Organ Donation Gap: Less than 1% Indians Donate Organs

5 lakh people die waiting for an organ every year in India, here’s what you can do to change that

3 decades ago, most patients used to buy blood because of a shortage of voluntary donors. Today, nearly all the blood used across India is received as replacement blood from relatives and as altruistic donations. If attitude towards blood donation can change to this extent - is the future bright for organ donation as well? (Photo: iStock)

• 5 lakh Indians die waiting for an organ every year.
• 1 in 5000 patients on the waitlist actually gets an organ.
• Only 1% of Indians donate their organs after death.
• In the West around 70-80% of people pledge their organs.

(Source: Mohan Foundation)

“Please don’t take your organs to heaven,” read the sticker in the government hospital when I pledged my eyes. “Heaven knows that we need them here on earth.”

Last year around 5 lakh Indians died awaiting an organ transplant - that is more than the number of soldiers killed in all our wars put together. India has a rate of less than 0.2 donors per 1 million population. The worst is, even though organ donations have seen a slight increase, too often, doctors do not notify brain deaths leading to wastage of many organs.

But if India can learn to donate blood, what is stopping it from donating more organs?

The Organ Donation Law is Too Restrictive

Flashback to 2012. Former Maharashtra CM, Vilasrao Deshmukh passed away failing to secure a matching liver on time. Imagine if an ex Minister does not bump the organ donation waiting list, then who will?

In India, 2 lakh people need a new kidney every year and one lakh need a new liver, only 2% to 3% of the demand for  new organs is met (Photo: iStock)

Finding a donor match in India is not only rare and difficult to begin with, the challenge is compounded by bureaucratic hurdles and lack of awareness.

The current law allows organ donations from ‘near relatives’, which it defines as spouse, son, daughter, father, mother, brother or sister but not in-laws or anyone from the spouse’s family. And if the potential donor is not related to the person who needs the organ, the transplant needs to be approved by a state-level committee that includes government officials and doctors. This causes unnecessary delays.

Lack of Awareness

Many people wait for months and years for an organ. Too often, they don’t survive that long (Photo: iStock)

Even if a person has pledged their organs, at the time of death, the relatives have a final say. A big challenge then is for family members to accept their loved one is brain dead. Till date, even some doctors don’t understand the concept of brain death despite the law being in force since 1995.

Brain death: when the brain is damaged irreversibly, mainly caused by road accidents. India has the world’s largest number of traffic accident deaths. At any given time, in metros, at least 5-10 patients could be brain dead across hospital ICUs. But with no organised deceased-organ transplantation system, these patient’s organs go ‘waste’.

Sometimes it is the religious superstitions which become hurdles in organ donations. In a report to the Wall Street Journal, a kidney specialist in Bangalore’s Columbia Asia Hospital, tells about a startling case where a family refused to donate organs of their relative because it was a full moon night, which they considered inauspicious. Preserving organs for 24 hours would be impossible but the family refused to budge.

Tackling Organ Shortage

Another option to lessen the shortage of organs is to monetize organ donors.

(Photo: iStock)

Singapore legally pays its organ donors. Iran has eliminated waitlists for kidneys entirely by paying its citizens to donate. Israel implemented a “no give, no take” system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ.

But in India the law is too rigid to make way for paid donors and there are ethical issues. Paying consenting donors for organs sounds grey but it is not the same as illegal organ sale rackets. If there are official rules, the practice becomes transparent. But this is a long shot in India.

A country which invests less than 1% of its GDP in healthcare, will in no way look at such drastic steps for organ donation just yet.