 85 per cent, or 1,486, of all the deceased donations seen in 2021, according to the data presented in Parliament.

Delhi, which is also a hub for medical treatment, saw only 34 organs from deceased donors — as against 86 in 2017, 80 in 2018, and 74 in 2019, as per the data. However, when it came to living donors, Delhi reported the highest number (1,738) of organs donated, followed by Tamil Nadu (1,419), and Maharashtra (1,051).

“When it comes to deceased donations, it has always been the trend to see the highest numbers in the southern states, followed by the western states,” said Dr Sibal.

Kalpesh Mhatre, Transplant Coordinator at the Maharashtra ROTTO-SOTTO (Regional and State Organ and Tissue Transplant Organisation), said: “The numbers in Maharashtra are perhaps higher than other states because it has multiple medical hubs such as Mumbai, Pune and Nagpur where people not only from within the state but also from outside come for treatment. We also have very good coordination between the networks and the entire state is divided into zones to ensure that most organs are used locally and sent to other parts only if a recipient match is not there in the same zone.”

He added: “We also have very good teams of doctors and counsellors wherein our conversion rate (percentage of brain dead patients who end up donating the organs) is higher than other places. To be sure, as a country our conversion rate is low — less than 1 per cent and we need to work on that.”