It's time to make swap organ donation legal

by Shreyashi on Aug 17, 2010      Category: Health & Disability Tags:

NEW DELHI: Dike and Priya were among a lucky few. The Nigerian boy and the Mumbai housewife last week became India's first patients to successfully undergo a swap liver transplant surgery. Priya's husband donated 20% of his liver to Dike while the child's mother donated 50% of her liver to save Priya.

This was because both donors' blood groups did not match their own recipients' but were suitable for the other.

Interestingly, swapping is still not officially allowed in India. The team of doctors at Gangaram hospital who conducted the swap did take the approval from an in-house regulatory body before going ahead. "It was the only way to save Dike and Priya. Three members in the committee are from the government," said a doctor.

The case has once again highlighted the dire need in India to make swap donations legal.

What's interesting is that India has been planning to launch a national organ transplant programme. The health ministry had finished drafting changes in the Transplantation of Human Organs Act, 1994 under which swapping of vital organs between willing but incompatible donors was to become legal.

The current rule restricts organ transplant to between blood relatives (father, mother, son, daughter, wife, husband, sister and brother), near and distant relatives and those having love and affection towards the patient. "The proposal has been lying around with the law ministry for many months now. The faster they clear the file, the earlier we can take it to the Cabinet and then to Parliament. Thousands of people die in India every month due to unavailability of donated organs or lack of a compatible donor within the family," a health ministry official told TOI.

Swapping will help patients who have relatives willing to donate but are medically incompatible for the recipient.

The amendment also says when the proposed donor or recipient or both are foreigners, the ministry plans to make it mandatory for a senior embassy official of the country of origin to certify the relationship between the donor and the recipient.

The ministry plans to set up Organ Retrieval and Banking Organistions in the four metros and cities like Hyderabad, Bangalore, Lucknow, Ahmedabad and Guwahati where these organs will be stored. At present, there is only one national level ORBO at the All India Institute of Medical Sciences.

The ministry also planned sops for live cadaver donors like a 50% discount on second-class rail tickets, lifelong free medical check-up and care in the hospital where organ donation takes place, a customised life insurance policy of Rs 2 lakh for three years with one-time premium to be paid by the recipient in case of a mortality and a preferred status in organ transplantation waiting list if the next-of-kin of a brain-dead donor requires organ transplantation in future.

Blood relations will also not have to pass through a screening authority anymore and undertake several tests. Simple documents like the birth certificate will be enough.

A proposal was also there for post-mortems to be conducted round-the-clock in all government hospitals across India. This will help hospitals harvest healthy vital organs from brain dead patients, for use on others needing it to survive.

At present, most post-mortems are done during the day. This leads to loss of crucial time, which makes most organs unusable.

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