Docs, experts warn against legalising commercial organ donations in India

NEW DELHI: Commercial donation — where recipients pay for healthy organs — should be legalised to meet their acute shortage, say some experts. But the majority insist it will lead to the exploitation of the poor and end the donation of organs after death.

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The Delhi police on Friday busted a kidney racket at Apollo hospital and arrested five for selling kidneys to recipients for R 25-30 lakh.

Every year in India, around two lakh people get listed for kidney transplants but only about 7,500 receive an organ. Of this, less than 1% is from organ donation by families of brain dead patients, says the National Organ and Tissue Transplantation Organisation (NOTTO), a national level transplant network.

In India, around 6,000 kidneys are transplanted from live donors and hardly any from brain dead patient, says Dr Harsh Jouhari, chairman of the department of renal transplant at Sir Gang a Ram Hospital and an advisor on organ transplantation to the ministry of health and family welfare.

“We have the second highest number of trans plants from living donors. America has the highest but they also have around 10,000 transplants from brain dead donors,” he said.

Legalising commercial donations is a strict no-no, Jouhari says. “An organ cannot be a commodity. It is banned world over and should be, otherwise, people would be coerced and blackmailed into giving an organ,” he said.

It will also negatively affect programmes promoting organ donation from brain dead patients. “If people are just allowed to pay money for the organs, these programmes will never take off,” he said.

Dr Vimal Bhandari, director of NOTTO, agreed. Legalising commercial donation may reduce the need gap but it will have a negative affect, he said. “The rich will be able to pay but the poor will suffer. Most trans plants will start happening at private centres and it will become a flourishing business,” he said.

But director of All India Institute of Medical Sciences Dr MC Misra felt a legal tag may stop the exploitation of poor donors.

“There must be a fixed price for organs and the money must be directly paid to the donor through a corpus, which can hold back around 20% of the money. This money can be used to subsidise or even completely pay for the transplants in poor patients,” he said.

This, Misra says, is necessary in India because the proportion of cadaveric donation is very small.

Dr Bhandari says retrieval centres in all hospitals, motivating kins of brain dead patients and improving transportation facilities, would help. “Retrieval does not happen in many hospital seven though we have so many road traffic accidents. Transporting the organ quickly is an issue. Fast air-travel and green corridors will help. Pledging of organs is the only way forward,” he said.