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Hundreds die in India for lack of organs
Monday August 5, 2013 3:50 PM, Sreeparna Chakrabarty, IANS

Neera Yadav (name changed), a 20-year old college student suffering from an end-stage renal disease, was in desperate need of a kidney transplant. Though her parents went from pillar to post, they could not find a donor for her in Delhi and she died last month.

Experts say this is not an isolated case. Hundreds of people in need of organ transplants cannot be saved every year because of lack of donors.

According to M. C. Misra, chief of the Jai Prakash Narayan Apex Trauma Centre at the All India Institute of Medical Sciences (AIIMS), the donor scene in India is still very "dismal" despite amendments to a law which the government passed in 2008. The amendments to the Transplantation of Human Organs Act (Thoa), 1994, were passed following the unearthing of a thriving kidney donation racket in northern India.

While in western countries around 70-80 percent of people pledge their organs, in India only about 0.01 percent do so, Misra stated.

Sanjiv Gulati, director of nephrology at Fortis Hospital in Vasant Kunj, told IANS: "There has been almost no improvement in the organ donation situation. Things have not changed at all. People are not ready to part with organs of their loved ones even after death."

While most donors in India are women, many don't come forward to pledge organ donation because of religious or superstitious reasons, the expert said.

"We need to rope in religious leaders to make people aware of the need for organ donation. People have weird thinking like whichever organ you donate, in the next life you will be born without that," Misra told IANS.

Another major problem is that in India brain death itself is not recognised by many people. "People think till the heart is beating the person has to be alive. Which makes it difficult for us to harvest organs," Misra explained.

According to AIIMS figures, of the 205 patients declared brain dead at the trauma centre in the past five years, only 10 were potential donors.

In a study published in the Indian Journal of Anaesthesia, the AIIMS Trauma Centre, which admits over 6,500 patients every year, analysed the number of cadaver donations between September 2007 and August 2012.

The study said that 90 percent of donors were middle-aged males. The cause of brain death in 70 percent of cases was injuries sustained in road accidents, 20 percent after falling from heights and 10 percent due to being gored by animals, particularly cows.

The average time recorded from certification of brain death to organ harvesting was 33 to 46 hours, the study said, adding the organs harvested were kidneys, hearts, heart valves, livers and corneas.

Gulati said in case of live donations, it was mostly women who were donating their body parts like kidneys. The ratio of male versus female in live donations was around 20:80.

The amended version of the Transplantation of Human Organs Act allows donations from a "near relative" defined as spouse, son, daughter, father, mother, brother or sister. The amended law broadens the definition of "near relative" to include grandparents, grandchildren, uncles and aunts.

Also, not-so-close relatives who have stayed with the patient can donate organs, provided there is no commercial dealing.
The law makes swapping of organs between two unrelated families legal in cases where organs of willing near-relative donors are found medically incompatible.

But the swap should be without any commercial transactions, it stipulates.

Misra said the organ donation scene could change in the country if the government offers incentives.

"Donors should also be appreciated on events like Independence Day and Republic Day," he said, adding that concessions in railway reservations and medical benefits to the donors can make others come forward to pledge their organs.

(Sreeparna Chakrabarty can be contacted at sreeparna.c@ians.in)

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