Why in the News?

Around three lakh patients wait for organ donation in the country and the country’s increase in donors has not kept pace with demand; experts say country urgently needs to increase its deceased donation rate, and there should be greater awareness among ICU doctors and families on how one deceased donor can save several lives.

Key Data Highlights:

Health Ministry's Insights:

• The count of donors, comprising both living and deceased, witnessed a growth from 6,916 in 2014 to approximately 16,041 in 2022.
• Within the domain of deceased donors, the nation achieved notable milestones with 1,589 kidney transplants, 761 liver transplants, and 250 heart transplants during 2022.
• A substantial progression was seen in kidney and pancreas transplants, ascending from merely three in 2014 to a significant 22 in 2022.
• Analysis of the statistics reveals a compelling trend where approximately 70% to 75% of donors are female. The roles of wives, mothers, and sisters have prominently emerged as major sources of organ donation.

Global Perspective:

• On a global scale, the reality remains that a mere 10% of individuals necessitating organ transplants are able to access them in a timely manner.
• Noteworthy examples of more robust organ donation systems can be observed in countries such as Spain and the United States. These nations exhibit higher numbers, with 30 to 50 organ donations per million people, showcasing a commendable commitment to addressing the shortage of organs.

Current Scenario of Organ Donation and Transplantation in India:

• The practice of organ transplants in India has witnessed a remarkable surge, growing by more than threefold, escalating from 4,990 instances in 2013 to an impressive 15,561 cases in 2022.
• The foremost among organ transplants remains the kidney transplant, followed by liver, heart, lung, pancreas, and small bowel transplants, collectively contributing to the medical landscape.
• The year 2022 stood out with the execution of nearly 12,791 living donor transplants and an additional 2,765 transplants from deceased donors.
• Of note, a notable proportion of these transplants (14%) were sourced from deceased donors, underscoring the significant role of living donors, particularly in kidney and liver contributions.
• In terms of geographic distribution, the organ donation dynamic is concentrated. In 2021, the bulk of deceased organ donations occurred within 15 specific states, with the top five states collectively accounting for an impressive 85% of the total contributions.

Why India Needs More Organ Donations?

• India boasts the distinction of being the world's third-largest performer of transplants. However, the demand for organs significantly outstrips the supply of available transplants.
• The surge in lifestyle-related illnesses is amplifying the call for organs, particularly for vital organs like hearts and lungs that are solely obtainable from deceased donors.
• An alarming number of approximately 1.5 lakh individuals succumb to road traffic accidents each year in India. This presents an opportunity to potentially harness organs from these cases, contributing to a more robust supply.
• Beyond saving lives, the practice of organ transplantation serves to alleviate the burden on healthcare systems. This includes a reduction in hospital stays, the need for repeat surgeries, and extended treatments.
• India's existing organ donation rate stands at a modest 0.52 per million population, notably lower than the figure in countries like Spain, which boasts a rate of 49.6 per million.
• One of the most compelling aspects of organ donation is its capacity to impact multiple lives simultaneously. A single donor can serve as a source of numerous organs and tissues, magnifying the potential to save and enhance multiple lives.

Issues, Challenges and Ethics in Organ Transplantation:

• Lack of Public Awareness:
• A prevailing challenge revolves around inadequate public awareness regarding the significance of organ donation and the subsequent transplantation process.
• This lack of understanding contributes to a dearth of available donated organs.
• Shortfall in Donors:
• Despite heightened efforts in awareness campaigns, a shortage of willing organ donors persists due to factors such as religious beliefs and a lack of trust in the healthcare system.
• Ethical and Legal Complexities:
• The arena of organ donation faces intricate ethical and legal dilemmas. These encompass matters like consent, the fair allotment of organs, and equitable distribution, presenting multifaceted challenges.
• Transportation and Preservation:
• The preservation and transportation of organs demand specific conditions to maintain their transplant viability.
• These logistical hurdles are especially pronounced for organs with limited shelf lives.
• Medical Suitability Constraints:
• The suitability of donated organs for transplantation can be impeded by medical conditions or other considerations.
• This dynamic can impose restrictions on the available pool of organs for potential transplant recipients.
• Financial Implications:
• A significant challenge arises in the form of the associated costs linked with organ transplantation.
• These financial burdens can potentially restrict access to treatment for certain patients, creating disparities in care.

What are the Government Steps Taken to Promote Organ Donation in the Country?

• National Organ Donation Day:
• Designating November 27 as National Organ Donation Day, the Indian government seeks to heighten public awareness about the significance of organ donation and encourage individuals to pledge their organs.
• National Organ Transplant Programme (NOTP):
• Launched in 2014, NOTP is a comprehensive endeavor.
• It aims to create a national registry encompassing both organ donors and recipients, bolster the presence of organ transplant centers, and foster greater awareness about the critical nature of organ donation.
• Deceased Organ Donation Program:
• The Ministry of Health and Family Welfare introduced this program to actively encourage organ donations from individuals who have passed away.
• Transplantation of Human Organs and Tissues Act (THOTA):
• Instituted in 1994, THOTA serves as the framework regulating organ transplantation within India.
• This legislative act also establishes the National Organ and Tissue Transplant Organization (NOTTO) and State Organ and Tissue Transplant Organizations (SOTTO).
• Their roles encompass overseeing organ transplantation activities and donations.
• Swasth Bharat Yatra:
• Spearheaded by the government, this campaign is dedicated to promoting a health-conscious lifestyle, preventing lifestyle diseases, raising awareness about organ donation, and motivating individuals to pledge their organs.
• National Organ and Tissue Transplant Registry:
• Establishing a dedicated National Organ and Tissue Transplant Registry, India now maintains comprehensive records of organ donations and transplantations across the nation.
• This database aids in formulating effective policies and strategies for fostering organ donation and transplantation.
• Organ Retrieval Banking Organization:
• Housed within the All India Institute of Medical Sciences (AIIMS) in New Delhi, this organization assumes responsibility for retrieving, preserving, and efficiently distributing organs for transplantation in the Delhi-NCR region.

Moving Ahead:

At present, India is witnessing an enhanced consciousness regarding organ donation, with a growing number of families expressing willingness to engage in this altruistic endeavor, as reported by medical professionals. In the journey forward, it is imperative to emphasize awareness, cultivate trust, and augment the cadre of medically proficient transplant coordinators. This collective effort holds the potential to amplify deceased donations significantly. In the broader spectrum, organ transplantation stands as a pivotal pillar in the medical domain. It not only bestows hope upon individuals grappling with organ failure but also elevates their quality of life, embodying a profound impact on healthcare.

Mains Question:

• Discuss the impact of government initiatives like the National Organ Transplant Programme and the Deceased Organ Donation Program on addressing challenges and increasing awareness in organ transplantation in India. (15M)