Despite Ban, Organs Still Sold in India
By Sanjay Kumar
Originally published by Reuters Health, March 9, 2001
NEW DELHI (Reuters Health) — Despite 1994 legislation banning the sale of human organs, organ sales still continue, albeit surreptitiously, experts at a special meeting organized by the Indian Society for Histocompatibility and Immunogenetics said.
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 wealthy from around the world.
A residential colony of largely poor people in Madras in south India called Villivakkam became infamous as 'Kidneyvakkam' because almost every house had a resident who had sold his or her kidney for money.
The 1994 legislation was aimed to change the thriving organs bazaar. It legally recognized brain death for the first time so that the organs of the brain dead could be used for transplants. It stipulated the procedure to be followed for retrieval, donation and transplant of organs, including that the transplant donors be largely limited to relatives of people needing transplants.
"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, at the meeting.
Nundy cited the examples where people who spoke different languages and came from different states were 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 which allow them recognizing their emotional closeness,'' Dr. Sandeep Guleria, a professor at the All India Institute of Medical Sciences (AIIMS), told Reuters Health.
Meanwhile, a lack of acceptance of the concept of brain death means organs from dead donors are still in short supply. ''We get 89,000 new chronic renal failure patients every year in India and only 3,000 transplants are done,'' Guleria said.
"Out of all the renal transplants done in India currently, only 30% are from relatives whereas 64% are from unrelated 'donors,''' Guleria pointed out. "Only a miniscule 6% transplants'' come from donors classified as brain dead, he said.
"We have failed miserably in educating and motivating the society after passing the Act,'' D. S. C. Dash, head of nephrology at AIIMS, told Reuters Health.
"The medical staff is predominantly ignorant about brain death,'' Guleria told the meeting. "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.''
