Highest-ever Organ Transplants in India in 2023: A Record Achievement by NOTTO

 What’s in today’s article?

• Why in News?
• What is National Organ and Tissue Transplant Organisation (NOTTO)?
• Regulatory frameworks guiding the organ transplantation in India
• Key Highlights of the report

Why in News?

• According to the annual report of the National Organ and Tissue Transplant Organisation (NOTTO), in 2023, India achieved a record 18,378 organ transplants, with 10% going to foreign nationals.
• As per this report, 2023 saw highest-ever organ transplants in India. With this, India ranked third in the world in organ transplant and second in corneal transplant in 2023.

What is National Organ and Tissue Transplant Organisation (NOTTO)?

• NOTTO is a national level organization set up under Directorate General of Health Services, Ministry of Health and Family Welfare.
• It functions as apex centre for all India activities of coordination and networking for:
  • procurement and distribution of organs and tissues; and 
  • registry of Organs and Tissues Donation and Transplantation in country.

Regulatory frameworks guiding the organ transplantation in India

• Legislation
  • In 1994, The Transplantation of Human Organs Act (THOA) was promulgated by the government of India. 
  • The Transplantation of Human Organs Rules followed in 1995 and were last amended in 2014, increasing the scope of donation and including tissues for transplantation. 
  • The act made commercialization of organs a punishable offence and legalized the concept of brain death in India allowing deceased donation by obtaining organs from brain stem dead person.
• Institution
  • National Organ and Tissue Transplant Organization (NOTTO) is a national level organization set up under Ministry of Health and Family Welfare.
  • Besides laying down policy guidelines and protocols for various functions, it coordinates all the activities associated with organ donation at national level.
• Organ transplant rules
  • In February 2023 the govt modified national organ transplantation guidelines.
  • The new guidelines have done away with the 65-year age limit for registration of patients seeking organs from a deceased donor.
    • There was no age cap for living donor transplants, where family members donate organs like kidneys and livers.
    • However, people over the age of 65 years couldn’t register to receive organs from deceased donors as per guidelines of NOTTO.
  • It has asked states to remove the domicile criterion for registering those seeking organs from deceased donor for transplant procedures.
    • Now the needy person can go to any state of the country and register for getting organ and also get the transplant done.
    • The patient will be allotted a unique ID by NOTTO on registering.
    • This will get carried forward even if the patient changes multiple hospitals in different States.
  • Noting that some states have been charging fees ranging between Rs 5,000 to 10,000 for registering such patients, this guideline has asked them not to charge money.
• Steps are being taken to develop a uniform organ transport policy for the country
  • To develop a uniform organ transport policy for the country, consultations were held with seven ministries coordinated by NITI Aayog.
  • Standard Operative Procedures have been drafted, which prescribe that: 
    • every concerned ministry will have a nodal officer and 
    • State Organ and Tissue Transplant Organisation (SOTTO) will coordinate with a nodal officer to facilitate organ transport.

Key Highlights of the report

• Status of organ transplants recorded in a year
  • Organ transplants recorded in a year have more than tripled in the last decade, with kidney transplants accounting for a majority of them.
  • In 2023, a total of 18,378 transplants were carried out in India, which ranks third in the world in organ transplant and second in corneal transplant.
    • The total number of transplants comprising, both transplants from living donors and those from deceased donors, in the country was recorded at 4,990 in 2013.
• Milestones achieved in deceased organ donations
  • India achieved another milestone in 2023 -- more than 1,000 deceased organ donations in a year for the first time, breaching its record from last year.
  • The number of deceased-donor transplants has increased from 837 in 2013 to 2,935 in 2023.
• Trend in organ donation based on gender
  • Among living donors, the number of females (9,784) was almost double the number of males (5,651) in 2023.
  • However, among deceased donors, males outnumbered females at 844 compared to 255.
  • Among the recipients, 30% were women.
• Organ transplants to foreign nationals in India
  • There were 1,851 organ transplants to foreign nationals in the country and Delhi-NCR accounted for nearly 78% of these.
    • Foreigners are allocated organs from deceased donors only when there are no Indian patients at the state, regional, or national level who matches.
  • There were allegations of irregularities in approval for transplants in foreign nationals reported from Delhi and Rajasthan. 
    • There were allegations of Myanmarese nationals “purchasing” kidneys from poor people in their country and getting the surgeries done at Delhi hospital.
• Organ donation rate
  • The organ donation rate in our country still continues to be less than 1 per million population.
  • There is need to encourage organ donation from deceased individuals to meet the growing demand for organs. 
  • This is important because more people are suffering from severe organ failure due to the rise in non-communicable and lifestyle diseases.

Q.1. What is Transplantation of Human Organs Act (THOA)?

The Transplantation of Human Organs Act (THOA), enacted in 1994, regulates organ donation and transplantation in India. It legalizes brain death, making deceased donation possible, and criminalizes organ trade. The act was amended in 2014 to expand the scope of organ and tissue donation, ensuring ethical practices.

Q.2. What is State Organ and Tissue Transplant Organisation (SOTTO)?

The State Organ and Tissue Transplant Organisation (SOTTO) is a regional body under India's Ministry of Health and Family Welfare. It coordinates organ and tissue donation activities within a state, implements national guidelines, manages organ allocation, and works with hospitals to facilitate and oversee transplantation procedures.

Source: 2023 saw highest-ever organ transplants in India, 63% of living donors were women: NOTTO report

National Organ and Tissue Transplant Organisation

DIRECTORATE GENERAL OF HEALTH SERVICES

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