Parliamentary Committee recommends continuation of National Organ Transplant program

The Department-related Parliamentary Standing Committee on Health and Family Welfare, headed by Prof. Ram Gopal Yadav, has submitted its 126^th report on Demands for Grants 2021-22 on 08.03.2021.

The standing committee report has highlighted the vital role played by NOTP in substantially improving the awareness around organ donation in the country. According to the report, the total number of transplants done in the country has increased from 4990 in 2013 to 12666 in 2019 indicating a marked improvement in infrastructure for undertaking transplants in the country. Also, 529 Hospitals undertaking transplantation or retrieval out of the total estimated 690 in the country are now registered with NOTTO for the purpose of networking and National Registry.

The central govt. has implemented the NOTP to promote organ donation in the country by bridging the gap between demand and supply of organs from transplantation. Under this program, an apex level National Organ and Tissue Transplant Organisation (NOTTO) at New Delhi and Five Regional Organ and Tissue Transplant Organizations (ROTTOs) at Chandigarh, Mumbai, Chennai, Kolkata, and Guwahati have been set up. Further, State Organ and Tissue Transplant Organization (SOTTO) have been established in twelve States

Indicating a significant progress in the establishment of an organized system in the country for organ procurement from deceased donors and their distribution and transplantation to the needy citizens of the country, the standing committee has not only recommended the continuation of the NOTP, but also stressed the need to strengthen the program in terms of infrastructure, administrative powers, human resources, training, and budget, etc.

However, The Committee has expressed its concern over non-receipt of proposals from State Governments and underutilization of funds earmarked to the State Governments for the establishment of State Organ and Tissue Transplant Organisations (SOTTOs).

According to the report, no proposal was received from the States during 2019-20. Similarly, the Revenue Outlay earmarked to the tune of Rs. 31.65 crore in the budget estimate 2020-21 was drastically reduced to Rs. 6.0 crore in revised estimate 2020-21.

The Committee, in its recommendations, has asked the department to persuade the State Governments to submit proposals for the establishment of SOTTOs and ensure optimal utilization of funds for the purpose.

The committee report also urges the State Governments to adopt THOA (Amendment) Act, 2011 which came into force on 10-01-14. The committee has expressed its concern, that the amendment act and the rules are applicable only in the 16 States and UTs.

Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The act was amended in the year 2011. The amendment has  provisions for improving organ donation rate in the country:

• 'Near relative' definition has been expanded to include grandchildren, grandparents.
• Provision of 'Retrieval Centres' and their registration for retrieval of organs from deceased donors. Tissue Banks shall also be registered.
• Provision of Swap Donation included.
• There is the provision of mandatory inquiry from the attendants of potential donors admitted in ICU and informing them about the option to donate – if they consent to donate, inform retrieval center.
• Provision of Mandatory 'Transplant Coordinator' in all hospitals registered under the Act
• Constitution of Brain death certification board has been simplified- wherever Neuro physician or Neurosurgeon is not available, then an anesthetist or intensivist can be a member of the board in his place, subject to the condition that he is not a member of the transplant team.
• National Human Organs and Tissues Removal and Storage Network and National Registry for Transplant are to be established.
• Enucleation of corneas has been permitted by a trained technician.

•  There is a provision of Advisory committee to aid and advise Appropriate Authority.

•  The act has made provision of greater caution in case of minors and foreign nationals and prohibition of organ donation from mentally challenged persons.
•  To protect the vulnerable and poor there is provision of higher penalties have been made for trading in organs.

India is the 3^rd country in the world after USA and China, in terms of the total number of transplants done in a year. Capacity for undertaking rare transplants e.g. Pancreas, Intestine, hand, limbs, Lung, Uterus have developed with in the country, besides a significant enhancement in capacities for undertaking relatively common transplants of Kidney, Liver, and Heart.