State witnesses steady decline in number of organ donations, donors

Although awareness on organ donation has increased over the years in Tamil Nadu with 11,500 pledged organ donors available in the state, the number of organ donations has been steadily declining.

While 2016 saw 1,065 organ donations, in 2017, the number came down to 943. It further fell to 924 in 2018. By June this year, only 450 organs were donated across the state.

Not just organ donations, even the number of organ donors too has declined over the past four years. There were about 185 organ donors in 2016, and it fell to 160 in 2017 and to 137 in 2018. By June this year, only 66 donors donated organs. As of now, more than 5,513 patients await organ transplants.

Despite recording the highest number of organ donations in the country — the medical fraternity is worried about the declining numbers and blame it mostly on misinformation.

While awareness on kidney donation and a few other organs has improved over the years, skin donation, hand donation, back bone and disc tissue donation, bones and abdominal flaps are yet to take off in the Tamil Nadu. So far, only two hand transplants, 124 skin transplants, two blood vessel donations, 26 back bone and disc tissue donations, 41 bone donations and two abdominal flap donations have been performed in the state.

According to doctors, the lack of awareness and religious beliefs continue to refrain families of the dead to donate organs. Dr Rama Devi, chief of plastic surgery department at Stanley Medical College, said, “There are traditional beliefs that bodies should be buried or cremated and not amputated. It is easier for the family of the deceased to agree for donation of internal organs, but it is difficult to convince them for skin, hand and bones donation.”

As per the TRANSTAN data, as on June 18 this year, there are about 11,586 pledged donors, but the waiting list remains long with a total of 5,513 single registrations. The authorities at TRANSTAN had recently removed multiple registries of the same person with similar names and different hospitals. Sources claimed that there 1,800 such entries that were dropped off. The waiting list, however, remains long and organ donation rate is yet to match the demand of organs in the state.

On condition of anonymity, a senior official from TRANSTAN said that the issues regarding non-transparency in the allotment of organs remain one of the responsible factors for lower organ donation numbers. There is, however, a need to strengthen the organ donation and transplantation programme, he said.

Frequent news reports of kidney rackets and the controversy surrounding foreign patients being given the priority for cadaver donations has led to mistrust among the people, say doctors. Statistics reveal an increase in the total number of donations for international patients over the last few years. There were only 10 donations for international patients in 2014 which increased to 12 in 2015. It then saw a steep rise in 2016 as the donations for international patients that year stood at 39 and rose further to 52 in 2017. Thirty-four organs were donated to international patients in 2018. Sunil Shroff, the founder of Mohan Foundation which maintains organ donation registry in Tamil Nadu, said, “There have been cases where pledged donors withdrew their consent after they came to know about the controversy surrounding organ donation to foreigners. TRANSTAN needs to initiate more programmes to promote organ donations in the state.”

Of the total number of hospitals approved for organ transplants, several of them do not get their approval renewed. For kidney transplants, there are 104 hospitals in the approved list for organ transplants. But, the approval of 26 hospitals has either expired or they do not perform transplants anymore even as there are 5,020 patients in the waiting list for kidney transplants. State health department officials say that hospitals need to apply for renewal of the approval after it expires.

Meanwhile, Tamil Nadu has seen an increase in the number of dead bodies that are given up for donation. Families of the dead have been volunteering to donate the body for the benefit of those awaiting transplants. While there were only 417 cadaver organ donations in 2014, it increased to 519 in 2015 and to 648 in 2016. The numbers increased further to 673 in 2017 and to 700 in 2018. There are, however, only 18 registered hospitals in Tamil Nadu that accept cadaver donations in the state.

Uma Maheswari, the director of Tamil Nadu Health Systems Project, said, “With an increase in the number of emergency care units in the state, the accident victims are attended to immediately. If the person is declared dead, the family can be approached easily at the centres for cadaver donations.”

When contacted, the TRANSTAN member secretary Dr R Kanthimathy said that the number of pledged donors has been on the rise as more people have been becoming aware about the concept. “TRANSTAN will initiate more number of awareness programmes and ensure transparency in the system. The organ donation programme in the state will be intensified if the need arises to improve the waitlist registry,” she added.