New Rules Notified for Organ Transplant Allocation

Organ Transplant Latest News

• The Union Government has revised the organ transplant allocation policy, giving priority to women patients and relatives of deceased donors to address gender disparity and boost donations.

Introduction

• The National Organ & Tissue Transplant Organisation (NOTTO) has issued a new 10-point advisory aimed at improving transparency, equity, and inclusivity in India’s organ transplant system. 
• A key highlight of the revised allocation criteria is the provision of priority status to women patients and relatives of deceased donors awaiting organ transplants. 
• This landmark decision is part of a broader effort to address gender imbalances in organ transplant recipients and to encourage more citizens to pledge organ donation.

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Organ Transplant Allocation in India

• Organ allocation in India is governed by guidelines formulated by NOTTO under the Ministry of Health and Family Welfare. The allocation criteria already prioritise recipients based on:
  • Medical urgency (severity of illness)
  • Duration of wait time on the transplant list
  • Matching parameters such as blood group, organ size, and age
  • Special cases, such as children or patients whose living donor had previously donated an organ but now requires a transplant themselves
  • Geographical proximity for optimal organ viability
• The allocation system ensures that organs are distributed fairly and transparently, with the goal of achieving the best medical outcomes.

New Priority Criteria for Women and Donor Families

• The revised guidelines introduce “additional points in allocation criteria” for:
  • Women patients on the national waiting list
  • Immediate relatives of deceased donors
• Rationale
  • Gender Disparity: Historically, women have had lower representation among organ transplant recipients, often due to socio-economic and cultural factors that lead to delayed diagnosis or treatment.
  • Encouraging Donations: By offering priority to donor families, the policy aims to increase deceased organ donations, addressing the chronic shortage of organs in India.

National Registry and Data Compliance

• NOTTO maintains a digital national registry of both donors and recipients. Hospitals performing transplants must register patients through this system.
• Key compliance measures:
  • All transplant centres must mandatorily submit data for each donor and recipient to the national registry.
  • Non-compliance could result in legal action against hospitals.

Organ Donation Milestones in India

• India has seen a remarkable growth in organ donation and transplant numbers:
  • 2023: Launch of Aadhaar-based NOTTO online pledge portal.
  • 2024: Over 3.3 lakh citizens pledged to donate their organs.
  • 2024: A record 18,900 organ transplants were performed, a sharp rise from fewer than 5,000 in 2013.
• These figures indicate growing public participation and improved medical infrastructure in the organ transplantation ecosystem.

Strengthening Transplant Infrastructure

• The advisory also calls for:
  • Permanent posts for transplant coordinators in hospitals performing organ retrieval and transplantation.
  • Development of organ retrieval centres in all trauma centres and registration of these facilities with NOTTO.
  • Encouraging medical colleges to develop retrieval facilities in a phased manner.
  • Training emergency responders and ambulance staff to identify potential deceased donors early, especially in cases of road accidents or strokes.

Broader Impact and Future Outlook

• The new allocation rules mark a significant shift in India’s approach to organ transplantation by integrating social equity considerations into medical prioritisation. 
• By tackling gender disparity and recognising the contribution of donor families, NOTTO aims to create a more balanced, transparent, and humane system.
• In the long term, these changes are expected to:
  • Increase deceased organ donations
  • Improve gender balance in transplants
  • Enhance trust in the allocation process
  • Strengthen national transplant capacity

Source: TH