Lok Sabha Question No. 4267 (UNSTARRED), answered on 2024-12-20
Subject: Gap in Demand and Supply of Organs  for Transplants
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Chamala Kiran Kumar Reddy

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 4267 TO BE ANSWERED ON 20 TH DECEMBER, 2024

## GAPIN DEMAND AND SUPPLYOF ORGANS FOR TRANSPLANTS

## 4267. SHRI CHAMALAKIRAN KUMAR REDDY:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the steps taken/proposed to be taken by the Government to address the demand-supply gap in organ transplants in the country particularly for critical organs like kidneys and livers and the massive discrepancies in States such as Tamil Nadu, State-wise;
- (b) whether there are plans to incorporate successful strategies from States like Tamil Nadu which have higher organ donation rates into the national organ donation program and if so, the details thereof, State/UT-wise; and
- (c) whether the Government is considering an opt-out system in organ donation of the deceased and if so, the associated timeline, anticipated challenges and strategies to address ethical and cultural concerns?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

- (a) & (b) It is primarily the responsibility of the States/UTs to address the demandsupply gap in organ transplants.

However, the Government of India has enacted The Transplantation of Human Organs and Tissues Act (THOTA), 1994 (as amended in the year 2011), and notified The Transplantation of Human Organs and Tissues Rules in 2014. The aforementioned Act and Rules have the following provisions to augment organ donations in the country:

- Registration of Retrieval-only Centers;
- Expansion of the definition of near relative to include grandparents and grandchildren;
- Mandatory provision of transplant coordinators in hospitals performing organ transplantation/retrieval;
- Mandatory request for organ donation from potential donors admitted in Intensive Care Units;
- Permitting certification of brain stem death by anesthetists/intensivists if neurosurgeons/neurologists are not available;
- Eye/Cornea retrieval permitted by trained technicians;
- Allowing the exchange of biologically incompatible near-relative donors.

In pursuance of the mandate given to the Central Government under THOTA, a three-tiered structure of networking organizations has been established. This structure includes the National Organ and Tissue Transplant Organization (NOTTO) at the national level, Regional Organ and Tissue Transplant Organizations (ROTTOs) at the regional level, and State Organ and Tissue Transplant Organizations (SOTTOs) at the state level, which provides an efficient and organized system of organ and tissue procurement from deceased donors and their allocation to waiting recipients. So far, NOTTO has been set up at New Delhi, with 5 ROTTOs established in Chandigarh, Mumbai, Chennai, Kolkata, and Guwahati, and 21 SOTTOs in various States/UTs. More than 900 institutions and hospitals performing organ/tissue transplantation, organ retrieval, and tissue banking are linked with this network. NOTTO also maintains a national registry of organ recipients and donors.

NOTTO follows a consultative process involving all States and UTs including states with higher donation rates (such as Telangana, Tamil Nadu, Karnataka, Gujarat, Maharashtra), various organizations, including non-governmental organizations, professional societies, and other stakeholders. The best practices and successful strategies are adopted and included for drafting and issuing policies and guidelines to ensure uniform implementation across the country. However, it is within the ambit of the States/UTs to adopt and implement the NOTTO policies and guidelines, as available on the NOTTO website.

The Government of India is implementing the National Organ Transplant program (NOTP), which aims to improve access to organ transplantation for needy citizens. Under NOTP, grants are provided to States/UTs for the establishment of ROTTOs/SOTTOs, augmentation of infrastructure in public sector such as Organ Transplant/Retrieval Centers/Tissue Banks, hiring of Transplant Coordinators by Medical Colleges and Trauma Centers, maintenance of deceased donors, organ transport, post-transplant immune-suppressant medicines, awareness initiatives, training and capacity building programs etc. ;

A website (www.notto.mohfw.gov.in) is operational along with a 24x7 call center with a toll free helpline number (1800114770) to provide information, tele-counseling and to help in coordination for organ donation. NOTTO, ROTTOs, SOTTOs and institutions carry out activities across the country for generating awareness, such as celebration of Indian Organ Donation Day annually, seminars, webinars, workshops, debates, sports events, walkathons, marathons, nukkad natak, legal symposium, NOTTO Scientific Dialogue etc. ;

(c) At present, there is no proposal in the Ministry of Health & Family Welfare for the introduction of an opt-out system in organ donation.

*****