India’s Organ Crisis Deepens

Speaking at an event to mark Organ Donation Day in Delhi on November 30, Union Health Minister Dr Harsh Vardhan admitted that there has been a huge gap between those requiring transplants and the actual number of organs available for transplant. So, he called for an awareness drive on a monumental scale.

“India has a dismal 0.65 per million population (PMP) Organ Donation Rate, and we need to improve this. We need to create awareness about organ donation on a monumental scale, such that it becomes a jan andolan and people voluntarily pledge to donate their organs,” the minister said.

The minister said public representatives need to become ambassadors of this movement to not only spread awareness, but also dispel myths and apprehensions in the communities regarding organ donation. Lack of training to doctors, misgivings among people and lack of trust in the system have triggered a major organ crisis in most of the hospitals in India.

As a result, the organ donation ratio in India is estimated to be a meagre 0.6 per million population in India. According to Organ Retrieval Banking Organisation (ORBO) of All India Institute of Medical Sciences (AIIMS), while there are not exact figures, there is a need of about 1.5 to 2 lakh kidney transplants a year, while only about 8,000 transplants happen. Also, as against 40,000-50,000 liver transplants required a year, about 1,700-1,800 happen each year.

“Estimates also say that about 15,000 heart transplants are required a year but only about 250 heart transplants happen every year. We are only able to collect about 60,000 corneas,” said Dr Aarti Vij, the in-charge of ORBO. Doctors said even in Delhi-NCR only 10% patients are receiving renal transplant and 90% are still on the waiting list. As things stand, even those who are willing to donate organs are not able to. When Dr Pragya Shukla’s father died, she had a tough time finding a hospital to have her father’s organs donated, as per his last wish, not just in Jhansi but in Delhi too. “We were in one of the bigger private hospitals in Jhansi when I was told that there is no cell for organ retrieval. There was no one who could come before 6 hours to start the process for organ retrieval. I was told, they have to inform someone in Delhi for the due process, by then, it was too late. If there is no facility in a hospital or in other cities of India, however, well the intention may be, one still wouldn’t be able to do anything,” recalls Dr Shukla, who heads clinical oncology in one of the prominent hospitals in the Capital.

Roughly 5 lakh people die annually in India due to lack of an organ donor but with less than one per million people opting to donate, the organ donation rate in the country is one of the lowest in the world, according to estimates. Even when a patient is brain dead, he or she is capable of saving six lives since a deceased can donate heart, lungs, kidneys, pancreas, liver, and intestine including tissues like corneas, tissue and skin.

Dr (Prof) Sandeep Guleria, senior consultant, GI surgery and transplantation, Apollo Hospitals believes that apart from awareness issues, trust deficit in the system is also hampering organ donation in India. “While we need to make people aware about the benefits of organ transplant, we also need to develop a trust in the system. We need to have whiter than white system while people know that the organs they are donated are being used for the deserving people. Donors need to be assured that no organ donation racket or big money is involved,” said ‘Padma Shri’ Dr Guleria. Doctors feel in the current scenario, the liver transplants have risen in comparison. “The kidney still has a dialysis option even though there are people waiting for it. But when you compare the availability and supply then the liver precedes it because liver is a single organ, while two individuals can be given kidneys. But in case of a liver disease, there is a high demand-supply gap in the case of liver donations,” said Dr (Prof) Naimish N Mehta, co-chairman, chief liver transplant surgeon and head of department of surgical gastroenterology, Sir Ganga Ram Hospital in Delhi.

Despite India performing the second largest number of transplants in the world, next only to the U.S. as per data available on the Global Observatory on Donation and Transplantation. Doctors say that there is more awareness today than 15 years ago. Earlier, people only donated corneas and now there is general awareness. But there has been just a little improvement in the knowledge of brain death. Families still find it difficult to believe and that the patient is dead. Among other reasons, religious beliefs and myths are a stumbling block.

At the country’s biggest and most busiest hospital in Delhi, AIIMS, special care is taken to ensure that organ donation is a educative that families will help save precious lives of those still awaiting transplants.

“We have real-time information on deaths in the hospital. We have 3 transplant coordinators available around the clock. they approach the treating doctors and make assessment about organ or tissue donation. The family is educated on the same and asked whether they would want to donate the organ voluntarily,” said Dr Aarti Vij. To increase awareness and make the process a clock-work addition, AIIMS provides training to all resident doctors on organ donation.-India Today

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