Organ donations rise, lack of infrastructure plays spoilsport

NEW DELHI: The rate of organ donations has increased in India over the last few years thanks to increased awareness and government’s efforts to ease procedures. However, experts say lack of technology and equipment, infrastructure to transfer organs and the enormous cost of transplantation and post-surgery care continue to play spoilsport.
Organ donation rate in India after brain death increased from 0.05 per million population in 2006 to 0.34 per million population in 2014, estimates by Mohan Foundation, a not for profit organization that coordinates organ donation and transplantations activities in India.
In 2014, there were 411 organ donors after brain death. This resulted in the transplantation of 720 kidneys, 354 livers, 54 hearts and 16 lungs.
Doctors say while transplantation of liver and kidney are easier, organs like heart and lung are very difficult mainly because of the time limitation. For instance, in case of heart, the organ has to be transplanted within four hours of taking it out.
“Organs cannot be stored. Therefore, there is a need for preparedness and equipment to be able to transplant at the earliest without losing time,” says Dr Avnish Seth, director, Fortis Organ Retrieval & Transplant. According to Dr Seth, even as there is more awareness about organ transplant now, in 2014 around 50 donors were lost across the country because of problems like time lag, lack of equipment, unpreparedness etc.

Experts say it is time to move on to donation after circulatory death (DCD), where organs are retrieved for the purposes of transplantation after death is confirmed using circulatory criteria. However, the challenge includes how to identify patients as suitable potential DCD donors, how to support and maintain the trust of bereaved families etc.
Doctors also point out challenges in terms of a countrywide data base. “There is a need for a central database which can indicate the demand and supply without a time lag,” says Dr Kewal Krishan, senior consultant –cardiovascular surgery, Max Hospital. According to Dr Krishan, there is a sheer dearth of infrastructure and logistics for transferring an organ from one spot to another, posing a major hurdle in transplants even as awareness among people have increased.
Several hospitals are now working towards creating a system which can keep organs alive for a longer time even as patients are declared brain dead. Besides, more emphasis on green corridors and air lifting is given by private as well as public sector, says Dr Seth.
“We are engaging with authorities and government officials to bring in more awareness. There are countries like Spain and Australia which have done very well and we are trying to import expertise from there to make it happen in India,” Dr Seth said.