The Paradox in Organ Transplantation in India

The news of India being number two on the list of organ transplantation globally was surprising and, at the same time, came as a shock. This is due to the fact that it created a paradox. Because most of the organ donors were living and organ transplantation from the deceased body was significantly low. The majority of donors of liver transplants in India are living.

The Paradoxical situation-

India ranked number two in organ transplants only after the U.S.A. Over 100,000 people in India pledged to donate organs in November 2019. The paradox is that the level of organ donation in India is still rather low. Even when the pledges increased quickly from nine thousand to over 1.5 million in the last two years, the organ donation rate was unspeakable. The level was under 0.5 donors per million Indians. The data shows a stark contradiction from the estimations of other nations like 43.6 in Spain, 30.7 in the U.S with respect to per million population. The figures also include institutes of best liver transplant in India.

The consequences of this paradox include:

  • Numerous patients don’t get the organs when they need them. Due to this reason, over 500,000 people die in India each year.
  • Most of the donations are living. While this may sound like a series of acts of kindness, it is for the commercial gain of organ harvesting.  
  • There is also gender discrimination in the play. As the deceased donors are lower than living donors, it is evident that women donors are higher in count than men. Liver transplants in India come from 60.5% women donors, and 74% of females are kidney donors.

The Paradox in Organ Retrieving Process:

Though pledges are going on about donating organs, sadly, they don’t account for anything as there are insufficient resources to retrieve the organs and transplant them successfully. 

The country is infamously called the “kidney bazaar,” as the poor people donate their kidneys for money. Thus, the prime goal of the National Organ & Tissue Transplant Organization (NOTTO) was to grow the number of deceased donors. Though the people of India are aware of the significance of organ donation and promote the cause, they are not ready to be a donor themselves. 

Furthermore, even if deceased donors are available, most hospital infrastructure is not equipped to do the procedure. This is the place where support from the state government is necessary. In this regard, South India is far ahead of North India. 

North India Versus South India:

Liver transplants in India, along with heart and lung donations, have a high success rate. Best liver transplants in India cost up to 35 lakhs, while a hospital could earn around 5 lakhs in kidney transplants. Despite that, hospitals don’t get enough support from the state government in North India.

  • In India, most South Indian cities like Kochi, Bengaluru, Hyderabad, and Chennai get about 875 donations from deceased donors. They have the proper equipment and infrastructure to retrieve the organ. In addition to that, heart and lung transplants require deceased donors that the North Indian states lack. 
  • In the South Indian states, the governments diligently promote the donation of deceased’s organs. Vasanthi Ramesh, the director of NOTTO, also believes that the doctors are not properly trained to announce someone brain dead on time in Delhi/NCR. Here comes the state support. They can promote understanding and train the surgeons, intensivists, and anaesthetists to declare someone brain dead on time. 
  • According to an anonymous social worker, most of the time, the governments don’t support the allocation of organ donors. For instance, in Tamil Nadu, if the victim is declared brain dead in a road accident, there is a protocol to convince the family to donate the organs of the deceased. Whereas, in Delhi/NCR, the police, government hospitals, and forensics are not on the same page.
  • Moreover, Ayushman Bharat, a government health insurance scheme with other health insurers, does not cover organ transplants. In contrast, Tamil Nadu partially covers organ transplantation under the state health insurance scheme.

Taboo Regarding Organ Donation:

People in India are uncomfortable having an open conversation about organ donations. Indians are aware of the requirement of organ transplants as the data of pledges is proof of that. However, it is difficult for a doctor to ask about donating organs to the relatives of a deceased person.

Additionally, there are many stereotypes revolving around organ donation. Around 20% of the population fear that if they donate an organ from their body, they will be reborn devoid of that organ. About 21% are in a dilemma whether that can happen or not. 

Along with this, there are also various factors working into not donating organs. Such as,

  • People have little to no faith in medical professionals nowadays.
  • Indians have a fear of facing the disapproval of family members.
  • Low results in transparency also lead to the dismissal of being a donor.

In conclusion, all you should know is that NOTTO is dedicated to transparency. They are devoted to gathering all the data to show the success rates of liver transplants in India with other organ transplants.

By Adam

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