Source: PIB & DIrectorate General of Health Services, Ministry of Health & Family Welfare
Government initiatives to promote Organ transplantation
To improve access to transplantation for needy patients by promoting deceased organ donation,the Government has put in place National Organ Transplant Programme (NOTP).
Under this programme,an apex level National Organ and Tissue Transplant Organisation (NOTTO) at New Delhi. NOTTO disseminates relevant information to all concerned.
Five Regional Organ and Tissue Transplant Organizations (ROTTOs) at Chandigarh, Mumbai, Chennai, Kolkata and Guwahati have been set up.
The Government has released funds to establish State Organ and Tissue Transplant Organizations (SOTTOs) in the States of Madhya Pradesh, Kerala, Rajasthan, Haryana, Goa, Jammu & Kashmir, Odisha and Uttar Pradesh to organize an efficient mechanism for organ and tissue procurement/retrieval to promote deceased organ and tissue donation.
Infrastructure: Further, to improve infrastructure for human organ and tissue retrieval, storage and transplantation in all parts of the country, the Government has:
Set up National/ Regional Bio-material Centres
Provided financial support for establishing new Organ Transplant/retrieval facilities and strengthening of existing Organ Transplant/retrieval facilities.
Provided training to transplant experts including surgeons, physicians, transplant coordinators, etc.
Provided financial support for provision of Transplant Coordinators to medical colleges and trauma centres.
A 24×7 call centre with a toll free helpline number (1800114770) has been made operational.
Awareness: A number of activities, for generating awareness and for imparting training to all those associated with transplant activities including doctors and transplant coordinators, such as celebration of Indian Organ Donation Day every year, seminars, workshops, debates, sports events, walkathons, participation in marathons, nukkadNatak, etc. are organized at different places in the country.
Audio-visual messages to promote cadaver organ donation are also telecast on Doordarshan and other television channels.
About National Organ Transplant Programme
The shortage of organs is virtually a universal problem but Asia lags behind much of the rest of the world. India lags far behind other countries in Asia. It is not that there aren’t enough organs to transplant. Nearly every person who dies naturally, or in an accident, is a potential donor. Even then, innumerable patients cannot find a donor.
To organize a system of organ and Tissue procurement & distribution for transplantation.
To promote deceased organ and Tissue donation.
To train required manpower.
To protect vulnerable poor from organ trafficking.
To monitor organ and tissue transplant services and bring about policy and programme corrections/ changes whenever needed.
The legal Framework in India
Transplantation of Human Organs Act (THOA) 1994 was enacted to provide a system of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs. THOA is now adopted by all States except Andhra and J&K, who have their own similar laws. Under THOA, source of the organ may be:
Near Relative donor (mother, father, son, daughter, brother, sister, spouse)
Other than near relative donor: Such a donor can donate only out of affection and attachment or for any other special reason and that too with the approval of the authorisation committee.
Deceased donor, especially after Brain stem death e.g. a victim of road traffic accident etc. where the brain stem is dead and person cannot breathe on his own but can be maintained through ventilator, oxygen, fluids etc. to keep the heart and other organs working and functional. Other type of deceased donor could be donor after cardiac death.
Government of India initiated the process of amending and reforming the THOA 1994 and consequently, the Transplantation of Human Organs (Amendment) Act 2011 was enacted. Some of the important amendments under the (Amendment) Act 2011 are as under:-
Tissues have been included along with the Organs.
‘Near relative’ definition has been expanded to include grandchildren, grandparents.
Provision of ‘Retrieval Centres’ and their registration for retrieval of organs from deceased donors. Tissue Banks shall also be registered.
Provision of Swap Donation included.
There is provision of mandatory inquiry from the attendants of potential donors admitted in ICU and informing them about the option to donate – if they consent to donate, inform retrieval centre.
Provision of Mandatory ‘Transplant Coordinator’ in all hospitals registered under the Act
To protect vulnerable and poor there is provision of higher penalties has been made for trading in organs.
Constitution of Brain death certification board has been simplified- wherever Neurophysician or Neurosurgeon is not available, then an anaesthetist or intensivist can be a member of board in his place, subject to the condition that he is not a member of the transplant team.
National Human Organs and Tissues Removal and Storage Network and National Registry for Transplant are to be established.
There is provision of Advisory committee to aid and advise Appropriate Authority.
Enucleation of corneas has been permitted by a trained technician.
Act has made provision of greater caution in case of minors and foreign nationals and prohibition of organ donation from mentally challenged persons