Organ & Tissue Transplant- Policies, Technologies, etc.

Amendments to Organ Transplant Rules

Note4Students

From UPSC perspective, the following things are important :

Prelims level: NTTO

Mains level: Liberalizing organ transplant rules in India

organ

In a major tweak to the organ donation policy, the Union Ministry of Health and Family Welfare said that the clause that people beyond 65 years could not receive cadaver organ transplants had been removed.

What are the changes introduced?

(1) No Age Bar

  • Now an individual of any age can register for organ transplant.
  • People beyond 65 years in need of an organ donation will also be eligible to get one.
  • The government has decided to do away with a clause in the National Organ and Tissue Transplant Organisation (NOTTO) guidelines as the clause violates the Right to Life.

(2) Doing away with domicile compulsion

  • Earlier an organ recipient could register for a prospective transplant in domicile State.
  • States like Gujarat had made it mandatory for registered patients to furnish a domicile certificate to be eligible for a transplant.
  • In November last year, the Gujarat High Court quashed the discriminatory policy of the State government.

Organ transplant in India: Key statistics

  • According to data accessed from the Health Ministry, the number of organ transplants have increased by over three times from 4,990 in 2013 to 15,561 in 2022.
  • Of the 15,561 transplants, a majority — 12,791 (82%) — are from live donors and 2,765 (18%) are from cadavers (the dead).
  • Up to 11,423 of the 15,561 organ transplants are for the kidney, followed by liver (766), heart (250), lung (138), pancreas (24) and small bowel transplants (3).
  • Most of these transplants occur in private hospitals, the numbers in government hospitals are relatively lower.

Challenges to Organ Donation in India

  • Lack of awareness: There is a lack of awareness among the general public about the importance of organ donation, the legal framework governing it, and the procedures involved. This can limit the number of potential donors.
  • Cultural beliefs and superstitions: In India, there are several cultural beliefs and superstitions that discourage organ donation. Some people believe that organ donation is against religious beliefs, or that it can impact the soul or afterlife.
  • Lack of infrastructure: India faces a shortage of hospitals and medical facilities that are equipped to handle organ transplantation. This can limit the availability of organs for transplantation.
  • Regulatory bottlenecks: While the legal framework exists, there is a lack of implementation and enforcement of the law. This can lead to issues such as organ trafficking and black market activities.

Way ahead

  • To address these challenges, the government and other stakeholders are working to raise awareness, improve infrastructure, and strengthen the legal framework governing organ donation.
  • Campaigns and initiatives are being undertaken to educate the public and healthcare professionals about the importance of organ donation, and to dispel myths and misconceptions.
  • Efforts are also being made to improve the infrastructure and facilities for organ transplantation, and to enhance the regulatory framework to prevent illegal activities.
  • These steps are aimed at promoting organ donation and increasing the availability of organs for transplantation, which can save lives and improve the quality of life for many people in India.

About National Organ Transplant Programme (NOTP)

  • In 2019, the GoI implemented the NOTP for promoting deceased organ donation.
  • Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994.

Types of Organ Donations

  • The law allows both deceased and living donors to donate their organs.
  • It also identifies brain death as a form of death.
  • Living donors must be over 18 years of age and are limited to donating only to their immediate blood relatives or, in some special cases, out of affection and attachment towards the recipient.

(1) Deceased donors:

  • They may donate six life-saving organs: kidneys, liver, heart, lungs, pancreas, and intestine.
  • Uterus transplant is also performed, but it is not regarded as a life-saving organ.
  • Organs and tissues from a person declared legally dead can be donated after consent from the family has been obtained.
  • Brainstem death is also recognized as a form of death in India, as in many other countries.
  • After a natural cardiac death, organs that can be donated are cornea, bone, skin, and blood vessels, whereas after brainstem death about 37 different organs and tissues can be donated, including the above six life-saving organs

(2) Living donors:

They are permitted to donate the following:

  • one of their kidneys
  • portion of pancreas
  • part of the liver

Features of the NOTP

  • Under the NOTP a National Level Tissue Bank (Biomaterial Centre) for storing tissues has been established at National Organ and Tissue Transplant Organization (NOTTO), New Delhi.
  • Further, under the NOTP, a provision has also been made for providing financial support to the States for setting up of Bio- material centre.
  • As of now a Regional Bio-material centre has been established at Regional Organ and Tissue Transplant Organization (ROTTO), Chennai, Tamil Nadu.

 

Back2Basics: National Organ and Tissue Transplant Organization (NOTTO)

NOTTO is a national-level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare.

1.  National Human Organ and Tissue Removal and Storage Network

2.  National Biomaterial Centre (National Tissue Bank)

[I] National Human Organ and Tissue Removal and Storage Network

  • This has been mandated as per the Transplantation of Human Organs (Amendment) Act 2011.
  • The network will be established initially for Delhi and gradually expanded to include other States and Regions of the country.
  • Thus, this division of the NOTTO is the nodal networking agency for Delhi and shall network for the Procurement Allocation and Distribution of Organs and Tissues in Delhi.
  • It functions as apex centre for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.

[II] National Biomaterial Centre (National Tissue Bank)

  • The Transplantation of Human Organs (Amendment) Act 2011 has included the component of tissue donation and registration of tissue Banks.
  • It becomes imperative under the changed circumstances to establish National level Tissue Bank to fulfil the demands of tissue transplantation including activities for procurement, storage and fulfil distribution of biomaterials.
  • The main thrust & objective of establishing the centre is to fill up the gap between ‘Demand’ and ‘Supply’ as well as ‘Quality Assurance’ in the availability of various tissues.

The centre will take care of the following Tissue allografts:

1.  Bone and bone products

2.  Skin graft

3.  Cornea

4.  Heart valves and vessels

 

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