With a waiting list of over three lakh patients and at least 20 persons dying each day waiting for an organ, India’s paucity of organ donations, especially deceased donations, has been exacting a steep toll. According to the Health Ministry’s own data, the number of donors (including deceased) only grew from 6,916 in 2014 to about 16,041 in 2022.
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Vivek Kute, secretary, Indian Society of Organ Transplants, said that India’s deceased organ donation rate has been under one donor per million population for a decade now.
“India needs to increase this to 65 donations per million population and for that to happen, public sector healthcare must step up. The country has about 600 medical colleges and over 20 AIIMS. Even if we get one donation each from them every year we will be in better shape. Even worldwide, only 10% of patients needing organs get them in time. Spain and the U.S. have better organ donation systems clocking 30-50 donations per million. The need of the hour is to train trauma and ICU doctors to help patients’ families to come forward and donate. In India living donors comprise 85% of all donors,’’ Dr. Kute said.
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Data from 2022 show India’s poor record in deceased donations. The country registered 1,589 kidney transplants, 761 liver and 250 heart transplants in the deceased category in 2022. Kidney and pancreas transplants grew from three in 2014 to 22 in 2022. In contrast, living donor kidney transplants rose from 4,884 in 2014 to 9,834 in 2022. Liver transplants in this category grew from 1,002 to 2,957.
Experts have warned that one person is added to the wait list every 10 minutes in the country. Though the Ministry has announced a series of steps to promote organ donations, including doing away with the domicile rule; removal of age bar for registration of recipients; removal of fee for registration for transplant; easing rules on withdrawal of life support (passive euthanasia); facilitation of organ transport across the country; special casual leave for organ donors etc., this isn’t enough, say experts.
Anant Kumar, chairman Urology Renal Transplant and Robotics, Max Super Speciality Hospital, Saket, said that India faces a significant disparity between demand and supply in kidney transplant.
“The annual need for 2,00,000 kidney transplants highlights the pressing urgency of the situation. However, a mere 10,000 transplants are performed each year, revealing a staggering gap. The demand for deceased donors is substantial because many families lack suitable living donors. Therefore, relying on deceased donors can help partially meet this demand,’’ Dr. Kumar explained.
He added that statistics indicate around 70%-75% of donors are female. Wives, mothers, and sisters have emerged as most prevalent sources of donation.
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Vatsala Trivedi, former professor, Department of Urology and Transplant Services, Lokmanya Tilak Municipal General Hospital and Municipal Medical College, Maharashtra said that organ donation pledges in India need to translate into actual donations and for that, medical staff need to be educated. They must be able to recognise, identify, inform, and counsel families about brain death and the importance of organ donation. “The gap between demand and supply continues to be tremendous and the faster we equip our ICU staff with knowledge and awareness, the sooner the gap will close,” added Dr. Trivedi, who is one of the pioneers in cadaver transplants in the country.
One donor, eight lives
One deceased organ donor can save up to eight lives. Two donated kidneys can free two patients from dialysis treatments. One donated liver can be split among two patients on the waitlist. Two donated lungs mean two other patients are given a second chance, and a donated pancreas and donated heart translate to two more patients receiving the gift of life.
One tissue donor — someone who can donate bone, tendons, cartilage, connective tissue, skin, corneas, sclera, and heart valves and vessels — can impact the lives of as many as 75 people.
Today, India has greater awareness about organ donation and doctors say more families are coming forward for this noble deed. Indraprastha Apollo Hospital, Delhi, late last year witnessed the family of a 14-year-old brain-dead patient donate his vital organs to save the life of six persons.
Jyotiraditya Khanna of Haridwar suffered severe brain and chest injuries after falling off the third floor of his house on November 15, 2022. Sudheer Kumar Tyagi, senior consultant, Neurology, at Indraprastha Apollo said amid the loss, the family expressed the boy’s childhood wish of donating his organs and living through other people.
The boy’s heart was donated to a 44-year-old retired Armyman, who was on his deathbed as his heart wasn’t able to pump blood properly. His corneas were donated to Dr. Shroff Charity Eye Hospital, while one kidney was transplanted into a 44-year-old woman at Apollo Hospital. His second kidney saved the life of a 43-year-old woman at Jaipur Golden Hospital while two persons - an eight-year-old boy and 54-year-old man - benefitted from his liver. His lungs helped save a 37-year-old man from Punjab at Medanta Hospital.
Speaking about the compassionate act, Anupam Sibal, group medical director, said paediatric cadaver donation is extremely rare. “This is a brave decision by Jyotiraditya’s family, particularly when they were still coming to terms with their loss. Their son saved the lives of six people, including an eight-year-old boy with liver failure who only had a few days left to live.”
Meanwhile, Ministry data also show that last year the largest number of deceased organ donors were from Telangana, Tamil Nadu, Karnataka, Gujarat, and Maharashtra. On the other hand, the maximum number of living donors was reported from Delhi-NCR, Tamil Nadu, Kerala, Maharashtra, and West Bengal. Additionally, the largest number of deceased donor transplants took place in Tamil Nadu and Telangana.
