READ: Apollo Hospitals accused of being involved in ‘cash for kidney’ racket: 6 things you need to know (indianexpress.com)

An investigation carried out by the United Kingdom’s Telegraph newspaper has revealed Apollo Hospitals chain allegedly involved in an international ‘cash for kidney’ racket. As per the report impoverished people from Myanmar are lured to sell their kidneys for profit.

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The Union Health Ministry, in February 2023, modified national organ transplantation guidelines to allow even those above 65 years of age to register to receive an organ for
transplantation from deceased donors.

Earlier, according to the NOTTO (National Organ and Tissue Transplant Organization) guidelines, an end-stage organ failure patient above 65 years of age was prohibited from registering to receive the organ.

The ministry has also decided to remove the domicile requirement to register as an organ recipient in a particular state.

There will be no registration fee that states charged earlier for registration. 

As per Global Observatory on Donation and Transplantation, India performs the second largest number of transplants in the world, after the USA.

Cadaveric donation comprises organ donation—that is, taking organs (heart, lungs, kidneys, liver, pancreas) from brain-dead people, as well as tissue donation, meaning taking tissues (skin, corneas, tendons, bone) from brain-dead as well as heart dead people.

Transplantation of Human Organs Act
(THOA) 1994 was enacted to provide a system of removal, storage, and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs. Under THOA, the source of the organ may be:

Near Relative donor (mother, father, son, daughter, brother, sister, spouse)

Other than near relative donor: Such a donor can donate only out of affection and attachment or for any other special reason and that too with the approval of the authorization committee.

Deceased donor, especially after Brain stem death e.g. a victim of a road traffic accident etc. where the brain stem is dead and the person cannot breathe on his own but can be maintained through ventilator, oxygen, fluids etc. to keep the heart and other organs working and functional. Other type of deceased donor could be a donor after cardiac death.

Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994.

The 2014 rules also enable the public to pledge to donate various tissues. Although there is an opt-in system in place, an individual can make his/her wish to donate on their own and the decision to donate or not in the event of brain stem death of an individual rests with the family and their decisions.Hence, the family plays a major role in deceased organ donation as they must decide if they want to donate the organs of their loved one to save others’ life or not.

The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death.

According to data accessed from the Health Ministry, the number of organ transplants has increased by over three times from 4,990 in 2013 to 15,561 in 2022.

Of the 15,561 transplants, a majority — 12,791 (82%) — are from live donors and 2,765 (18%) are from cadavers.

Up to 11,423 of the 15,561 organ transplants are for the kidney, followed by liver, heart, lung, pancreas (24) and small bowel transplants.

Most of these transplants occur in private hospitals, the numbers in government hospitals are relatively lower.

The NOTTO is a National level organization set up under the Directorate General of Health Services, Ministry of Health and Family Welfare. The National Network division of NOTTO would function as an apex center for All India activities of coordination and networking for procurement and distribution of Organs and Tissues and registry of Organs and Tissues Donation and Transplantation in the country.

                  
Lack of training for doctors, misgivings among people, and lack of trust in the system have triggered a major organ crisis in most of the hospitals in India.
There is a huge scarcity of Organ Transplant and Retrieval Centres in the country.