  
Selling of donor organs continues in India despite ban
Last Updated: 2001-03-09 18:52:08 EST (Reuters Health)
By Sanjay Kumar
NEW DELHI (Reuters Health) - Despite legislation banning the sale of human organs in 1994, organ sales in India still continue, albeit surreptitiously, experts at a special meeting organized by the Indian Society for Histocompatibility and Immunogenetics said here this week.
Before India promulgated the Transplantation of Human Organs Act in 1994, the country had achieved considerable notoriety internationally for its organ trade, especially of kidneys, bought from poor people by the rich from all over the world. The legislation aimed at putting a halt to India's thriving "organs bazaar."
With the law, brain death was recognized legally for the first time so that organs of brain-dead patients could be use for transplantation. The law also stipulated that those related in some way to a patient in need could donate organs. The legislation outlines the procedure to be followed for retrieval, donation and transplant of organs.
"There is a major loophole in the legislation whereby hospital authorization committees--in many places perceived to be very corrupt--are allowed to permit nonrelated donors to give organs for transplant if they are emotionally close to the patient ," said Dr. Samiran Nundy, a senior surgeon at Ganga Ram Hospital, in Delhi, and a moving spirit behind the enacted legislation, at the meeting.
Dr. Nundy cited the examples of people speaking different languages from different states and unknown to each other having been cleared as "emotionally close" and fit for transplantation by some hospital committees.
"Now you have a number of unrelated people actually selling organs with 'approval' of the hospital authorization committees," Dr. Sandeep Guleria, of the All India Institute of Medical Sciences (AIIMS), told Reuters Health.
"We get 89,000 new chronic renal failure patients every year in India and only 3000 transplants are done", said Dr. Guleria. "Out of all the renal transplants done in India currently, only 30% are from relatives, whereas 64% are from unrelated 'donors,'" Dr. Guleria pointed out.
Organs from brain-dead patients are an untapped resource in India, speakers said. "We have failed miserably in educating and motivating society [about organ donation] after passing the Act," Dr. S. C. Dash, from AIIMS, told Reuters Health.
"The medical staff is predominantly ignorant about brain death," Dr. Guleria told meeting attendees. "The paramedical staff is even worse and the nurses couldn't care less about potential donors," he added. "There is absolutely no acceptance of brain death by the public."
"Until India allocates more financial resources to healthcare and critical care units, develops its infrastructure, telecommunication systems and transportation facilities, the cadaver programme will never take off," cautioned Dr. Guleria.
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