Towards achieving national self-sufficiency in organ donation in India - A call to action

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V. Jha

Every description of advances in organ transplantation starts by extolling the virtues of surgical technique and medical management of recipients. Indeed the success of modern day transplantation owes a lot to these progresses. However, underpinning all organ transplants is that act of supreme human charity - willingness to donate an organ - either of oneself, or that of a loved one (in the case of deceased donors) even in the face of tragedy.

All transplant professionals and patients with end-stage organ failure are painfully aware that availability of organs is a major limitation in current day practice of transplantation. This shortage has led to suggestions of ways of overcoming this barrier: use of organs from donors after cardiac death, marginal donors, transplantation across ABO barrier, swap and domino transplants, etc. All of these all have met with broad approval and were being practiced increasingly - albeit with varying success - in different parts of the world.

The one suggested solution that has created deep divisions among transplant professionals, ethicists, social scientists, law-makers and even the general public, is the suggestion of incentivizing organ donation. [1] Altruism, consistent with respect for fundamental human rights - in particular that of human dignity - has been the bedrock of organ donation, and the overwhelming consensus so far has been that any kind of payment or reward for organ donation is contrary to the human values, and hence banned throughout the world - with the notable exception of Iran. [2]

Professional societies, transnational organizations such as the World Health Organization (WHO) and other global groups have strongly opposed incentives for organ donation, at the same time supporting removal of any disincentive such as loss of wages, medical bills, medical insurance, travel expenses etc., related to the act of donation. [3],[4],[5],[6],[7] These voices include WHO Guiding Principles and the Declaration of Istanbul, which provide guidance on how to remove such disincentives. The Indian Society of Nephrology and the Indian Society of Organ Transplantation have endorsed the Declaration of Istanbul, and many countries have enacted laws in accordance with these principles...

Read the full article from the Indian Journal of Nephrology here.

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