India has launched its first registry for patients needing hand transplants.

Registry of hand transplants

• The registry, under the National Organ and Tissue Transplant Organisation (NOTTO), aims to ensure transparent and priority-based allocation of donated hands.
• Patients requiring hand transplants can register with the National Organ and Tissue Transplant Organisation (NOTTO) under the “bone” category. 

About Hand Transplantation

• Hand transplantation is a surgery where a new hand or arm from a donor is attached to someone who has lost their own hand or arm.
  • Hands fall under the category of ‘composite tissue’.
• Registered Hospitals: There are currently nine hospitals registered for performing hand transplants in the country.
• Conditions for Hand Donation
  • Brain Death: Hands can be donated after the donor has been declared brain dead.

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• • Cardiac Death: In some cases, hands can also be donated after cardiac death. 
    • However, this requires that the donation takes place within 30 minutes of the heart stopping.

Benefits and Challenges of Hand Transplantation in India

Benefits

• Improved Quality of Life: Hand transplantation can significantly enhance the quality of life for individuals who have lost one or both hands. 
  • It can restore functionality, independence, and self-esteem.
• Increased Access: The establishment of a national registry will improve access to hand transplants by facilitating the efficient allocation of donated organs.

Challenges

• Lack of Donated Hands: The primary challenge is the shortage of donated hands.
• Logistical Difficulties: Transporting donated hands across the country can be logistically challenging.
• Surgical Complexity: Hand transplantation is a complex procedure requiring specialized expertise.
• Financial Costs: The procedure can be expensive.
• Other Risks: infection, nerve damage, and blood vessel problems. 

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Regulatory Framework for Organ Transplantation in India

• Transplantation of Human Organs and Tissues Act (THOTA), 1994

• THOTA 1994 Provides the legal framework for organ transplantation in India.
  • Organ Donation: Organs can be donated by deceased individuals or living donors.
  • Altruistic Donations: Donations from distant relatives, in-laws, or long-time friends are allowed but require additional checks.
  • Unrelated Donors: Must provide documents to prove a long-term connection.
  • Organ Trafficking: Offering or paying for organs is illegal and punishable by up to 10 years in jail and a fine.
  • Brain Death: Brain stem death is legally recognized as death.
  • Transplantation Rules: The Transplantation of Human Organs and Tissues Rules 2014 promote organ donation from deceased donors.

• National Organ and Tissue Transplant Organisation (NOTTO)

• • NOTTO provides a national system for organ procurement and distribution.

• • • National Organ Transplantation Guidelines

      • Removed Age Cap: There is no longer an upper age limit for organ recipients.
      • No Domicile Requirement: Patients can register for organs in any state.
      • No Registration Fees: States are instructed to discontinue registration fees.

    • Organ Transport Policy

      • Uniform Policy: A uniform policy has been finalized to speed up organ transport between hospitals.
      • Involvement of Ministries: The policy was created by Niti Aayog with input from various ministries.

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