Rise in Organ Donation

For Prelims: Organ Donation, Covid-19 pandemic, Transplantation of Human Organs Act, 1994.

For mains: Rise in Organ Donation and Need for increasing Deceased Donations.

After a fall during the first year of the Covid-19 pandemic, organ donation numbers increased back in 2021.

In India, Transplantation of Human Organs Act, 1994 provides various regulations for the removal of human organs and its storage. It also regulates the transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs.

India has an organ donation rate of about 0.52 per million population. In comparison, the organ donation rate in Spain, the highest in the world, is 49.6 per million population.
- Unlike India where a person has to register to be an organ donor — and the family has to consent to it after death — Spain has an opt-out system where a person is presumed to be a donor unless otherwise specified.
Although organ donation has increased, however, the number of deceased donations has remained lower than the number of donations from living persons.
- Deceased Donation is the organs donated by the kin of those who suffered brain death or cardiac death.
Only 14.07% of the total organs harvested in 2021 were from deceased donors, much less than the 16.77% of 2019.
Of the 12,387 organs harvested in 2021, only 1,743 — a little more than 14% — were from deceased donors. The numbers harvested in 2021 were close to the highest in the last five years (12,746, in 2019).
There is also a geographical skew in deceased donations. All but two deceased organ donations in 2021 were in 15 states, with the top five — Telangana, Tamil Nadu, Maharashtra, Gujarat, and Karnataka — accounting for more than 85% of the total. Two organs were harvested from a deceased donor in Goa.
- One reason for the geographical skew could be that most organ transplant and harvesting centres are concentrated in these geographies.

Gap in the Number of Organs Needed:
- The first reason is the gap in the number of organs needed and the number of transplants that happen in the country.
- In absolute numbers, India conducts the third highest number of transplants in the world.
- Yet, of the estimated 1.5-2 lakh persons who need a kidney transplant every year, only around 8,000 get one.
- Of the 80,000 persons who require a liver transplant, only 1,800 get one. And of the 10,000 who need a heart transplant, only 200 get it.
Prevalence of Lifestyle Diseases:
- Demand is on the rise because of the increasing prevalence of lifestyle diseases.
- Besides, organs like heart and lungs can be retrieved only from deceased donors.
Only Harvested from Brain Dead Persons:
- The second reason is that without deceased donations, a precious resource is wasted.
- Nearly 1.5 lakh persons die in road traffic accidents every year in India, many of whom can ideally donate organs.
- Although donations are possible after the heart stops working, almost all organs are currently harvested from brain dead persons.

For increasing accessibility of donated organs to weaker sections, the public hospitals need to increase the infrastructural capacity to carry out transplantation and provide affordable proper treatment to the poor.
It is suggested that cross-subsidization will increase accessibility to the weaker section. For every 3 or 4 transplants, the private hospitals should carry out free of cost transplantation to the section of the population that donates a majority of organs.
The Transplantation of Human Organs Act, 1994, need to be amended to substitute the rigid bureaucratic procedure of hospitals by self-declaration and mandatory verification involving civil society.

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