Thoughts on Cadaver Organ Donations in India

Organ donation in India is still in its infancy. Everyone from the Union Health Minister Ghulam Nabi Azad to doctors working in both private and public sector hospitals concur on the need for more donations and advocate the creation of Organ Banks, greater public awareness about the noble cause of organ donations as well as on the urgent need of passing laws and developing transparent, hassle-free mechanisms, which allow swift organ retrieval, banking and transplantation.

I believe that the entire Transplant Program suffers from at least three severe malaise. These are lack of governmental regulation, poor infrastructure for quick retrieval and transplantation and total public apathy.

Apparently a comprehensive  ‘Transplantation of Human Organs Act’ is being considered by the Indian Parliament. The act once cleared by the parliament will hopefully lead to a far better utilization of the donated organs and create a network of Organ Banks, which would be able to freely exchange information about the availability of an organ, its swift retrieval, its likely recipient and the hospital, where the procedure might be done. While one can hardly fault the government on its intent, the execution of the program will determine its success.

The government must establish clear guidelines on brain death, when can organs be harvested, which hospitals (both privately owned as well government hospitals) are notified for organ harvesting as well as transplants, who all can donate an organ and what would be the process for locating the recipient once brain death has been established.

I would recommend that the government should establish an autonomous body, comprising of eminent doctors, organ transplant surgeons, lawyers of repute and other medical professionals who can come together to formulate guidelines on organ donations and transplants, establish mechanisms for quick retrieval and harvesting of organs from a brain dead donor and most importantly locate a recipient awaiting a transplant.

A national registry of all those who are in need of organ transplant should be established forthwith. It should list all individuals who need a transplant and should have their detailed medical records available on the touch of a button.  The registry should also list organ banks and the hospitals who have the infrastructure and the capability to carry out transplants. These hospitals must have nodal officers/doctors, who can act quickly once a brain death has been established. These officials should access the medical records of those listed as needing an organ on the national registry, check out if they are suitable candidates for receiving an organ, establish the logistics of getting the organ and the recipient together at a hospital where a transplant can be carried out and than start the process of getting the patient and the organ to the hospital.

While, this may sound simplistic, this would require immense coordination and effort. This calls for a dedicated body, state of the art IT infrastructure, logistical support in safely transporting the organ, getting the recipient to the hospital at a moment’s notice and gearing up the hospital for a fairly complicated surgery at a very short notice. The government must take the lead in setting up this mechanism and ensure that it is fast, efficient and incorruptible. Most importantly the workings of this body, should be completely transparent. I fully understand that often this body will have to take decisions regarding who gets an organ and perhaps a new lease of life and who doesn’t. These will always be hard decisions, involving questions of life and death and must be taken with utmost care, without any prejudice and in a completely transparent manner. Thus, we must have people with a track record of great efficiency and  of unimpeachable integrity running this institution.

Last but not the least, it is imperative that the government create awareness about organ donations. Cadaver donations in our country are minuscule. The trauma of the untimely and unexpected death of a loved one itself usually numbs the minds of those, who have take decisions related to donations. To make matters worse, many people still believe in reincarnations and can never imagine donating organs lest it impacts life in the other realm. The government must fight these obstacles resolutely, it should educate people about the benefits of organ donations and maybe reward folks who decide in favour of donations.

Donating organs of a loved one  so that people, mostly strangers, get a new life is undoubtedly the most noble of gestures. It requires courage, conviction and immense generosity. The government must ensure that once someone takes a decision like this, the organ reaches the right recipients and many lives are saved. This should happen all the time, seamlessly and without fail.