Chronic Kidney Disease is a result of poor health upkeep and can demand very high health care cost. Older adults with diabetes, hypertension, heart disease and stroke, all are at a higher risk with a fear of death and disability. In acute cases, transplantations are usually the way to go.
Organ transplantations are one of the greatest advancements of medical technology. Transplantations have improved the lives of many people worldwide and increased longevity. Kidney transplantations are among the highest transplantations that are undertaken.
Since the last 45 years, the kidney transplantation program in India has evolved tremendously. In fact, it is second only to the USA. Transplantation from deceased donation has become possible since 1995. Successful kidney transplantations offer the best quality of life to the receiver.
There are more people coming forward to donate their kidneys, thus making a great example of human resilience and solidarity.
However, the difference between the demand and supply of organs is a major cause of concern. Organ shortage has now become a major issue globally. This is mainly because the deceased donation is the major means of acquiring kidneys for transplantation and as longevity has increased, the supply has automatically gone down.
According to a study, the total number of deaths due to road accidents in India in 2013 was 1,37,572. This contributed to about 1.1% of the total deaths in the world. In more than half the cases, death has been due to head injury. The kidneys can be procured for transplantation in such cases. Even if 5-10% of these people signed up for organ donation, the supply would meet the demand. However, there are a number of challenges that come in the picture before we can achieve this goal of matching demand with supply.
Challenges faced for Kidney Transplantation
Studies show that the deceased donor donation rate in India is around 0.34 per million. This is very low as compared to the organ donation rate in other countries. Many cultural and religious beliefs prevalent in India that influence the decision of organ donation significantly. There is also a lack of awareness among the majority of the population regarding donation. In fact, 80.1% of people do not donate due to lack of awareness, 63.4% of the population avoids donation and transplantation due to religious beliefs and superstitions, and 40.3% lack faith in the Indian healthcare system.
Lack of effective communication is one of the major concerns in India behind such a low rate of kidney donations. An educated donor should ideally spread the knowledge about ‘brain death’ and other things related to kidney donation to his relatives and colleagues. Lack of such communication means that most people remain unaware of the benefits other people would reap from their donation.
There are other roadblocks like lack of trained staff and medical amenities in rural areas that make it very difficult for the majority of the population to access proper medical treatment in case of transplantations. Negative propagation by the media is another major obstacle. Many donors are put off seeing negative news about kidney donations. All these factors contribute to a very low supply.
The Silver Lining
Though there are many obstacles, the Government of India has undertaken efforts to facilitate the donor-to-transplant procedure. Private-public partnerships with the help of transplant coordinators have made the process very easy. The kidney-donation rates all over India have steadily risen over the last few years due to this. MOHAN (Multi-Organ Harvesting and Networking) is an NGO that has been ceaselessly working in this field since 1997. It also started the Indian Network for Organ Sharing (INOS) in 2000 that centralized the entire system of kidney sharing.
Transplant coordinators are also appointed at every health center that performs transplantations. They help in counseling families regarding kidney donations. They try to get consent for organ donations and coordinate the entire process of the donation and transplantation.
NOTTO (National Organ and Tissue Transplant Organization) is a national level organization set up the Directorate General of Health Services, Ministry of Health and Family Welfare. The National Human Organ and Tissue Removal and Storage Network is a subdivision of this organization. NOTTO acts are the central point of contact for all activities related to coordination and networking, procurement and distribution, maintaining the registry of organs and ensuring safe and fast transportation and transplantation of harvested organs.
Green corridors (where a vehicle carrying an organ for transplantation is not stopped) and tissue banks (where kidneys and other organs are stored in cryogenic conditions) are being developed to make transplantations easier.
While still low, the rate of kidney transplantation in India is rising steadily. Thanks to the efforts of the government and NGOs that help spread awareness on this topic, more people are coming forward to donate their kidneys. We can only hope to see the day that sees the demand matching the supply.
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