Serious concerns have been expressed by the Ministry of Health and Family Welfare over hospitals not sharing data on organ transplantation activities with them in a circular.

About the Circular

• The National Organ and Tissue Transplant Organisation (NOTTO) in a communication sent to Health Secretaries of all States/Union Territories has called for urgent intervention to check the non-compliance in updating the organ transplantation data 
  • Non Compliance: Many registered transplant hospitals are not submitting the daily and monthly data on organ transplantation activities and register transplantations on the National Transplant Registry.
• Legal Provision: Transplant Hospitals are in violation of the provision of Section 13D of the Transplantation of Human Organs and Tissues Act (THOTA), 1994 under which,
  • NOTTO is entrusted with the statutory responsibility of establishing and maintaining a National Transplant Registry which was essential for monitoring organ and tissue transplantation activities.
• Data Collection: The Centre has directed hospitals and transplant centres to furnish comprehensive data related to deceased as well as living donors and recipients on a monthly basis. 
• Updation: It is mandatory to update the organ transplantation data online on the NOTTO web portal regularly and register both the donors and recipients of living transplants in the National Transplant Registry within 48 hours of the transplant procedure.
• Authority: The State Appropriate Authority (SAA) is responsible to ensure compliance with the provision of data by hospitals for the National Transplant Registry and take suitable action against those violating the rules
  • They have the powers of a Civil Court under the Act.

About Organ and Tissue Transplantation

• Organ donation is the process of donating organs or biological tissue to a living recipient, who is in need of a transplant.
• Types: There are two types of organ donation:-
  • Living Donor Organ Donation: A person during his lifetime can donate one kidney, a portion of pancreas and a part of the liver.
  • Deceased Donor Organ Donation: A person can donate multiple organs and tissues after (brain-stem/cardiac) death. His/her organ continues to live in another personӳ body
• Organ Transplantation: It is the act of surgical removal of an organ from one person and placing it into another person. Transplantation is needed when the recipient’s organ has failed or has been damaged due to illness or injury.
• Statistics:
  • Donors Numbers: According to the Health Ministry’s data, the number of donors (including deceased) only grew from 6,916 in 2014 to about 16,041 in 2022.
    • In India living donors comprise 85% of all donors
  • India sees 17,000–18,000 solid organ transplants performed every year ranking 3rd after the US and China
  • The transplantation rates per million population is only 0.65 in India , which is behind several high-income countries
  • OrganTransplants Per Donor: The average number of organ transplants per donor has  increased from 2.43 in 2016 to 3.05 in 2022. 
  • Waiting List: One person is added to the wait list every 10 minutes in the country comprising over three lakh patients and at least 20 persons dying each day waiting for an organ.
  • The Most Transplanted Organ: Kidneys are the most transplanted organ in India with approx 11,243 transplantations performed every year against the demand of an estimated 200,000 renal failures a year.
• Legislation and Rules: 
  • The Transplantation of Human Organs & Tissues Act (THOTA), 1994: It provides for regulation of removal, storage and transplantation of human organs & tissues for therapeutic purposes and for prevention of commercial dealings in human organs & tissues
    • The law allows transplantation of human organs and tissues from living donors and cadavers (after cardiac or brain stem death).
    • Defining the constitution of Regulatory and advisory bodies for monitoring transplantation activity..
  • National Organ and Tissue Transplant Organisation (NOTTO)-ID: All cases of organ transplants will be allocated a unique (NOTTO)-ID for both the donor and the recipient being generated by the hospital 
    • The directive has been issued to eliminate commercial dealing in organs, especially those involving foreign citizens.
• Challenges:
  • Low Public Awareness and Education: There is a general lack of awareness regarding the process and  need for organ donation in India. 
  • Public Bias: Prevailing Religious and Cultural beliefs and values often prevent organ donation as they discourage any alteration to the sanctity of the body after death and also fears about the process. 
  • Commercial Exploitation: Organ Trafficking is a  rampant problem raising fears about the illegal harvesting of organs without consent for financial gain.
  • Inadequate Infrastructure and Resources: There are not enough hospitals or trained personnels equipped to perform organ transplants, especially in rural areas. Also there are transportation and storage challenges due to lack of suitable logistical facilities.
  • Shortage of Trained Personnel: There is a shortage of trained transplant coordinators and other medical professionals who can identify potential donors and facilitate the donation process. 

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