Facing low organ donations, Centre warns hospitals over transparent organ transplantation in India

The direction follows persistent non-compliance by hospitals which have failed to submit detailed reports to the government on the number of deceased donors, names and nationality of recipients, and in which city and hospital the organs are being transplanted.

The directive concerns brain stem death (BSD), the term used for natural deaths. Indians are notoriously diffident about organ donation – their own and families' – because of cultural reasons and a general lack of awareness. 

It is thought that organs from each deceased person can save up to eight lives. 

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Officials familiar with the matter said that many hospitals based in South India are not following government rules, prompting the Centre to take action against them.

Hospitals will be penalized if they fail to comply with the provisions of the Transplantation of Human Organs and Tissues Act (THOTA). 

People aware of the matter said that organ transplants are happening but on the sly. "When every transplant is registered on the government platform, it will automatically increase the numbers. The suspicion is about any commercial dealing, which obviously, hospitals will not report."

What are BSD cases?

Brain Stem death is recognized as legal death in India under Transplantation of THOTA. After a doctor declares brain stem death case, a deceased donor can save up to eight lives by donating kidneys, heart, liver, lungs, pancreas and intestine. Additionally, many types of tissues such as cornea, skin, heart valves, and bones can be donated.

"It is a matter of serious concern that many registered hospitals have persistently failed to submit the daily and monthly data on organ transplantation activities and register transplantations on the National Transplant Registry and mandatory reporting of Brain Stem Death cases," Dr Anil Kumar, Director, National Organ and Tissue Transplant Organization, in a letter to all the State/UT governments, reviewed by Mint.

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“It directly impacts our collective efforts to enhance organ donation rate in India, which currently remains alarmingly low at less than One donor per million population annually," said Dr Kumar said.

The central government has urged state governments to push hospitals within their jurisdictions to rigorously monitor and certify brain death cases, and submit a monthly proforma on BSD cases to the relevant state agency for onward transfer to the central government by 7th of every month.

Hospitals may attract show cause notice or license cancellation

“We are not getting patient-wise record from the states. Who are the donors and recipients of a particular organ? For instance, states share consolidated figures on the number of kidney and liver transplants. But this is not enough, and this data has a lot of gaps as they are not sharing the details of the patient. So, we have empowered the state government to take strict action against hospitals for not adhering to the government directions. The state government may issue show cause notice to the hospitals and further warn them for license cancellation in case of non-adherence," said the official aware of the matter requesting anonymity.

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“We will allow the government to keep a close surveillance on the organ donation in Inia and strictly prohibits any kind of commercial dealings," the official added.

Under the relevant sections of the THOTA Act, hospitals are required to identity each potential brain stem death cases, admitted in the ICU and educate family members about organ donation before the heart stops.

Last year, 861 deceased organ donors were registered, out of which 2410 organ transplantation took place. Queries sent to the health ministry remained unanswered till press time.