Organ transplantation in the Indian state of Tamil Nadu is regulated by India's Transplantation of Human Organs Act, 1994 and is facilitated by the Transplant Authority of Tamil Nadu (TRANSTAN) of the Government of Tamil Nadu and several NGOs. Tamil Nadu ranks first in India in deceased organ donation rate at 1.8 per million population, which is seven times higher than the national average. [1]
Tamil Nadu made brain death certification mandatory in 2008, becoming the first Indian state to do so. The move improved the odds of deceased organ donations in the state. It was also the first state to create "green corridors" to quickly transport donated organs to its destined hospital. [2] Between 2008 and 2019, after restraining organ trade with new regulations, the state has recorded 7,783 organ transplants. Non-profit organisations such as MOHAN Foundation have also played a major part in the domain of organ transplantation.
After facing a kidney donation scandal in 2007, the Government of Tamil Nadu took measures to promote deceased donor organ transplants in Tamil Nadu, to curb illegal trade of organs. [3] [4] It started the Tamil Nadu Cadaver Transplant Program (CTP) on 16 September 2008, [5] conducted workshops to build awareness among the medical society in the state, and also collected feedback on the process of allocating organ donations for patients. [6]
Another major stimulus for organ transplantation awareness in the state is said to be a particular incident in 2008 in which the physician parents of a 15-year-old motorcycle accident victim, donated their son's organs. [3] On 20 September 2008, the youth named Hithendran had a motorcycle accident. [7] He sustained several injuries and was declared brain dead after being admitted to Apollo Hospital in Teynampet. After not finding any improvement in his condition for three days, his parents decided to donate his organs. [8]
Hithendran's functioning organs, including heart, liver, kidney, corneas and bone marrow, were donated. [7] A 9-year-old from Bangalore in need of heart was found in the city's Frontier Lifeline Hospital in Mogappair. The heart was harvested in a record time of 11 minutes. [9] The surgeons, state, and city police coordinated to transport the heart swiftly. With traffic cleared and signals turned green, the 45-minute journey took only 11 minutes for the ambulance. [7] [8] [9] After a successful transplant, the recipient of the heart lived for a year post-transplant. [10] At least seven other people benefited from Hithendran's organ donations. [9]
This generated widespread attention and support for deceased organ donation in the state. [6] People began to enquire about organ donation and brain death more after the incident, which became known as the 'Hithendran Effect'. [8] A memorial service for Hithendran was arranged at the Raj Bhavan afterwards by the governor, Surjit Singh Barnala. [9] A street in his hometown, Thirukalukumdram, was also named after him. [8] [11]
Abbreviation | TRANSTAN |
---|---|
Formation | 2014 |
Type | Government agency |
Purpose | Organ transplantation |
Headquarters | Tamil Nadu Government Multi Super Speciality Hospital |
Location | |
Parent organization | Department of Health and Family Welfare, Government of Tamil Nadu |
Website | transtan |
The Transplant Authority of Tamil Nadu was formed by the government on 12 December 2014 under the chairmanship of the chief minister of Tamil Nadu. This authority consists of 21 members, including the Minister for Health and Family Welfare and Minister of Finance. An executive committee manages the functions of the agency. The committee comprises the principal secretary to the Government of Tamil Nadu, Department of Health and Family Welfare. [12] TRANSTAN coordinates the transplant activities and also overlooks the CTP. [13] The government also took steps to coordinate with non-profit organisations and private and public hospitals. [6]
Tamil Nadu made certification of brain death mandatory, becoming the first Indian state to do so. [3] It also established clear procedures on declaration of brain death and enlarged the panel of members who could certify brain death. [14] This was considered a major measure as it enhances the chances of deceased organ donations. The state authority has created a centralised waiting list system to ensure proper allocation of donor organs. [6]
The state has also created green corridors, routes that are cleared out for an ambulance carrying harvested organs to ensure their delivery at the destination in the shortest time possible. [2] [15] For this, the hospitals involved in a transplantation, city traffic authorities, and in certain cases airport authorities, collaborate to transport an organ from one hospital to the other. [2] [16] The first use of a green corridor took place in July 2014, when a hospital and police coordinated to transport a heart from one hospital to another in half the usual time in Chennai. [2] [17]
The state also made it mandatory for hospitals conducting transplants to register with the state. To ensure that every available organ is utilised, guidelines for non-transplant centres were set. [3] According to the member secretary of TRANSTAN, R Kanthimathy, only Tamil Nadu uses "skin, tissues, kidney, liver and heart, among others for transplant, while most others states focus on heart and kidneys". [18] Sunil Shroff of MOHAN Foundation had said that their NGO used to work with six to eight hospitals on organ transplants. But after the government coordination, this number went up to 30. [3]
In 2019, TRANSTAN compiled post-transplant data of patients for the past ten years which outlined patient health and survival rates. [19] However, this data has not been made public. [20]
On 25 March 2020, organ transplants across the state were halted due to the coronavirus pandemic in Tamil Nadu. [21]
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India, with a population of more than one billion, lags far behind western nations like Spain, United States, and United Kingdom in national deceased organ donation, with a rate of 0.34 per million population. Tamil Nadu has a deceased organ donation rate of 1.8 per million population, which is seven times higher than the national average. [1]
Between 2008 and 2013, more than 2,000 transplants were recorded in Tamil Nadu, the highest in the country at the time. [23] From 2018 to 2016, the state transplanted 4,938 organs from 887 donors. [6] By 2019, this number went up to 7,783 organs. [19] Most of these were kidney transplants.
The state suffered a dip in number of organ donations received in 2018, reportedly due to a controversy over preference given to foreign patients. Organ donations dropped from 185 in 2016 to 160 in 2017 and 140 in 2018. [24] In 2019, the state recorded 128 deceased donors. [19]
The state has been awarded the 'Best State Award' in cadaver organ donation from the National Organ and Tissue Transplant Organisation, for five consecutive years (2015–19). [25]
Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient.
Rajiv Gandhi Government General Hospital is a major state-owned hospital situated in Chennai, India. The hospital is funded and managed by the state government of Tamil Nadu. Founded in 1664 by the British East India Company, it is the first modern hospital in India. In the 19th century, the Madras Medical College joined it. As of 2018, the hospital receives an average of 12,000 outpatients every day.
Organ transplantation in China has taken place since the 1960s, and is one of the largest organ transplant programmes in the world, peaking at over 13,000 liver and kidney transplants a year in 2004. Involuntary organ harvesting is illegal under Chinese law; though, under a 1984 regulation, it became legal to remove organs from executed criminals with the prior consent of the criminal or permission of relatives. Growing concerns about possible ethical abuses arising from coerced consent and corruption led medical groups and human rights organizations, by the 1990s, to condemn the practice. These concerns resurfaced in 2001, when a Chinese asylum-seeking doctor testified that he had taken part in organ extraction operations.
Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.
Certain fundamental Jewish law questions arise in issues of organ donation. Donation of an organ from a living person to save another's life, where the donor's health will not appreciably suffer, is permitted and encouraged in Jewish law. Donation of an organ from a dead person is equally permitted for the same purpose: to save a life. This simple statement of the issue belies, however, the complexity of defining death in Jewish law. Thus, although there are side issues regarding mutilation of the body etc., the primary issue that prevents organ donation from the dead amongst Jews, in many cases, is the definition of death, simply because to take a life-sustaining organ from a person who was still alive would be murder.
Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.
Organ transplantation in Israel has historically been low compared to other Western countries due to a common belief that organ donation is prohibited under Jewish law. This changed with the passage of new organ donation laws in 2008. If two patients have the same medical need, priority will now go to the patient who has signed an organ donor card, or whose family members have donated an organ. This policy was nicknamed don't give, don't get. The law also defines "brain death" as an indication of death for all legal purposes, including organ donation. Additionally the law provides financial reimbursement to living donors for medical expenses due to donation and lost time at work. Organ trafficking is explicitly banned. Health insurance plans can no longer reimburse patients who go abroad to receive transplants.
Healthcare in Chennai is provided by both government-run and private hospitals. Chennai attracts about 45 percent of health tourists from abroad arriving in the country and 30 to 40 percent of domestic health tourists. The city has been termed India's health capital. Multi- and super-specialty hospitals across the city bring in an estimated 150 international patients every day. Factors behind the tourists' inflow in the city include low costs, little to no waiting period, and facilities offered at the speciality hospitals in the city.
MOHAN Foundation is a not-for-profit, registered non-government charity organisation in India that works in the field of deceased organ donation and transplantation. MOHAN is an acronym for Multi Organ Harvesting Aid Network. It has offices in Chennai, Hyderabad, Bengaluru, Delhi, Mumbai, Chandigarh, Nagpur, Jaipur and information centers at Kerala and Imphal.
Sunil Shroff is the managing trustee of a non-government and non-profit organisation called MOHAN Foundation and is well known for his work in the field of deceased donation transplantation in India. He has worked towards improving the deceased organ donation rate in India.
Transplant coordinator is a healthcare professional – doctor, nurse, or allied health science graduate – who coordinates activities related to organ donation and transplantation. Transplant coordinators can either be Donor Coordinators or Recipient Coordinators.
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Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.
BC Transplant Society (BCTS) founded in 1985 is now an agency of Provincial Health Services Authority (PHSA) in the Canadian province of British Columbia that registers consent to be donors of organs for Organ transplantation.
The Trillium Gift of Life Network was an agency of the Government of Ontario responsible for the province's organ donation strategy, promotion, and supply. Ronnie Gavsie was the President & CEO. The agency maintained the popular BeADonor.ca website. It was subsequently subsumed under Ontario Health in 2019.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.
Sri Ramakrishna Hospital is a 1000-bedded multi-specialty hospital located in Coimbatore, Tamil Nadu. The hospital was started in 1975. Sri Ramakrishna Hospital was established and is run by the SNR Sons Tru,swhichat was founded ir 1970 by Mr. R. Doraiswamy Naidu (RD) and Sevaratna Dr. R. Venkatesalu, sons of Si. S.N. Rangasamy Naidu. The trust successfully runs 15 organizations that catrs to the social causes of socie,ty primarily focusing on Health Careeducation,on ans Service.