Presumed consent clause will improve transplant cases: AIIMS

New Delhi: Doctors at AIIMS suggested bringing in the norm of "presumed consent" for harvesting of organs in case of accidental fatalities, to improve the rate of organ donation in the country where nearly 50,000 people are in immediate need of heart transplants.

Spain and few other European countries have the system of "opt-out" where organ donation will occur automatically unless an explicit request is made before death for organs not to be taken.

"As per a rough estimate, at any time, 50,000 people in India are in need of heart transplant, about 3 lakh for kidney transplant, and a lakh each for liver and corneal transplants.

"So, there is a huge shortage as far as organ donation is concerned though awareness created by the media and other health programmes have helped in making the situation better than it was a few years ago," AIIMS Director M C Misra told reporters.

He was addressing a press conference at the institute's campus to mark the 50th heart transplant conducted by AIIMS recently.

Spain has the highest organ donation rate in Europe at about 34 donors per million while India has nearly 0.03 per million.

"The system of opt out will improve the scenario. Heart and other organs go unutilised after accidental fatalities, even though patients are in need of various transplants. So, we must have a presumed consent for harvesting of the organs, but it has to be made legal to address the shortage," Misra said.

According to Indian Society for Trauma and Acute Care (ISTAC), injury and trauma are steadily increasing in third world countries and becoming a major public health issue. Also, one trauma-related death occurs in India every 1.9 minutes, it said.

Misra said, however, the increase in transplant rate cannot be achieved by just addressing one aspect, but several other processes also must be streamlined.

The organ donation process in the country is administered by the National Organ and Tissue Transplant Organisation (NOTTO).

"We should also have such state-level bodies and also district-level harvesting facilities must be strengthened," Professor of Cardiothoracic and Vascular Surgery at AIIMS, Balram Airan said.

Misra said another key factor is "for critical care doctors to be pro-active about identifying brain-death cases."

"We had written to the LG last year for making brain-death notifiable, which was done. Now, we would soon do a workshop for critical care doctors on this subject," he said.

"Roughly, 10,000 brain deaths take place in Delhi-NCR every year. So, even if we can harness 1,000 of the, we can address the issue," he said. According to AIIMS, eight patients are waiting for heart transplants, who have registered at the premier institute.