HUMAN ORGAN

TRANSPLANTATION

WHAT IS ORGAN
TRANSPLANTATION?
Organ transplantation is the moving of an organ
from one body to another or from a donor site on
the patient's own body, for the purpose of
replacing the recipient's damaged or absent
organ. The emerging field of regenerative
medicine is allowing scientists and engineers to
create organs to be re-grown from the patient's
own cells. Organs and tissues that are
transplanted within the same person's body are
called autografts. Transplants that are performed
between two subjects of the same species are
called allografts. Allografts can either be from a
living or from a cadaver.
Organs that can be transplanted are the heart,

HISTORY IN SHORT

TRANSPLANTATION OF HUMAN
ORGANS ACT, 1994
An Act to provide for the regulation of removal, storage and
transplantation of human organs for therapeutic purposes
and for the
prevention of commercial dealings in human organs and for
matters
connected therewith or incidental thereto.
It applies, in the first instance, to the whole of the States of
Goa, Himachal
Pradesh and Maharasthra and to all the Union territories and
it shall also
apply to such other State which adopts this Act by resolution
passed in
that behalf under clause (1) of article 252 of the Constitution.

FEATURES OF THE ACT

THE Transplantation of Human Organs Act, 1994 is meant to

"provide for the regulation of removal, storage, and transplantation
of human organs for therapeutic purposes and for the prevention
of commercial dealings in human organs.

The Central Act illegalizes the buying and selling of human organs
and makes cash-for-kidney transactions a criminal offence

The law establishes an institutional structure to authorize and

regulate human organ transplants and to register and regulate,
through regular checks, hospitals that are permitted to perform
transplants.

It recognizes, for the first time in India, the concept of brain-stem

death, paving the way for a cadaver-based kidney transplant
programme.

 The Act defines two categories of donors. First, it permits a near

relative, defined as a patient's spouse, parents, siblings, and children, to
donate a kidney to the patient. Secondly, live donors who are not near
relatives but are willing to donate kidneys to the due to attachment or
any other reasons are permitted to do so, provided that the
transplantations have the approval of the Authorization Committee,
established under the Act.
Section 19 of the Act states: "Whoever (a) makes or receives any
payment for the supply of, or for an offer to supply, any human organ; (c)
offers to supply organs for payment; (d) initiates or negotiates any
arrangement involving the making of any payment for the supply of (e)
takes part in the management or control of a body of persons, whether a
society, firm or company, whose activities consist of or include the
initiation or negotiation of any arrangement referred to in clause (d); or
(f) publishes or distributes or causes to be published or distributed any
advertisement shall be punishable with a term of imprisonment ranging
from two to seven years or with a fine not less than Rs.10,000 and not
greater than Rs.20,000."

AMENDMENTS IN THE ACT

1. To empower Union Territories, specially Government of NCT of
Delhi to have their own appropriate authority instead of DGHS
and / or Additional DG (Hospitals).
2. To make the punishments under the Act harsh and cognizable
for the illegal transplantation activities to deter the offenders
from committing this crime.
3. To provide for registration of the centres for removal of organs
from the cadavers and brain stem dead patients for harvesting
of organs instead of registration of centres for
transplantations only.
4. To allow swap operations between the related donor and
recipients who do not match themselves but match with other
similar donors / recipients.

PROPOSED AMENDMENTS
1. The current age limit of 60-years should be removed for cadaver donors. Improved
health and longer life expectancy means some older people could be suitable donors,
upping the organ donor count to an extra 10 or 12 a year.
2. It has also been proposed that paired matching should be permitted i.e. if patient A's
donor does not match A and likewise for patient B, then donor switch should be allowed,
if it results in a match. Swaps or exchanges between families unable to fulfill the need of
their family member in need of a transplant due to incompatibility, are known to take
place. However, this is not legal and is mostly done under cover. The proposed
amendment seeks to convert the de facto into de jure, encouraging more families to
swap organs amongst themselves, to be vetted by an authorization committee.
3. Direct costs should be given to donors for a donation, including indirect losses like lost
earnings and future expenses. The compensation framework should be in line with
international and local ethical recommendations.
4. Higher penalties should be imposed for deterring organ trading syndicates and
unscrupulous middlemen.

IMPACT OF TRANSPLANTATION ON
PATIENTS
Infections
Attempts to suppress the immune response to avoid graft rejection and GVHD
weaken the ability of the body to combat infectious agents (bacteria, viruses,
fungi). More rarely, the donated organ may be infected and transmit the agent to
the recipient. Tuberculosis, rabies, syphilis, hepatitis B, HIV, and several other
diseases have been transmitted in this way. Potential organ donors are now
routinely tested for evidence of infection by HIV, HTLV, hepatitis B and C (HBV,
HBC), human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) as well as by
Treponema pallidum (syphilis).
Cancer
Suppressing the host's immune responses also increases the risk of cancer.
(Evidence supporting the theory of immune surveillance.)
Hypertension
Hypertension, or high blood pressure, is common immediately after transplant.
Certain anti-rejection medications, as well as the original disease, all can
contribute to hypertension.
Shingles
People with weakened immune systems, such as transplant recipients treated
with immunosuppressive drugs, risk developing shingles. Shingles is a painful
infection of the central nervous system caused by the Varicella virus that causes a

INDIAN POSITION
Ethical Issues
The ethics of transplantation can be expressed in three requirements:
1. Medical integrity: Patients and the public must be able to trust their
doctors not to sacrifice the interest of one to that of another. Individual
may make that sacrifice, but not their doctors.
2. Scientific validity: the basic biology and technology must be sufficiently
assured to offer a probability of beneficial outcome, case by case.
3. Consent: Consent based upon information adequately presented,
weighted and understood, and unforced.

Unregulated medicine practice

Medical councils and organizations have played a passive role on ethical
issues. They have failed to make their stand public or take action even in
obvious malpractice. Although the press has been publishing explicit
details on rackets in kidney transplantation in various cities no medical
body has thought it fit to even conduct an investigation into them.

Illegal organ trade

India's slums are a gold mine for organ traders, full of poor people
desperate enough to sell their organs. But with a healthy kidney fetching

SCANDALS
This is the list of top five countries where
organs are illegally traded and harvested:

Moldova
China
Egypt
Pakistan
India

CONCLUSION
Organ transplantation is linked with organ donation. It is a
worldwide campaign which urges people to donate. According to
unos.org ( United network for organ sharing) the number of
donors in January-July 2011 were 8132, transplants in the same
period was 16,416 and as per yesterday the waiting list of
patients who require organ transplants has 112,309 people on it.
When a person in your family, relative, friends expire.. all you
need to do is call the donor bank, and they come to your place,
take 5 minutes time, issue a certificate, and two people get
eyesight... how difficult is that???
Please keep the telephone number of your city handy.
Call Toll Free number across India for any information on organ
donation or to donate organ at: 1919

THANK YOU
ANURAG KHUNGER
ARJUN KRISHNAN
HEER KHANT
KRITI KRISHNAN
SAACHI KANJANI