States moves to bring organ donations under a single entity

Kerala to be first State to set up such an entity with overarching powers as per the THOA

Thiruvananthapuram

Kerala is taking the decisive step to set up the State Organ and Tissue Donation Transplantation Authority, which will be the ‘appropriate authority’ with quasi-judicial powers, as envisaged under the Transplantation of Human Organs Act (THOA), 1994.

None of the States have set up such an authority with overarching powers as envisaged in THO Act. Kerala would be the first State to do this.

It will be the single umbrella organisation to coordinate the organ donation and transplantation process, both live and deceased donation, in the State.

Though it has been eight years since the government launched the deceased donor organ donation programme, Mrithasanjeevani, lack of an organised administrative machinery, human resources, a proper technical agency with expertise and legal authority to guide has left the programme in a mire of mistrust.

With thousands of patients suffering from chronic end-stage organ failure in the State, the huge mismatch in the demand for and supply of organs has been driving people to desperate measures to procure organs, raising the spectre of a possible commercial trade in organs.

Despite the measures taken to ease administrative hurdles, both deceased donor and live donation in the State has more or less been centred around a handful of corporate hospitals, which has also raised serious questions.

Though Kerala had initially set up a Core Committee for Cadaver Transplantation to facilitate organ donation, the said committee has rarely met. “The daily administrative aspects of transplant activities were being managed by the Directorate of Medical Education. While this arrangement might have worked on a case-by-case basis, Kerala now has some 45 hospitals registered as organ transplant centres. Mrithasanjeevani still does not have a State Nodal Officer, and Kerala Network for Organ Sharing (KNOS), which has been coordinating the transplant activities till now, does not even have a proper administrative structure,” says Noble Gracious, nodal officer, KNOS.

“A good organ transplantation programme can be built only on the foundation of public trust. And to build that trust, it is important that the processes is subjected to regular and intense scrutiny,” he adds

The recent police enquiries into possible organs for money trade in the State is just one more reason why a unified transplant programme needs to be built around the public sector hospitals, which as of now have been burdened by the issues of shortage of critical care staff, facilities and overcrowding.

Health experts have been advocating a private-public partnership to strengthen the organ transplantation programme in government hospitals. A uniform transplantation authority will hence be better placed to enter into partnerships with other hospitals or health systems.

A legal body like that can reinstate public’s confidence in the organ transplantation programme, eliminate organ trade, and focus on providing a better quality of life to those donating organs. “We are talking about bringing in quality control measures, equity in organ distribution, improved access to organs for all and a well-equipped system of documentation and data banking,”a senior Health official said.

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