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New Delhi, June 14, 2024 – The potential for expanding India’s organ donor pool by permitting organ exchanges between unrelated individuals was highlighted by experts on Thursday. The Centre is reportedly in discussions with NGOs and transplant surgeons regarding this significant policy shift.
Current legislation predominantly permits living donations from close relatives, including parents, siblings, children, spouses, grandparents, and grandchildren. Unrelated or altruistic donations from distant relatives, in-laws, or long-time friends are subject to rigorous scrutiny to eliminate the possibility of financial transactions.
“Opening up organ exchange between unrelated individuals could considerably increase the donor pool in India, potentially saving numerous lives,” stated Dr. Sudeep Singh Sachdev, Director and Senior Consultant Nephrology at Narayana Hospital Gurugram. “Medically, the main concern is the risk of organ rejection due to genetic dissimilarity. However, advancements in immunosuppressive therapies have made such transplants more feasible and successful.”
Dr. Bishnu Panigrahi, Group Head of Medical Strategy and Operations at Fortis Healthcare, emphasized that India’s donation rates are currently very low compared to countries with robust transplant numbers. “This policy change could significantly help patients waiting for transplants,” he said.
Despite the potential benefits, experts stress the need for stringent regulatory controls. “The advantages include reduced wait times and improved health outcomes for patients. However, the risks encompass higher chances of complications and ethical concerns about ensuring truly altruistic donations, free from coercion or financial incentives,” Dr. Sachdev explained.
Dr. Panigrahi called for “robust regulatory frameworks and comprehensive pre-transplant evaluations,” suggesting that authorization for non-related transplants should involve an external committee with government nominees, a lawyer, and a social worker to ensure transparency and fairness.
Not all experts agree on the necessity of altruistic organ donations. Dr. Arvinder Soin, Chairman and Chief Surgeon at Medanta Institute of Liver Transplantation, warned against potential exploitation. “Although it may modestly increase donation rates, it opens up the possibility of the poor being exploited by the rich,” he stated.
Dr. Soin advocated for improving deceased donation rates in India, currently at 0.7 per million compared to 38 per million in the US. “For India, unrelated altruistic donation is not the answer at this stage. Instead, efforts should focus on promoting deceased donor organ donation through widespread government and NGO-led public campaigns, mandatory brain death declarations in all ICUs, and required requests from families of clinically brain-dead patients,” he suggested.
According to Dr. Soin, these measures would significantly enhance organ availability and save thousands more lives than the proposed policy change.
As the discussions continue, the balance between expanding the donor pool and ensuring ethical, safe practices remains at the forefront of this critical healthcare debate.
