Organ donation has less uptake in India, when compared to western nations. Covid-19 pandemic raging over the last 18 months, has further dwindled down the number of organ donations, say health experts.
August 13 is observed as World Organ Donation Day every year to motivate people to pledge organ donation after death and to spread awareness and eliminate myths and fears regarding organ donation.
During Covid pandemic lockdowns, fear of infection, and lack of awareness compounded the reduction in organ donation chances, the experts said.
"The number of organ donations in our country has been very low in comparison to the western countries. Furthermore, there is a significant drop since the start of the pandemic, the reason being Covid recovered patients cannot donate immediately after recovering. Too much focus on Covid and the lack of awareness on organ donation are also the reason why this number has dropped significantly," Vishwanath S, HOD and Consultant - Nephrology, Transplant Physician, Manipal Hospitals, Bengaluru.
There are two ways to donate organs: a living donor -- a healthy person who donates one of a pair of organs such as the kidney or part of an organ such as the liver; and/or through Cadaveric donation -- when you harvest organs (heart, lungs, kidneys, liver, pancreas) from brain dead people, as well as tissue donation, meaning taking tissues (skin, corneas, tendons, bone) from brain dead as well as those whose heart has stopped, but in that case it has to be done with limited time period.
A single cadaveric donor can give life to about six-nine recipients (two kidneys, liver, heart, lungs, pancreas, intestine, eyes and tissues).
"Due to Covid-induced lockdowns and reduced traffic on the roads, accidents with consequent head injury and brain death related organ donors have reduced. On the other hand, even the recipients are unable to travel to transplant centres due to intra and interstate travel restrictions," Mukul Rastogi, Additional Director-Hepatology, Fortis Noida.
"There is also an apprehension regarding Covid status and potential transmission from deceased donors to recipients and healthcare providers. Similarly, there is a risk of recipients, live donors and the healthcare team inadvertently transmitting Covid to each other," he added.
However, the doctors suggest that it is safe to donate after two-three months of Covid recovery. A complete vaccination before the process can make it safer, protecting both the donor and the recipient from the future infection of Covid. Even if they develop Covid, it will be very mild.
"After the Covid pandemic, doctors have been extra cautious in the procedures of organ donation. It is safe to donate once you recover from Covid. Post-Covid, we assess whether there is any Covid-related involvement of the organs. If any person wants to donate organs post-recovery, we evaluate them completely. In cases when lungs are needed to be donated, we ensure there are no residual problems before donation," Vishwanath said.
Moreover, with the availability of accurate tests (RT -PCR and antibody) for Covid with a rapid turnaround time (4-6 hours), it is possible to determine whether transplant can be safely performed, the doctors said.
In India, every year almost 3.5 lakh people need some form of organ transplant but less than 11,000 transplants are carried out. The overall organ donation rate in India is quite low at around 0.52 per million population, compared with 36.07 donors per million in the US.
The Cardiology Society of India reveals that over 50,000 patients need heart transplantation in a year but less than 250 actually get one.
As per the Indian Society of Organ Transplantation, of the 21,395 kidneys transplanted in India between 1971 and 2015, only 783 were from cadaveric donors. Out of more than 50,000 people who need liver transplant, only 2,000 procedures are being done, according to Indian Society of Gastroenterology.
"Organ donation in India needs to pick up the pace to match the humongous gap that is existing between patients who need organs and organ availability. As critical illnesses are on the rise, harvesting organs from deceased bodies and making it accessible to the one who needs should be the priority," D. Nageshwar Reddy, Chairman, AIG Hospitals, in Hyderabad.