Tuesday, September 1, 2015

Deceased organ donation in India

The Times of India has the story:  Many pledge, but long way to harvest

"Almost one lakh people have signed up for organ donation dur ing the annual organ donation day campaign of the Times of India, over the last three years. That could translate into several lakhs of lives transformed or saved if all the pledged organs could be retrieved. However, the organ donation process is yet to be streamlined and not all donors are able to donate their organs because of the lack of infrastructure and adequate awareness.

"Thousands have registered as donors in a span of a fortnight. But experience has shown that of thousands of people who pledge, only a few are likely to convert into donations after brain death.
"One of the most glaring inadequacies in the organ donation programmes is the lack of a national registry for organ donation, a centralised registry in the form of an electronic database, readily available to personnel involved in organ donation. Some states like Tamil Nadu and Kerala which have successful organ donation programmes in place have taken the initiative to set up their own centralised registry for organ donation, but a national-level database is still missing more than two decades after the Transplantation of Human Organs Act was enacted in 1994. In 2011, the 1994 law was amended to mandate various kinds of registries to track the organ transplantation system.The rules to implement the amendments were framed in March last year. Servicing large national-level registries would need support and financial commitment from the government. But almost Rs 150 crore allocated for it remained unutilized.
"Several people working to boost organ donation have pointed out that along with a registry for donors, there is the need for a recipients' registry too. The concept of cadaveric organ donation is built upon public trust which expects a system in place to ensure fair distribution of the organs donated. A centralized registry for recipients helps to build this trust as it guarantees fair allocation of organs for transplant. Lot more people would be willing to donate if they knew that there are strict rules dictating how transplant surgeons and coordinators determined who should be placed on the waiting list for organs and if the system was fully transparent, stated volunteers who work on campaigns for organ donation.
"Transplantation procedures are restricted almost entirely to private hospitals and thus remain beyond the poor and middle classes' reach. Even in public hospitals, where transplantations are infrequent, a liver transplant costs about Rs 12 lakh.With post-transplant costs of around Rs 10,000 a month, for immunosuppressive drugs to prevent rejection of the new organ, such procedures remain inaccessible for the poor. If no system is put in place by the government to help fund the cost of transplants, India's organ transplant programme would become one accessible only for a small section of those rich enough to afford the surgery and treatment costs. There is an urgent need for the government to come up with financial support to make transplant surgeries accessible for all who need them, even the poor."

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