Organ transplantation in India is saving lives of patients across the globe

How chronic kidney disease leads to kidney failure?

Dialysis is not the cure for kidney failure. The only effective treatment for kidney failure is kidney transplantation. 

The results of organ transplantation in India, including kidney transplantation, are as good as in any other developed country.

Let’s share the experience of one of our patients.

Samuel is a 52-year-old owner of a tour and travel company in Addis Ababa, Ethiopia. He has been running his business for the past 25 years. He has a pretty wife and two kids, both of them studying in the USA.

Samuel’s dream is to become a very successful businessman in his country, and he wanted to have a long vacation in Europe with his wife. 

Samuel was so busy in his business that he compromised his health and worked for hours without caring for his health. He also had the bad habits of smoking and drinking alcohol. One day when he was getting ready for his work, he fainted. His wife Laura called their family doctor for a checkup. The doctor advised Laura to have a full-body health checkup to find out the root cause.  

The next day Samuel went to the hospital to have the checkup done. 

Reports came, and his creatinine level was 6, which indicates severe kidney damage. The doctor suggested him for weekly dialysis and medication. 

After a few years, the decline of kidney function was gradual but continual. His wife, Laura, had seen this decline first-hand, was heartbroken to watch her husband suffer, and was willing to do anything possible to save her life.

One of the most visible signs of Samual’s illness was the swelling of his limbs that affects many patients with kidney disease.

Samuel was getting his dialysis done regularly, but he knew that a kidney transplant was his best option for recovery, as his kidney functioning had reduced at three percent.

His research understood that dialysis was only a supportive therapy for kidney disease symptoms and not a cure for the disease itself. Without a transplant, dialysis must be done a few times each week for life.

To save the life of Samuel both of his sons were willing to donate their kidneys to his father. They both were very informative and brave. They did HLA match testing, and the elder child’s kidney was declared suitable for transplant. 

Samuel’s wife Laura had done very well research on kidney transplantation options in different countries. Her sons checked in the USA, and she also explored India, Thailand, and Singapore. Being an educated family, their concern was to create a perfect balance in the success rate and affordable cost. During that stage, she got in touch with MedicoExperts, and the team helped her to make the right and informed decision. 

They eventually selected India to conduct the transplantation. MedicoExperts patient care executive helped her further to zero down the doctor and hospital as per her budgets and concerns. The family consulted with three doctors, one from Delhi, One from Mumbai, and one from Bangalore, sitting there in Addis. 

After a few weeks of the decision, all the documentation work was done, and she traveled to India with her husband and elder son. 

Samuels got admitted, an evaluation was performed, and finally, the transplant day came after all the paperwork in India. Laura was in a deep panic as her two important family members were being prepared for the surgery. 

She was absolutely relieved listening to the news that the surgery was successful and both his son and husband were fine. Samuel was given anti-rejection injections after the surgery. The doctors and their team took good care and monitored the progress very diligently. 

After three weeks, Samuel got discharged. The doctor had asked him to stay in India for one more month to monitor Samuel’s progress. Laura was very happy with the whole process.

After four months, Samuel was back in his rhythm without any tiredness and weakness. No dialysis anymore.  

There are many case studies of so many patients where families got a second lease of life with skillful surgeries and favorable outcomes. 

Now let’s understand in detail about organ transplants.

Different types of Organ transplantation in India

Different types of transplantations are listed below:

Transplantation of Human Organs Act (THO) passed in 1994, is the primary legislation related to organ donation and transplantation in India. This Act is aimed at regulation of removal, storage, and transplantation of human organs for therapeutic purposes and to prevent commercial dealings in human organs.

The amendment to the Act was passed by the parliament in 2011, and the rules were notified in 2014.

The essence of this legislation are :

• To accept brain death also as a definition of death
• To stop commercial dealing in organs
• To define the first relative (father, mother, brother, sister, son, daughter, and wife) who could donate organs without permission from the government

The main provisions of the Act (including the amendments and rules of 2014) are as follows:

• Brain death is identified as a form of death
• Allows transplantation of human organs and tissues from living donors and cadavers (after cardiac or brain death)
• Regulatory and advisory bodies for monitoring transplantation activity and their constitution defined.
  • Appropriate Authority (AA): Inspects and grants registration to hospitals for transplantation. It enforces required standards for hospitals, conducts regular inspections to examine the quality of transplantations.
  • Advisory Committee: It consists of experts in the domain who shall advise the appropriate authority.
  • Authorization Committee (AC): It regulates living donor transplantation by reviewing each case to ensure that the living donor is not exploited for monetary considerations and to prevent commercial dealings in transplantation. Proceedings are video recorded and decisions are notified within 24 hours. Appeals against their decision may be made to the state or central government.
  • Medical board (Brain Death Committee): It consists of a Panel of doctors responsible for brain death certification. In case of non-availability of neurologist or neurosurgeon, any surgeon, physician, anesthetist, or intensivist, nominated by medical administrator in charge of the hospital may certify brain death.
• Living donors are classified as either near relatives or non-related donors.
  • A near-relative (spouse, children, grandchildren, siblings, parents, and grandparents) needs the permission of the doctor in charge of the transplant center to donate his/her organ.
  • A non-related donor needs the permission of an Authorization Committee established by the state to donate his organs.
• Swap Transplantation: When a near relative living donor is medically incompatible with the recipient, the pair is permitted to do a swap transplant with another related unmatched donor/recipient pair.
• Authorization for organ donation after brain death
  • May be given before death by the person himself/herself or
  • By the person in legal possession of the body. A doctor shall ask the patient or relative of every person admitted to the ICU whether any prior authorization had been made. If not, the patient or his near relative should be made aware of the option to authorize such donation.
  • The authorization process for organ or tissue donation from unclaimed bodies is outlined.
• Organ retrieval is permitted from any hospital with an ICU facility once registered with the appropriate authority. Any hospital having Intensive Care Unit (ICU) facilities along with manpower, infrastructure, and equipment as required to diagnose and maintain the brain-stem dead person and to retrieve and transport organs and tissues including the facility for their temporary storage, can register as a retrieval center.
• The cost of donor management, retrieval, transportation, and preservation is to be borne by the recipient, institution, government, NGO, or society, and not by the donor family.
• Procedure for organ donation in medico-legal cases is defined to avoid jeopardizing determination of the cause of death and delay in retrieval of organs.
• Manpower and Facilities required for registration of a hospital as a transplant center are outlined.
• Infrastructure, equipment requirements and guidelines, and standard operating procedures for tissue banks are outlined.
• Qualifications of transplant surgeons, cornea, and tissue retrieval technicians are defined.
• Appointment of transplant coordinators (with defined qualifications) made mandatory in all transplant centers.
• Non-governmental organizations, registered societies, and trusts working in the field of organ or tissue removal, storage, or transplantation will require registration.
• The central government to establish a National Human Organs and Tissues Removal and Storage Network i.e. NOTTO (National Organ & Tissue Transplant Organisation), ROTTO (Regional Organ & Tissue Transplant Organisation), and SOTTO (State Organ &Tissue Transplant Organisation). The manner of establishing National or Regional or State Human Organs and Tissues Removal and Storage Networks and their functions are clearly stated.
• The central government shall maintain a registry of the donors and recipients of human organs and tissues.
• Penalties for removal of organs without authority, making or receiving payment for supplying human organs, or contravening any other provisions of the Act have been made very stringent in order to serve as a deterrent for such activities.