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1) Alarming rise in illegal human organ trade

The World Health Organisation is warning of an alarming rise in the illegal trade in human organs, saying around ten percent of transplant procedures involve organs that have been bought on the black market. The latest estimates show that organ traffickers are exploiting poor people in China, India and Pakistan to cash in on the rising international demand for replacement kidneys. Professor Jeremy Chapman, past President of the Transplantation Society, says that much of the demand for organs comes from citizens of developed countries. "People feel a great pressure here, and in other developed countries in the world, where almost all around the world the needs for transplantation are not completely met by our ability to find organ donors," Professor Chapman told the ABC. "They go overseas where the only criterion for suitability is the size of your chequebook." Professor Chapman says Australian patients have gone overseas despite warnings from their doctor and died after receiving illegal transplants. While desperation for a medical solution drives those that receive the organs, money and material reward is a force for the organ donors. "There are stories of brokers offering iPads for a kidney," Professor Chapman says. "People don't care, it's as simple as that." "It doesn't matter if the patient dies. It's an outrageous proposition but it's the truth."

2)

AHMEDABAD: For years, Gujarat was the leader in cadaver organ donation. Now, Tamil Nadu has reportedly beaten the state in this activity mainly due to state government there bringing in key amendments to norms that have helped in organ donation like compulsory notification of brain-dead patients and a common patient registry of patients needing organ transplants.

"What has made a difference is that the Tamil Nadu government introduced positive amendments three years ago to give a boost to organ donation in the state. If Gujarat government also decides to lend a hand, many patients on the brink of death due to kidney and liver failure can get a fresh lease of life", said Dr Desai. He said that TN has made notification of brain-dead patients compulsory due to which volunteers get a huge database of families that they can approach and convince for organ

donation. Also, a common registry of patients needing organ transplants allows for transparent and fair allocation of organs as and when they are available. Dr Desai said that with most corporate hospitals and Kidney Hospital in Civil Hospital campus offering kidney and liver transplants, the time has come for all stakeholders to meet and expedite the process of making more cadaver donations possible.

3 Only 2% get liver for transplant, says doctor


LUDHIANA: Jaspal Singh, 42, (name changed), a businessman of Model Town who used to drink heavily, got the shock of his life a year ago when he was diagnosed with the advanced stage of alcoholic liver disease. The doctors suggested him immediate liver transplant. But despite the fact that Jaspal managed to arrange Rs 25 lakh for the surgery, he has been unable to get a donor. Jaspal is not the only who is looking for donor, according to experts the crunch in organ donations is severely affecting the number of transplants in India - here nearly 25,000 patients need liver transplants annually but only 800 are able to get these.

Liver transplant is mostly required by the patients who are suffering from alcoholic liver disease, hepatitis C, B and non alcoholic speato hepatitis.

"Lack of donors and financial constraint are the two main causes affecting the number of liver transplants in the country," say experts.

Experts add that in Ludhiana too, annually, hundreds die in fatal road accidents - most of them due to brain death- and in such cases they can become potential organ donors. But sadly their families hesitate to do so because the 'myths' related to organ donation after death- this attitude needs to change. They add that this huge gap between the required number of liver transplants and the actual number can only be shortened by making people aware about the organ donations.

Dr Harmeet Singh Saluja, senior consultant at SPS Apollo Hospital, says, "On an average we get around 50-60 patients suffering from end-stage liver diseases every month, and 95% of these need liver transplant. We refer them to liver transplant centres in Delhi, but I know this for a fact that only 2-3% of these patients actually end up getting a transplant. Rest suffer either because of the unavailability of donors or finances." He adds, "Around 30 to 50% patients who require a transplant and fail to get it die in two to three years."

Should India follow Chinas lead and set up an organ transplant database?
4) China will establish a national database to record and distribute human organ donations, an official said on Wednesday. The health ministry has drafted an organ distribution regulation, spokesperson Deng Haihua said, adding that the regulation must pass a trial phase first, reported Xinhua. A network for organ donations and transplants will be formed by 164 qualified hospitals nationwide. Official statistics show that about 1.5 million people in China need organ transplants, although only some 10,000 transplants are performed annually. Medical experts have long urged the establishment of a transparent system for organ donation and distribution in order to boost the number of organ donors.

Campaign launched to create awareness on organ donation


5) City-based BLK Super Speciality Hospital launched a campaign on Thursday to create awareness on dead body organ transplantation. The campaign aims to encourage families of brain-dead patients to donate organs. The hospital also felicitated the parents of an accident victim who donated their daughters organs, which saved five lives. Their 17-year-old girl was recently declared brain-dead after an accident. A patient is termed brain dead when he/she is clinically and legally dead due to complete and irreversible loss of all brain functions. Almost 37 organs and tissues, including heart, kidneys, liver, lungs and pancreas can be garnered from such patients. My daughter met with an accident on August 23. She was declared brain-dead a few days later. We decided to donate all her organs. It was an emotional decision for all of us, the girls father said. We realized that our daughter was never going to return, so we decided to help others. The process of taking approval from authorities was arduous, but we managed to do that on time, he added. The case exposes the official procedures leading to delay in organ retrieval. The 17-year-old girl was declared brain dead on August 28 by the doctors at Delhis BLK super-specialty hospital. Her family had to wait for five days to get clearance from the authorities before her organs could be harvested. They required police approval since it was a medico-legal case. Local authorities were unaware of the process and took time to issue an NOC. So, the

victims family approached Delhi health minister A K Walia to speed up the approval from forensic experts. Ideally, organs should be harvested within 24 hours of declaring a patient brain dead, said Dr Rajesh Pande, director, department of critical care and emergency medicine. He added that they had to administer electrolyte, maintain the body temperature and ensure there is no infection till the time they got clearance. According to the Transplantation of Human Organs Act, 1995, cadaver donation is possible only when a patient is declared brain dead. If the deceased has not pledged during his or her lifetime to donate organs, the authority to give consent for cadaver donation lies with the person lawfully in possession of the body. Experts say that the law on organ transplant needs to be more clear and the need of the hour is to sensitize the authorities concerned police officers and doctors. According to a recent data, 1.25 lakh Indians died in road accidents last year, and less than 20,000 of them donated their organs. Thousands of patients die in India due to unavailability of organs. There has been a renewed interest in cadaver transplant because of the huge gap in supply and demand in cases of chronic renal failure, where the only possible remedy is cadaver transplant. In India, for varied reasons, this has not taken off to the extent of its potential, said Aditya Pradhan, senior consultant, urology at BLK Hospital.

6) Home / Diseases & Conditions / Maha govt steps up organ donation drive

Maha govt steps up organ donation drive


In a bid to boost organ donations, the Maharashtra government has initiated several measures aimed at strengthening the health network and widening the net of prospective donors, a top official said Monday. The state government issued a government resolution (GR) making it mandatory for hospitals to inform about their brain dead patients to organ transplant centres through Divisional Transplant Co-ordination Committees, said the health department official, requesting anonymity. There is already a provision to this in the Transplantation of Human Organ Act, 1994, along with a punishment of three years imprisonment to those who violate it, the official said of the GR, issued two days ago. However, on account of the punitive clause and lack of other legal safeguards, the efforts for voluntary organ donations and transplants have not picked up momentum. With the new GR, the state government has accorded a legal backing to the medical fraternity, making it compulsory for them to inform the authorities of all-brain dead patients, the official explained. Besides, organ harvesting facilities will now be made more widespread and become available in all hospitals with a minimum of 25 beds with operation theatre and intensive care facilities. The actual organ transplant surgeries will continue to be conducted only at registered transplant centres, he said. In an attempt to widen the net for organ donors,

the state government will soon offer a separate column in college admission forms seeking voluntary organ donation. If the students agree, it will be noted in their identity cards and on their driving licenses. We are currently coordinating with various Regional Transport Offices, the authority which issues driving licences to streamline this procedure, the official said. He added that without public participation, these measures would not yield the desired results and patients in need of vital organ transplants would continue to suffer or perish. The measures have been initiated after the state was shocked with the death of former chief minister Vilasrao Deshmukh Aug 14 as he waited in vain for an organ transplant operation.

7) Eye donation hit by lack of technicians: Experts


Theres no dearth of people willing to donate their eyes in India but more transplants cant be conducted due to a shortage of eye bank technicians and eye donation counsellors, experts say. India ranks high when it comes to people who pledge their eyes. But not many corneal transplants are performed due to a shortage of technicians and counsellors, said Tim Schottman, Chief Global Officer, Sight Life USA (the worlds largest eye bank association) at the fourth Annual National Continuing Medicial Education Conference on Eye Banking organised by the Eye Bank Association of India (EBAI). With around 1.1 million people afflicted with bilateral blindness (loss of eyesight in both eyes) and around 5.6 million suffering from lack of vision in one eye, corneal transplant has become a necessity in India. The percentage of transplants or grafts has gone up from 10 to 40 percent. We are aiming to touch the global target of 60 percent, said Samar K. Basak, vice president, EBAI. In-order to achieve this target, eye banks all over India have collaborated with Sight Life to train personnel. So far this training has already started in Chennai, Delhi, West Bengal and few other places. Gradually we will cover all the major cities, said Basak, who also serves as the medical director of Prova Eye Bank, Disha Eye Hospitals & Research Centre near Kolkata, the second-largest eye bank organisation in India. India is placed in the top three countries with respect to eye donation, but since the donation is done after the donor is dead, there is need to ensure that families do not relent. At present there are 700 eye banks in India, out of which only 150 do transplants and out of that 150, only 25 meet the standards, said Schottman. A major hurdle that keeps these eye banks from meeting international standards is the lack of accreditation. We have applied to the National Accreditation Board for Hospitals and Healthcare Providers (NABH) to provide the accreditations and we hope to achieve all our targets by 2020, said Basak. Home / Diseases & Conditions / Rajasthan man alleges docs removed his two-year old sons kidney

8) Rajasthan man alleges docs removed his two-year old sons kidney
A Rajasthan man has complained that doctors at a state-run hospital stole a kidney of his twoyear-old son undergoing treatment, police said. A court has ordered registration of cases against some doctors. The child died June 13 at SMS Hospital here about six days after he was admitted, police added. Ramu Kashyap, a resident of Mahua town in Dausa district, some 50 km from Jaipur, said he admitted his son Gaurav to the hospital June 8. Kashyap says that the doctors were to operate upon Gauravs hand. The surgery was carried out on June 9, investigation officer Bharat Singh told IANS. He said in the complaint that the doctors kept telling him that his son was well and would be discharged soon, said the officer. However, his son was declared dead June 13. Kashyap claims that there were marks of stitches on the boys stomach and back. He says that his sons kidney was removed, said the officer. Kashyap approached a court after his sons death. After hearing his case, the court ordered the police to register a first information report (FIR) against Dr. Pradeep Goyal and some resident doctors. The court orders reached us Friday evening. We have launched an investigation, the officer added. The doctors were booked under penal provisions for punishment for culpable homicide not amounting to murder and criminal conspiracy, he said.

9) The fact that a highly influential individual like former Maha CM Vilasorao Deshmukh passed away while waiting for a liver and kidney donor, points out how difficult it is to find an organ in time in India. So why is organ donation such a troublesome procedure in India? There are basically two types of organ donations: 1. Living organ donation where an individual donates a part of an organ or a renewable organ. These are possible in cases of organs which are either regenerative or surplus (skin, liver, blood). 2. Cadaver donations organs from patients who are brain dead. Organs which can be harvested include heart, eye, liver, lungs, kidneys, etc. Brain death usually occurs six to ten minutes after cardiac arrest and the person can be kept on ventilator support (so all other bodily functions are running) till the organs can be retrieved. Incidentally, brain death is an irreversible end of all brain activity and different from a coma or vegetative state. Skewed demand and supply It is estimated that around 200,000 kidneys and 100,000 livers are needed every year in India and only about 2-3% get it. By conservative estimates about 90,000 Indians die in road accidents every year and 40% of those people are left brain dead. Dr Sunil Shroff of the MOHAN foundation estimates that 50% of all organ donation needs could be met by simply using organs from road accident casualties.

Sadly theres a distinct lack of awareness about organ donation. Think about it yourself, if your loved one has just passed away how receptive would you be to a procedure like organ donation? The only way to improve this scenario is by educating people about organ donation and putting in place an easymechanism which will allow people to donate their organs upon death. To donate or not to donate? Various organisations like MOHAN (Multiple Organ Harvesting Aid Network) and the ZTCC, Mumbai (Zonal Transplant Coordination Centre) are working to increase awareness among the common man. One way to do this is by having driving licenses to double up as donor cards, a practice thats followed in various Western countries. The Central Government is currently working on a new draft of the Human Organ Rules 2012 in which the health ministry has suggested that all people applying for driving licenses be asked whether theyre willing to donate their organs upon death or not. This belief is echoed by Dr Ashwin Mallya, a surgeon from Sir Ganga Ram Hospital, New Delhi who feels that since most cadaver donors are deaths from road accidents having their assent on their driving licenses would go a long way in fulfilling organ demands. Lack of facilities Another issue is the lack of facilities; there are only 120 centres all over India which are deemed capable of organ transplant. One way to counter this would be to follow the Maha govts recent move to increase organ donation. This move has made it compulsory for all non-transplant hospitals equipped with an ICU and operation theatre to retrieve organs for harvesting and made it mandatory for them to officially identify brain dead patients. This would allow hospitals which dont have organ transplant facilities to at least harvest organs from brain dead patients for use by the facilities which can at least increase the availability of organs. and superstitious beliefs Another major hurdle in India is the superstition attached to death and reincarnation in India. Many people believe in afterlife and feel that organ donation could lead to the body not being whole. The only way to counter this is to raise the level of awareness about organ donation. Its important to note that none of the worlds major religions Judaism, Christianity, Hinduism, Islam are opposed to organ donation and in fact consider it to be a deeply altruistic gesture. Two recommendations that have been made include following the Spanish model of recovering all brain dead patients organs and the Singaporean model which looks to legalise the sale of organs. However, both initiatives are seen as too radical in India. The latter would in fact bolster the already rampant organ trade feels Dr Mallya. It would be better to increase media involvement and target youngster, whod be more receptive to the idea, he adds. Where can I donate my organs? The most common and least hassle-free option is to print a donor card. Many NGOs have the option to simply print an organ donor card in which its explicitly written which organs youd like to donate. At least until driving licenses start doubling up as donor cards this remains the

best option to ensure that your organs are donated. Click here to download the MOHAN foundations donor card. Its very easy to make and takes barely one minute of your time. Its also important to let your near and dear ones know, that youre open to organ donation so that they can inform the concerned authorities during the time of a mishap. Pledge your organs today and you can save lives too!

10) Home / Diseases & Conditions / No organ donation unless its a relationship of love, affection and attachment: High Court

No organ donation unless its a relationship of love, affection and attachment: High Court

Oct 3, 2012 at 7:54 AM Tags: Cadaver donation, Delhi High Court, Kidney transplant, MOHAN foundation, Organ donation, Organ Transplant

The Delhi HC has asked the Centre to explain what its policy was concerning organ harvesting from cadavers. Director General of Health Services is supposed to file an affidavit before the court on the policy which has been put in place by the ministry of health and family welfare with regard to organs harvested from cadavers, Justice Rajiv Shakdher said in an order on Monday. The affidavit will also disclose whether information with regard to swapping requests and donation of organs from cadavers is uploaded on official websitethere is an urgent need to inculcate complete transparency, accountability and general awareness in the citizenry at large by the state, the court added, giving the Centre a weeks time to file the affidavit. The need to give this direction came up in a case concerning Agra resident Pawan Anand who had sought the courts permission for liver transplant for his mother from a close family friend. The Transplantation of Human Organs and Tissues Act however doesnt allow this in fact only near relatives are allowed to donate their organs and it cant be allowed if a relationship of love, affection and attachment is not established.

Citing provisions of the Transplantation of Human Organs and Tissues Act, Justice Shakdher said the Act permits donation by a person, other than a near relative, for reasons of affection or attachment towards a recipient prohibits commercial dealings of human organs and there will rarely be a direct evidence with regard to commercial dealings which have to be inferred from the facts in each case.

Anand, in his petition, had challenged Director General of Health Services refusal to allow liver donation for his ailing mother by his family friend. Pawans 62-year-old mother, suffering from liver cirrhosis, had been advised urgent liver transplantation and had sought the sanction under the Act to receive the organ from Gulab Devi, 42, stated to be a family friend who was a tenant in her premises at Agra. Apollo Hospitals authorization committee however denied permission claiming that the relationship between donor and recipient was akin to one of a master and caretaker and there was gross financial imbalance between the two. The DGHS too had upheld the decision of the committee. The petition was filed in the high court against the decisions arrived at by the authorities below. Anand had alleged that the willing donor, in her affidavit made it clear she knew the recipient family since 1983 and their relationship is like a mother and her daughter.

One cannot find fault with the conclusion of the authorities below that the offer of donation of a part of her liver by petitioner number 2, ie, the donor is not propelled by love and affection, Justice Shakdher said. The court, however, made it clear that dismissal of Urmilas plea would not come in the way if she enters into a swapping transaction with relatives of similarly circumstanced families of patients who are willing to donate a part of their liver which matches the blood group of the recipient in the present case.

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