India's Organ Wastage Crisis: A Call for Action

India is struggling with a severe organ wastage crisis, with a significant number of vital organs lost annually due to a lack of awareness, deep-rooted superstitions, and myths, according to experts. This alarming situation was highlighted on World Organ Donation Day, observed annually on August 13, to raise awareness about the importance of organ donation and dispel misconceptions surrounding it.

The country's cadaver organ donation rate is distressingly low, standing at less than one per million people. This is in stark contrast to Western countries, where the deceased organ donation rate is between 70-80 percent.

Dr. Tanima Das Bhattacharya, a Consultant Nephrologist & Kidney Transplant at Narayana Health, Kolkata, stated, India faces a severe organ wastage crisis, losing approximately 2 lakh kidneys and other vital organs annually due to a lack of awareness, deep-rooted superstitions, and myths surrounding brain death.

She further emphasized that the crisis is exacerbated by the failure to properly identify and certify brain deaths in hospitals, which significantly reduces the country's organ donation rates despite the availability of potential donors. The experts noted that even with recent directives from the Union Health Ministry to improve documentation of brain stem deaths, the cadaver organ donation rate remains alarmingly low -- less than one donor per million population per year.

Dr. Rajesh Aggarwal, Director of Nephrology & Kidney Transplant at Sri Balaji Action Medical Institute, Delhi, pointed out the tragic irony of the situation in a country as populous as India. He said, Thousands of life-saving organs go to waste each year. The gap between the number of available organs and the patients in need is vast, and the wastage of viable organs due to logistical and systemic challenges is a critical issue that demands immediate attention."

Dr. Suganthi Iyer, Director-Legal and Medical at P. D. Hinduja Hospital and Medical Research Centre, suggested that organ wastage in India could be significantly reduced by addressing the lack of awareness among healthcare professionals and the public, particularly in rural areas, about organ donation post-brain stem death.

She also emphasized the importance of increasing the number of hospitals registered as Non-Transplant Organ Retrieval Centers (NTORC). Focused training for healthcare workers and community outreach can further help curb wastage, she added.

Dr. Bhattacharya proposed a shift in India's focus from Donors after Brain Death (DBD) to Donors after Circulatory Death (DCD), citing the example of Spain. The Organizacion Nacional de Transplants (ONT) model in Spain, which includes organ donations from patients experiencing circulatory death, has dramatically increased its organ donation rate.

The experts also called for ramping up infrastructure, streamlining organ transport protocols, and ensuring that every potential donor's gift is honored by minimizing any delay in transplantation. They highlighted the urgency of the situation, noting that when a brain-dead patient is identified, there is just a narrow window of just 12 hours to retrieve and transplant the organs, requiring seamless coordination and rapid action.

Dr. Aggarwal emphasized, "With every organ that is not transplanted in time, we lose the chance to save multiple lives, making it imperative for us to strengthen our organ retrieval and transplantation networks."

Dr. Bhattacharya further suggested that to bridge the gap between organ demand and supply, India must implement a comprehensive and centralized organ donation registry, revise laws, and launch extensive awareness campaigns to encourage more organ pledges and facilitate easier organ harvesting procedures.

The organ wastage crisis in India is a pressing issue that demands immediate attention and action. The experts' insights and suggestions provide a roadmap for addressing this crisis, emphasizing the need for increased awareness, improved systems for organ donation, and a shift in focus to include more potential donors. As India grapples with this crisis, the lessons learned could provide valuable insights for other countries facing similar challenges.