The Union Health Ministry has warned states and institutions for functioning without regular transplant coordinators, a critical role under the National Organ Transplant Programme (NOTP).

• NOTP has provision for two transplant coordinators for government medical colleges and one for well-performing private medical colleges.

National Organ Transplant Programme scheme

• The National Organ Transplant Programme (NOTP) is aimed at improving access to life-saving organ transplants for needy citizens.
• The current phase of the scheme covers the period from 2020-21 to 2025-26.
• Key objectives of the NOTP:
  • Promote deceased organ donation
  • Improve access to transplantation for needy citizens
  • Bridge the gap between availability and demand for organs and tissues
  • Enhance organ donation rates in India

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Strategies and activities under the NOTP

• Awareness campaigns: Conduct public awareness campaigns to educate people about organ donation and dispel myths and misconceptions.
• Training and capacity building: Train healthcare professionals in organ donation and transplantation procedures.
• Establishment of infrastructure: Develop a network of organ procurement and transplantation organisations (OPTOs) across the country.
• Financial assistance: Provide financial support to needy transplant recipients and deceased donors.
• Coordination and collaboration: Collaborate with various stakeholders, including government departments, NGOs, and medical institutions, to promote organ donation and transplantation.

Achievements of the NOTP

• Increase in organ donation rates: The organ donation rate in India has increased significantly since the launch of the NOTP.
• Establishment of OPTOs: A network of OPTOs has been established across the country, facilitating organ procurement and transplantation.
• Improved access to transplantation: More patients have been able to receive life-saving organ transplants due to the NOTP.

Organ Transplantation Data in India (2023)

• Global Context: India ranks third globally in total annual organ transplants, after the USA and China.
• Predominantly Living Donor-Based System:
  • Kidney and liver transplants are largely carried out with living donors.
  • Less frequent transplants: Heart, lung, pancreas, and small bowel.
• Highest Organ Transplants : Of the total 18,378 organ transplants in the country in 2023, 10% were to foreign nationals who had come to India for treatment.
• Donors: 63% living donors were women while 77% of deceased donors were men
• Recipients: 30% were women (Proportion being the highest among lung recipients at 47%)
• India achieved another milestone in 2023:More than 1,000 deceased organ donors in a year for the first time.

Eligibility for Organ Donation in India

• Living Donors: Living donors must be at least 18 years old, have no infectious diseases, active cancer, or severe infection, and are typically restricted to donating to immediate blood relatives.
• In special cases, donations can also be made out of affection and attachment for the recipient.
• Living donors are eligible to donate the following organs:
  • One of their kidneys
  • A portion of the pancreas
  • Part of the liver
• Deceased Donors: They have an opportunity to donate six vital organs: kidneys, liver, heart, lungs, pancreas, and intestine.
• While uterus transplants are performed, they are not classified as life-saving organs. 
  • Consent from the family is required for organ donation from a person declared legally dead.
• 2023 Revised Guidelines for Organ Donation:
  • Upper age limit of 65 years for receiving deceased donor organs was removed.
  • The domicile requirement for registering patients for deceased donor transplants was removed to increase accessibility.

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Legislation Governing Organ Transplantation in India

• Transplantation of Human Organs and Tissues Act (THOTA): It was  enacted in 1994 and amended in 2011, establishes the legal framework for organ transplantation in India. 
• This law governs multiple facets of organ donation and transplantation, including the recognition of brain death as a form of death and the necessity of family consent for organ donation following brain death.

Organ Transplant Governance

• The National Organ & Tissue Transplantation Organization (NOTTO), located in New Delhi, coordinates procurement and distribution of organs nationwide.
• Five Regional Organ and Tissue Transplant Organizations (ROTTOs) and 14 State Organ and Tissue Transplant Organizations (SOTTOs) have been established under NOTP.
• National Network division of NOTTO: It function as apex center for all India activities of coordination and networking for:
  • Procurement and distribution of organs and tissues.
  • Registry of Organs and Tissues Donation and Transplantation in the country.

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