‘The organ transplant act is seriously flawed’

27 Sep, 2002 l 2334 hrs IST
http://timesofindia.indiatimes.com/articleshow/23498564.cms

ANJALI SINGH JAISWAL
President of the Indian Society of Organ Transplantation Padamshree Dr KS Chugh was in town on Friday. In a candid conversation with Anjali Singh Jaiswal, he speaks on the controversal issue of cadaver donation
Why is cadaver dononation a better option?
Following the use of a drug called cycloscronin, success rates in transplants became phenomenal in the West. This prompted more and more people to come forward and donate their organs. The success of the transplants, however, became it's own victim. Before long, rich people and foreigners started coming to India to buy organs. It was a flourishing buiness, until the Human Transplant Act was introduced in 1994. Some middlemen and touts however still exploit the loopholes in the Act and the business of organ transplant continues unabated.
What are these loopholes in the Human Transplantation Act?
The organ transplant was big buinsess before the act was formulated. But it has not made the difference it set out to after its formulation. The clauess in the act are being exploited openly. A case in point is the the clause which allows,"unrelated donors offering organ on emotional grounds," and the inclusion of the wife as a prospective donor.
Only an affidavit has to submitted to the Authorisation Committee for clearance. Sure enough, the committee has been flooded with affidavits prepared by middlemen in conivance with the hospital staff, police and at times, even committee members.
What is the solution?
The Act has to been amended. The clause relating to emotional donors should be struck off. In the West, 20,000 transplants take place annualy, all from cadaver patients. But in India the figure stands at a dismal 4000-5000 transplants per year. Secondly, the wife should be excluded from the clause. Instead, cousins, neices, nephews, uncles, aunts should be included. A HLA Tissue typing should be made mandatory to ascertain the relationship of the donor with the patient.
Do you think amending the law will solve the problem?
Yes, to some extent. But a government initiative should also be encouraged. They have not been addressing the problem properly. The programme to make cadaver donors has been deliberately sabotaged by vested interests. As far as the cost of sustaining the cadaver donor once he is brain dead is concerned, it should be borne by the family of the recepeint issues like these should be addressed.
The recent case of an Indian doctor actually procurring organs from live Indian donors for British patients is an eye opener. What has discouraged cadaver donations is the absence of any registartion of the patients suffering from diseases requiring organ transplantion. As a result the deals are done unofficial without any database to give the actual figure. When it happens with kidneys, it is bearable as it is a paired organ, but what with liver transplants showing a success rate of 60-70% possibilities of tout involvement increases manifold.