List of Organ Transplant Centres

Organ donation is the process in which a person voluntarily allows one or more of their organs to be removed and transplanted into another person. Donors can be living or deceased. Living donors typically donate organs they can live without, such as one kidney or a part of the liver. Deceased donors can donate multiple organs, such as the heart, lungs, kidneys, liver, pancreas, and intestines, following brain death or cardiac death.

Organ transplantation is a surgical procedure in which an organ is removed from a donor and implanted into a recipient whose organ has failed or is damaged beyond repair. The aim is to replace the recipient’s diseased or non-functional organ with a healthy one, thereby improving or saving the recipient’s life.

Important aspects of organ donation and transplantation

• Donor types
  
  • Living donors: Typically donate kidneys, a part of the liver, a lobe of the lung, or part of the pancreas or intestines. This requires the donor to be in good health and is usually related to the recipient.
  • Deceased donors: Donate multiple organs after brain death or cardiac death. This is the primary source for organs such as the heart, lungs, and entire liver.
• Recipient selection
  
  • Patients in need of an organ transplant are placed on a waiting list. Matching criteria include blood type, tissue type, medical urgency, and time on the waiting list.
  • Compatibility between donor and recipient is critical to reduce the risk of organ rejection.
• Transplant procedure
  
  • Pre-transplant evaluation: Assess the recipient’s health and compatibility with the donor organ.
  • Surgical procedure: The donor organ is surgically removed and transplanted into the recipient.
  • Post-transplant care: Recipients require lifelong immunosuppressive medication to prevent organ rejection and regular monitoring for complications.
• Ethical and legal considerations
  
  • Regulations, such as the Transplantation of Human Organs and Tissues Act (THOTA) in India, govern organ donation and transplantation to ensure ethical practices and prevent illegal trade.
  • Consent is a key factor, with strict guidelines on how and when organs can be donated, particularly from deceased donors.

The Transplantation of Human Organs and Tissues Act (THOTA)

The primary framework for organ donation and transplantation in India is governed by the Transplantation of Human Organs and Tissues Act (THOTA) of 1994, which was last amended in 2014. The Act allows both deceased and living donors to donate their organs and tissues. The Act made commercialization of organs a punishable offense and legalized the concept of brain death in India. Here are some important points from THOTA:

• Authorization and Regulation

• THOTA mandates the establishment of regulatory bodies at the central and state levels to oversee the implementation of the Act.
• Hospitals must be registered and authorized to perform organ transplants.

• Consent for Organ Donation

• The Act differentiates between living and deceased donors.
• For living donors, informed consent is mandatory, and only close relatives (defined as parents, siblings, children, and spouses) are generally permitted to donate unless special approval is obtained.
• For deceased donors, consent can be given by the next of kin or the donor themselves before death.

• Brain Death Certification

• The Act provides a legal definition of brain death and outlines the procedure for its certification.
• A panel of medical experts, including a neurologist or neurosurgeon, must certify brain death before organs can be retrieved from deceased donors.

• Prevention of Commercial Dealings

• THOTA strictly prohibits any form of commercial dealings in human organs and tissues.
• Offenses under the Act, such as trading in organs, are punishable with severe penalties, including imprisonment and fines.

• Ethics Committees

• Every hospital authorized to perform transplants must have an ethics committee to review and approve transplant cases.
• The committee ensures that the process adheres to ethical guidelines and that no commercial transactions are involved.

• National and State Registries

• The Act mandates the establishment of national and state organ and tissue transplant registries to maintain transparency and facilitate the allocation of organs.

• Penalties for Violations

• THOTA specifies penalties for various offenses, including illegal removal or transplantation of human organs and tissues.
• Penalties include imprisonment, fines, and cancellation of registration for medical practitioners and hospitals involved in illegal activities.

• Promotion of Organ Donation

• The Act encourages public awareness and education about organ donation to increase the availability of organs for transplantation.
• Efforts are made to promote voluntary organ donation through campaigns and public outreach programs.

These provisions are designed to ensure that organ transplantation is conducted ethically, safely, and transparently, benefiting those in need while preventing exploitation and trafficking.

The transplant/ organ registry (statewise may differ?)

The transplant and organ registry systems in India can differ from state to state. The Act also established regulatory bodies such as the Advisory Committee, Authorization Committee, and Appropriate Authority to supervise the transplantation process. However, the implementation and organization of these systems can vary significantly across different states. 

• Different states have established their own organ and tissue transplant organizations to manage and facilitate organ donation and transplantation within the state. For example, Tamil Nadu has the Tamil Nadu Network for Organ Sharing (TNOS), and Maharashtra has the Zonal Transplant Coordination Centre (ZTCC).
• The process for registering as an organ donor can vary from state to state. Some states have their own dedicated websites and platforms for donor registration, while others may use a central registry managed by the National Organ and Tissue Transplant Organization (NOTTO).
• The coordination and allocation of organs can differ based on the state’s policies and infrastructure. While NOTTO oversees national coordination, state-level organizations play a crucial role in the local allocation and management of organs.

References

1. Organ Donation and Transplantation. Available from: https://my.clevelandclinic.org/health/treatments/11750-organ-donation-and-transplantation. Accessed on 4^th June 2024
2. Transplantation Immunology. Organ transplantation. Available from: https://medweb4.unige.ch/immunologie/home/organs/ Accessed on 4^th June 2024
3. Ministry of Health and Family Welfare. Transplantation of Human Organs & Tissues Act (THOTA), 1994. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=1842747 Accessed on 4^th June 2024
4. Vidhi. Organ transplantation law: assessing compatibility with the right to health. Available from: https://vidhilegalpolicy.in/wp-content/uploads/2020/06/171003_OrganTransplantsReportFinal.pdf Accessed on 4^th June 2024
5. Rise in organ donations. Available from: https://www.nextias.com/ca/current-affairs/22-12-2022/rise-in-organ-donations. Accessed on 4^th June 2024
6. Organ transplant laws and rules. Available from https://www.organindia.org/organ-transplant-laws-made-easy/
7. The Lancet Regional Health-Southeast Asia. Organ transplantation in India: needs a bigger push. Lancet Reg Health Southeast Asia. 2024;21:100366. Published 2024 Feb 9.