New Delhi, September 3
Hospital authorisation committees screening applications for organ donations from live donors can at best reject applications on detecting claims of false kinship. They are not authorised to take any punitive action.

Medical experts feel that detection and rejection in such cases is not enough. Letting off donors who furnish false affidavits purely for commercial gains encourages them to approach other patients in dire need of kidney, heart or liver, with the result that the racket in trade of human organs continues to flourish.

India’s dubious distinction in organising or negotiating for organs is proving to be embarrassing for transplant specialists. They have begun to get organ trade enquiries from overseas on e-mail.

Major-General (retd) B.M. Aiyanna, Director, Medical Services, Indraprastha Apollo Hospital, and a member of the hospital authorisation committee, says the absence of any mechanism to take punitive action is a “loophole.”

The head of the multi-organ transplant unit and chairman, Board of Management, Ganga Ram Hospital, Dr S.K. Sama, says that the best authorisation committees can be fooled by donor recipients coming together.

Surgical gastroenterologist and liver transplant surgeon at Ganga Ram Hospital, Dr Subhash Gupta, says about 4,000 persons are awaiting kidney transplants in the UK. “The core issue is that persons in the UK come to India for kidney transplant and go back to avail themselves of free post-transplant care.”

Dr Gupta says recent reports alleging involvement of two Indian doctors in the illegal organ trade is bound to affect the practice of Indian doctors.

The head of the liver transplant unit at Indraprastha Apollo Hospital and Human Organ Procurement and Education (HOPE) trustee, Dr M.R. Rajasekhar, says unlike other states like Tamil Nadu, no central body clears such applications in the national capital. An organ transplant unit is required to seek permission of the Director General, Health Services, to start transplant legally. They are then asked to submit to the DGHS names of five persons who have nothing to do with transplant or anaesthesia.

“Government guidelines have a lot of ambiguities. The only role of the committee is to make sure that there is no commercial transaction between an unrelated donor and the recipient. It is a tough task for the committee to make a judgement as they have to go by circumstantial evidence. Doctors are confronted with a moral dilemma — on the one hand you have a pleading patient who needs a transplant, and on the other, a donor who may be giving his organ for money. In the last one month, I have got mail from Austria, Europe and South Africa in the last one month, inquiring the price a kidney donor will demand. I have written back to them, saying that sale of organs is unlawful in India.”

Dr Rajasekhar says organ donations should be encouraged from first-degree relatives. “The Transplantation of Human Organ Act, 1994, should be amended and unrelated donors should be banned even if they have an emotional link with the recipients. The government should spend money to spread awareness to encourage cadaver donations. One lakh persons in India need a kidney transplant every year but only 5000 get it. On a national scale, 60 per cent kidney donations are from unrelated donors and 40 per cent from related donors.”

Dr Anupam Sibal, senior pediatric liver specialist at the Indraprastha Apollo Hospital, is of the view that cadaver donations should be encouraged. “About 2,000 persons die on Delhi roads every year, of which at least 200 may be live donors.”

Commenting on the recent reports indicating complicity of two UK-based Indian doctors in trade of human organs, Dr Sibal says, “It is a very sad reflection of the medical community in our country.”

Asked if this will affect the credibility of Indian doctors in the UK, he says, “There are rotten apples in every basket.”