Finalising the amendments to the Human Organ Transplant Act, the Union Health Ministry has taken the first step designed to facilitate organ donations. However, it does not do much to bridge the huge demand-supply gap.
Proposed amendments to the Transplantation of Human Organs Act 1994, seek to broaden the pool of donors, including increasing the supply of organs by widening the definition of 'near relatives' by allowing organ swaps among needy families, as well as, simplifying cadaver transplant procedures.
The proposed amendments are as follows:
1. The current age limit of 60-years should be removed for cadaver donors. Improved health and longer life expectancy means some older people could be suitable donors, upping the organ donor count to an extra 10 or 12 a year.
2. It has also been proposed that paired matching should be permitted i. e. if patient A's donor does not match A and likewise for patient B, then donor switch should be allowed, if it results in a match. Swaps or exchanges between families unable to fulfil the need of their family member in need of a transplant due to incompatibility, are known to take place. However, this is not legal and is mostly done under cover. The proposed amendment seeks to convert the de facto into de jure, encouraging more families to swap organs amongst themselves, to be vetted by an authorisation committee.
3. Direct costs should be given to donors for a donation, including indirect losses like lost earnings and future expenses. The compensation framework should be in line with international and local ethical recommendations.
4. Higher penalties should be imposed for deterring organ trading syndicates and unscrupulous middlemen.
A ban on donation of organs to foreigners by Indians has also been proposed, which will give a marked blow to illegal practices, such as, so-called doctor - Amit Kumar amassing a huge fortune by simply lining up Indian donors for his foreign clientele, unable to source required organs back home.
As well, broadening the 'near relative' definition to include of close relations allowed to donate organs to needy kin under the 1994 law, includes grand parents and grand children, which widens the pool of donors, significantly.
Designated surgeons, physicians and not just neurosurgeons, as is the case currently, will be authorized to remove organs. In addition the concept of 'required request' is proposed to be introduce, wherein hospitals will be allowed to ask ICU patients, whether they would be willing to donate organs. Though initially, required request will be limited to corneas.
Further, Union Health Minister Ramadoss told media in Chennai that a new legislation titled Transplantation of Human Organs and Tissues Act will shortly be introduced in Parliament and, which will make it mandatory for hospital ICUs to declare all brain deaths and register them with an online central organ registry. Besides, the health ministry is working to make it possible for prospective donors to be able to mention their willingness to donate organs on their driving licence.
The new law is also looking to prohibit the removal of human organs or tissues from the body of a living minor, except in the case of regenerative cell donations within families, in the absence of a compatible adult donor, and kidney transplantation between identical twins.
Welcome changes, indeed, as there is a huge shortfall in organ donation for an estimated 3-5 lakh organ transplant demand.