Domino kidney donation faces legal hurdles in Maharashtra

A domino kidney transplant operation in Mumbai is reported to have stuck into a legal hurdle of sorts, as one of the donor pair have failed to appear as close relatives in the eyes of the judiciary. As per the law, this pair of an uncle and a niece is not considered to be close relatives, thus don’t qualify to be pair kidney donors in this case.   

As a result of this untimely observation, even the State Authorization Committee, Maharashtra has not given its consent to the procedure. However, the doctors who are doing the treatment have expressed their concern over the judgment clearly expressing their anguish over the fact that the law is supposed to be facilitating this procedure in order to save three lives.

Clinically, in a domino kidney transplant procedure, the donor of one pair donates a kidney to the recipient of another pair. The transplant is then carried out in a series till the last donor in the chain donates to the first recipient in the line-up.

The procedure which currently hangs in the hands of the law is country’s third domino transplant which involves three donors and three recipients. As per a recent amendent to the Human Organ Transplant Act (Hota) in 2014, In India, the donors and recipients should be close relatives in domino kidney transplant.

As factually reported by the DNA newspaper, the pair in question are residents of Karnataka. The uncle was to donate his kidney to the recipient of another pair and the entire chain of donations would have ensured that his niece received the organ from the donor of another pair. Treating doctors had been trying to get the legal nod for almost a year.

“The committee has found that as per the Act maternal uncle and niece are not closely related. Hence, permission was denied,” said Dr Pravin Shingare, chairperson, State Authorisation Committee, Maharashtra.

Two of the three domino transplant procedures were to be conducted in Hinduja Hospital and one was to be done in Bombay Hospital.

Nephrologist from Hinduja Hospital Dr Jatin Kothari said: “Through this domino kidney transplant procedure, we would have given life to three patients. But it is very strange that permission has been denied even in such a situation. We don't know why it was denied in this case. There is no exploitation, eventually it's to help the patients. We will now try to seek legal opinion and approach the higher authority. This is the only way we can curtail the waiting list of kidney transplant patients.”

It takes one year to make a domino kidney transplant successful. “We really don't understand why the government has denied permission. Without the domino method, patients have to wait for seven to nine years for a transplant,” said Dr Ganesh Sanap, who maintains the swap registry at Shushrut Hospital in Chembur.

However, Dr Shingare said: “We understand the pain of the patients, but our committee has worked as per the law. We first go through all legal documents because if patients are related, permission is granted at the hospital level. When the donor and recipient are unrelated, only then does the matter come to us,” said Dr Shingare.