Are we making way for organ trade again?
With Mrithasanjeevani threatening to fall by the wayside and deceased donor organ donations going down, the steady rise in live and unrelated organ donations in the private sector – liver and kidney -- often with huge cash incentives, has begun to worry authorities.
Worse, most of these would never figure in any of the official records, it is feared.
“The government implemented Mrithasanjeevani to save lives through organ donations and to ensure that organ-for-money rackets do not thrive. It is extremely sad that a robust and legal deceased donor organ donation programme is being allowed to slide and that we are making way for organ trade,” health officials say.
“Live, unrelated donations have certainly gone up in the private sector. Globally, wherever the cadaver organ donation programme has weakened, organ trade or sale of organs for money flourishes. One of the private hospitals in Kochi has already done 62 live liver transplants this year. Patients are desperate and there are plenty of middlemen in Kochi who can facilitate organs. There is a clause in the Human Organs Transplantation Act, 1994 – Section 9(3) – which makes organ donation from second-degree relatives or friends out of ‘love or altruism,’ possible,” points out B. Venogopal, Consultant Liver Transplant Surgeon at KIMS here .
There is no exact data on the number of live donations, the health status of the donor, and the survival data of those who received the organs in the private sector.
As part of streamlining Mrithasanjeevani, the government had decided to keep a tab on all organ transplants in the State, live as well as cadaver organ donation, by maintaining a central registry containing the details of all donors and recipients. This has not materialised fully.
The crux of the whole issue is not the public’s lack of confidence in Mrithasanjeevani, but that brain death reporting is not happening in intensive care units of hospitals any more, Dr. Venugopal says.
“In Kerala, everything done in the private sector is now viewed with so much suspicion. Doctors are not taking any sides here, for one life lost is one life gained. Private or public sector, neurosurgeons are not reporting brain deaths any more. Because neurosurgeons would rather focus on salvageable patients than get into the hassles of brain death declaration, or be hounded by allegations and police investigations. Unless the government takes steps to reform the guidelines based on science and restore the confidence of neurosurgeons, it will be difficult to put Mrithasanjeevani back on its feet,” he points out. “The government should call a meeting of all transplant hospitals and ask them why brain death reporting is not happening in their hospitals now. We need to frame necessary protocols so that whenever a brain stem death happens in a hospital, mandatory brain death declaration should follow, regardless of whether organ donation takes place or not,” says Noble Gracious, the nodal officer of KNOS.
Another suggestion is that the government write to the National Organ and Tissue Transplant Authority on formulating uniform guidelines for brain death declaration and processes for all States The current impasse has affected only those poor patients who have registered under Mrithasanjeevani and are waiting for precious organs. All transplant hospitals are doing plenty of live donations, meaning that the rich are managing to find organs somehow. The poor have no option but to die.
