Organ transplant may get a legal nudge

NEW DELHI : An acute shortage of harvestable organs is prompting the government to rethink the definition of “death” in the law on organ transplants. The proposed change to the Transplantation of Human Organs and Tissues Act will aim to address an anomaly in the definition of death in death certificates.

Official in the health ministry and central think-tank NITI Aayog have observed that there is a difference in the way death certificates define death, in case of natural death, and for brain death.

Anup Kumar, head of kidney transplant department at Safdarjung Hospital said, “In case of natural death, a patient’s organs also stop working but in case of brain death, the death certificate mentions the vital organs that are alive like heart, lungs etc.

“Thus, patient’s family members consider that the patient is still alive because of functioning organs.”

An official said, “The plan is to create the harmony in the definition of “death” in death certificates, because brain stem cell death definition differs from that of natural death in the certificate.”

“As of now, doctors harvest organs from a patient who is declared as brain stem cell dead. So, there is a need to revise the definition of death specifically for the purpose of organ donation and amend the existing Transplantation of Human Organs and Tissues Act,” added the official.

The official said there is a further challenge in that doctors have to decide when to start counselling the patient’s family members about harvesting potential organs from their patient’s body.

Doctors say organs harvested from a braindead person can save at least seven lives and that at any given point of time in a metro city about 10 patients are referred to intensive care units as braindead.

“We are preparing a roadmap on how to increase cadaver organ donation in India. Brain stem cell death cases increase the chance of harvesting important organs like heart, kidneys, eyes, liver etc. We will present our report to the health minister in this week,” said the official aware.

Doctors say that every year hundreds of thousands of patients languish on waiting lists at top hospitals for life-saving organ transplants amid an acute shortage of donors.

In India, nearly 50,000 people are in need of heart transplants, another 200,000 for kidney, and 100,000 each for liver and eye transplants every year. But supply lags far behind.

“About 200,000 patients require renal (kidney) transplant, but we get only 10,000 live donations per year. The existing gap is huge. The ratio of organ donation stands at less than 0.8 per million population while in western countries it is around 30 per million,” said Kumar.

Other challenges include poor awareness among doctors, patient and police, religious sensitivities, and the lack of medical infrastructure.

Live organs have a short self-life. After retrieval of the organ from a body, the heart is alive for only 6 hours.

Queries emailed to health ministry spokesperson did not elicit any response.

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