Adherence and adoption of Transplantation of Human Organs Act (TOHA) by healthcare providers in India is a challenge, said Dr S Sudhindran, head, gastrointestinal, vascular and solid organ transplant surgery, Amrita Institute of Medical Sciences, Kochi.

Some recent instances of selling organs by private institutions constitute a regressive step which does not allow the noble intent behind organ donation to reach its true potential, he added.

There is a lack of awareness regarding organ donation. The concept of brain death has not been understood properly by healthcare professionals. Though India’s first-ever transplant was conducted in 1970s, there was no organised national body to promote organ donations for a very long time. AIMS is among India’s top centres of excellence in organ transplants. It is also the only hospital in India having the capability to conduct hand transplants and has done three till now, Dr Sudhindran told Pharmabiz in an email.

India has a poor organ donation rate of only 0.26 per million, compared to America’s 26, Spain’s 35.3, and Croatia’s 36.5 per million, respectively. Annually the country, has about 5,000 kidney transplants, 1,000 liver transplants, 30 heart transplants, 10,000 corneal transplants, 50 lung transplants, 100 kidney-and-pancreas transplants and 20 small bowel transplants. This is minuscule compared to the actual demand of about 200,000 kidney transplants, 50,000 heart transplants, and 50,000 liver transplants each year.

In this scenario, some philanthropists and NGOs took up the challenge and initiated the movement for organ donation. Later, the National Organ Tissue Transplant Organization (NOTTO) got established, which is the central donation registry, based at Delhi’s Safdarjung Hospital. States like Tamil Nadu and Kerala have an active organ sharing network. Through the Kerala Network for Organ Sharing (KNOS), hospitals get registered and recipient patients get organs according to their illness priority, he said.

“Better coordination among hospitals and the central network is the need of the hour so that organs don’t go waste. In recent years, the media and other channels of public education have helped generate awareness about organ donation, he said.

A visible trend is that youngsters are keen to sign when they are told about the importance of organ donation. Unfortunately, they don’t have complete information on where to go to sign up for organ donation and what it entails. Roping in brand ambassadors and movie stars to promote organ donation, such as Aishwarya Rai and Mohanlal, has helped the cause in recent years.

Although poor public education about organ donation is looming large in India, there is also the issue of low awareness among doctors on brain death and organ donation. Many families are unwilling to allow organ donation after brain death. The infrastructure of hospitals to retrieve organs needs strengthening. The networking of organ sharing among hospitals and states is still nascent. This is where adherence to TOHA and legal requirements can be a challenge for many hospitals, said Dr Sudhindran who has performed the highest number of liver transplants in Kerala and a pioneer in transplant surgery in Kerala.

“Going forward to increase awareness about organ donation in India, we need public education, use social media, active involvement of the government and engagement of key opinion leaders,” noted Dr Sudhindran.