A cadaver could be a source of many organs and tissues that could be transplanted in many recipients
Organ and tissue donation is defined as the act of giving life to others after death by donating one’s organs to the needy suffering from end-stage organ failure. Body donation is defined as the act of giving one’s body after death for medical research and education. Those donated cadavers remain principal teaching tools for anatomists and medical educators teaching gross anatomy. As there is no organised data available for the required organs, the numbers are only estimated ones. Every year, the number of persons who need organ/tissue transplant as per organs specified are: Kidney (2,50,000), Liver (80,000), Heart (50,000), Cornea (1,00,000) (Source: National Organ and Tissue Transplant Organisation, Union Ministry of Health and Family Welfare, Government of India). Legally, organ donation for therapeutic purposes is covered under Transplantation of Human Organs Act, 1994, while the whole body donation is covered by the Anatomy Act, 1984.
Unequal Transplant Facilities
Why do we need to up the ante on organ donation in India? Interestingly, India’s Health Minister JP Nadda himself emphasised this need. According to him (Times of India, August 1, 2016), “Against a requirement of 1 to 2 lakh kidneys, only about 5,000 transplantations are being done annually. Similarly, against a requirement of 30,000 liver transplantation, we are currently doing about 1,000 only. The main reason for this is very less number of organ donations from among the deceased. The fact is that it is not only the unavailability of the organs but also the unequal distribution of transplant facilities which makes it increasingly difficult for people from the rural and semi-urban India to go for organ transplantation. Ninety-five per cent of the transplantation facilities are available in the metropolitan cities only,” Shri Nadda said. He stressed to increase transplant facilities in other parts (of the country) too. “As a first step towards rectifying this, the Minister promised that transplant facilities will be opened in all major government hospitals.”
According to a research report, “A study of the deceased organ donation and environment in Delhi/NCR (by Organ India in partnership with Mohan Foundation), India has made a few strides forward, but a lot more needs to be done. The number of transplants done annually has been gradually rising. Currently, around 5,000 kidneys, 1,000 livers and around 15 hearts are transplanted annually. The report underlines, “There is a poor Organ Donation Rate — 0.26 per million in India, as compared to some of the better performing countries, such as America 26, Spain 35.3, and Croatia 36.5 per million respectively.” With 1 per million-donation rate, India would have 1,100 organ donors donating 2,200 kidneys, 1,100 hearts, 1,100 livers, 1,100 pancreas and 2,200 eyes. This should take care of almost all current demands for organs. At a 2 per million-donation rate, there would be 2,200 organ donors and these figures would double. Then there will be no need for living kidney donations.
Quantifying the problem, the research report says, “There is a need of roughly 2,00,000 kidneys, 50,000 hearts and 50,000 livers for transplantation each year.” The Parliamentary Standing Committee on Health and Family Welfare also expressed deep concern over the huge gap between the need and availability of organs for transplantation. While examining The Transplantation of Human Organs (Amendment) Act, 2009, the Committee in its report, which was presented to Rajya Sabha on August 4, 2010 observed, “…one disturbing trend which was raised again and again was wide disparity between the demand and availability of human organs in the country. The Committee was given to understand that organ donation rate was only 0.08 per million in our country.
Reason for Trafficking
Against requirement of around 1,00,000 eye donations, availability was only of 38,000. Similarly, only 4,000 kidneys against 1,50,000, only 10 livers against demand of 50,000 and just 43 hearts against a requirement of around 5,000 was being reported. The trafficking in organs was mainly attributable to this gap in demand and supply. A viable solution in this regard repeatedly emphasised by experts is that a cadaver could be a source of many organs and tissues that could be retrieved and transplanted in many recipients.” The Committee further observed, “It has been stated that even countries like Greece, Poland and Turkey could manage to have 4-6 per million donation rate.…India had 1,00,000 brain death cases in fatal accidents. If the donation rate was increased to 1 per million rate, there would be 1,100 organ donors donating 2,200 kidneys, 1100 hearts, 1,100 livers and 2,200 eyes.”
(The writer is author of Body-Organ Donation: Towards a Healthy Society)