Urge for survival is the key to medical research. Entire medical theory is a long history of research and trial. Today we have advanced medical services just because research and improvement of medical support is a continued process and has not come to the final stage of its evolution. Research means not only finding new medicines for known diseases but also the surgical part of it. Modern surgery is highly sophisticated in the sense that it treats human body extremely valuable and sensitive.
Transplanting of human organs means that a functional organ of human being is transplanted in another human body if the organ of the latter becomes dysfunctional. This process actually involves the donor and the recipient. The role of the surgeon who does the transplanting is pivotal as far as saving a life is concerned. But this process is neither easy nor without various complications. The most crucial part of transplant is the availability of the donor. It is to be noted that a living donor is a rare possibility except perhaps in the case of kidney transplant. The donor has to be one who has made a will of donating an organ after his death provided it passes the process of medical authorization.
The practice obtaining in parts of our country is that owing to acute poverty young people offer their organs for sale to a needy person. In return they are given a hefty amount by the patient on whom transplant has taken place. This is a practice disallowed by social, moral and ethical laws. Even the UN Human Rights Charter strictly disallows selling of human organs because it is violation of human rights to enjoy life in full. In social sense also, we do not appreciate a mentally dead person’s organs to be donated unless his close blood relation agrees that the organ by donated. Our country has laws governing donation of organs and their transplanting. It is true that donation of an organ can save a life but there has to be a recognized system and authorization for the same. For donation of organs, generally the organ of a mentally dead person is sought. By mentally dead person we mean a person who has died in accident owing to failure of brain. This is a very difficult process. In the first place, generally doctors are very hesitant in declaring a person mentally dead. Secondly, even if the mentally dead carries a card issued to those declaring their willingness that their organ be used after their death, it is not considered a legal document of expression.
The biggest problem of organ donation in our country is that we have a large number of patients waiting for transplant but we have very small number of donors. The gap between demand and supply is enormous with the result that a very large number of people die without being able to receive transplant in proper time. For example while 2.1 lakh Indians require kidney transplantation annually, only 3000 – 4000 kidney transplants are done. Again, according to the National Programme for Control of Blindness (NPCB) 2012-13 report, only 4,417 corneas were available in 2012-13 against a whopping requirement of 80,000-1, 00,000 per year.
Apart from scarcity of donors, in our country transplanting of organ is faced with two difficulties. One is the administrative complexities and the other is availability of facilities for transplanting in our hospitals. Very few hospitals in the country have the requisite infrastructure and those that have are over-crowded. Many myths are associated with transplant and people easily entertain doubtful rumours about the doctors handling human body. Educating people on the subject of transplants is very important.
Finally, the question of donating organ and transplanting it needs to be given some serious thought. Deceased donation is legal according to the law enacted in 1994. Transplantation Centre would do well to have its website in order to facilitate locating a donor. Then there has to be an authorization committee which will recommend transplant after completing all formalities. The government is seized of the matter and is going to set up an online network under the National Organ and Tissue Transplant Organization (NOTTO). The online service will be able to connect people directly to the donor.
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