India is switching up its rules for organ donation and transplants, making certain significant changes, including relaxation in some of the earlier age-related and domicile regulations. The Ministry of Health and Family Welfare announced these changes on Thursday to increase the flexibility and increased access to organ transplantation procedures in the country.
Despite performing the third-most number of transplants in the world, only about 0.01 percent of Indians donate their organs after death, according to the World Health Organisation. Could these changes in the national guidelines have any meaningful impacts? Let's take a look at them:
No age ceiling for organ receivers
With the new changes, patients who are 65 years and older can now register for receiving organs from a deceased donor. According to official sources, the National Organ and Tissue Transplant Organisation (NOTTO) updated its guidelines on Thursday.
Previously, the upper age limit for registering patients requiring organs from deceased donors was 65 years, but this ceiling has now been removed.
“Now an individual of any age can register for organ transplant,” they said.
The Health Ministry official reportedly said that 65 is not considered very old and the elderly should get an opportunity for organ transplantation. They added, however, that younger people with "more years of life left and likely to be healthier" will be given preference.
As a result, patients of all age groups are eligible to register for deceased donor organs. The revised guidelines have been published on the NOTTO website.
However, the ministry added that living donor transplants were exempt from the previous age cap.
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On the age-related rules, some doctors in September 2022 had argued that India should have a mandatory deceased organ donation programme.
The issue came to notice when a 17-year-old boy moved a plea before the Supreme Court seeking permission to donate his liver to his 43-year-older father who was suffering from acute liver.
As per the law, minor cannot donate organs or tissue before death, unless under exceptional circumstances fearing manipulation, coercion and human trafficking. Instead, the Centre should make organ donation mandatory after death, doctors said.
No domicile criteria for receivers
The Union Health Ministry has also recommended that all states eliminate the domicile criterion for registering to receive organs, so that patients in need can register in any state, sources said.
Currently, certain states restrict registration for deceased organ donors to only those who are domiciled in the state or give them preference. Organs harvested in one state are first shared with other hospitals within the same state, then in the region and then share nationally on the occasion that no match was found. The ministry, however, has suggested doing away with this rule.
“The states want to keep their organs to themselves, but they have been told not to make such distinctions,” the official said.
The Ministry's recommendation is intended to allow needy patients to register for transplants from deceased donors at any hospital, providing greater flexibility.
“People in need of transplant can go to any hospital in any state and register to receive an organ from a deceased donor,” the official said.
The registration process should, instead, be based on the waiting list, the source exclaimed. This would benefit patients seeking transplants from deceased donors and increase flexibility.
No registration fees
The ministry has also requested that states not impose any fees on patients seeking registration for organ transplantation, as it violates the 2014 Transplantation of Human Organs and Tissues Rules.
The official sources cited specific states such as Telangana, Maharashtra, Gujarat, and Kerala, which have charged patients between Rs 5,000 to 10,000 for registration.
“There is a need to remove hurdles for transplants and promote it across the country,” an official said.
Where does India stand?
According to latest available official data, the number of organ transplants has significantly increased over the past decade. In 2013, there were 4,990 organ transplants, whereas in 2022, there were 15,561 — a jump of 211 percent.
Specifically, the number of kidney transplants from living donors increased by approximately 181 percent from 3,495 in 2013 to 9,834 in 2022. The number of kidney transplants from deceased donors increased by approximately 193 percent from 542 in 2013 to 1,589 in 2022.
The total number of liver transplants from living donors increased by approximately 350 percent from 658 in 2013 to 2,957 in 2022, and from deceased donors, it increased by approximately 217 percent from 240 in 2013 to 761 in 2022. Deceased donors account for nearly 17 percent of all transplants in India.
Moreover, the total number of heart transplants increased by approximately 733 percent from 30 in 2013 to 250 in 2022, while lung transplants increased by approximately 500 percent from 23 to 138.
Furthermore, private hospitals lead in organ transplants while numbers in government hospitals remain relatively low, sources said.
With agency inputs.
(Edited by : C H Unnikrishnan)
First Published: Feb 17, 2023 1:59 PM IST
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