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Organ Donation Day: Life and death on the transplant list

Today marks Organ Donation Day, shedding light on an issue plaguing the health of many in India: the country’s shortage of organ donors.

Statistics on the situation are dire. According to Apollo Hospitals chairman Dr Prathap C. Reddy, just 3,500 organ transplants are conducted yearly despite there being an estimated one million people in India suffering from end-stage organ failure. As such, Dr Reddy asserts that fifteen people die each day waiting for an organ transplant whilst the transplant list itself grows at a rate of one name every ten seconds. 

Estimates on the subject do differ. According to Union Health Ministry data, 5,000 organ transplants are performed each year. Health Issues India has previously reported that 1.6 lakh Indians are in need of an organ transplant whilst just 12,000 organ donors are available. Regardless, data concurs on one major point: there is a major crisis when it comes to organ donation in India. 

To facilitate more donations, a nine-member panel of Postgraduate Institute of Medical Education and Research, Chandigarh issued a list of recommendations surrounding organ donation to the Chandigarh, Haryana, and Punjab governments earlier this year. The guidelines, which give an indication at the national level of how organ donation can be increased, included

  • Making it mandatory for intensive care units (ICUs) to provide daily information on potential organ donors
  • Employment of grief counsellors and transplant coordinators and establishment of a committee to certify brain death in every district, as well as district-level organ donation coordination offices in civil surgeons’ offices
  • Ensuring that such bodies provide continuous services and facilitate the safe transport of donors to retrieval or transplant centres
  • Creation of an ID number-based, centralised voluntary organ donor registry to enable donations from those who express willingness during their lifetimes to donate their organs
  • Involvement of NGOs and faith-based groups to raise awareness of the positive aspects of organ donation

An organ donation camp run by the National Trust in Pallavaram, Tamil Nadu. Image credit: National Trust [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)]
Such is the shortage of legal organ donors in the country, a black market of organ traffickers thrives on the sidelines to plug the gap. Kidney racketing is a notable example of this, with one of the most notable manifestations being so-called ‘kidney villages’, where the dearth of legal donors gives an obvious indication as to why the illegal kidney trade thrives: in 2015, 200,000 people were in need of a kidney transplant but a mere three percent could avail one. 

In India, all individuals above the age of eighteen can donate organs and tissue; those under the age of eighteen require consent from their parent or guardian. However, a range of factors inhibit the push for kidney donation from low awareness to cultural taboos surrounding organ donation at death. In the case of kidney transplants, living donations overwhelmingly account for the number of procedures; of the 21,395 transplants performed between 1971 and 2015, just 783 were transplanted from deceased donors.

Organ Donation Day provides an opportunity to raise awareness of the issues surrounding organ donation in India and the plight of those languishing in wait for a transplant which may never come. The need going forward is to raise awareness and have guidelines in place to facilitate more donations in order to save the lives of those in need. 

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