Govt invites public opinion on crucial national kidney transplant registry

In a first, the union ministry of health and family has come up with draft guidelines for those suffering from renal ailments. The draft states that those requiring transplant on an urgent basis can get priority over less critical cases in the waiting list.

The National Organ and Tissue Transplant Organisation (NOTTO) under the ministry of health and family welfare has issued the draft guidelines for the 'Allocation Criteria for Deceased Donor Kidney Transplant'.

Organ transplant has two sources — a living donor and a deceased donor. In case of a living donor, s/he is already decided for a specific recipient. With respect to a deceased donor, the recipient needs to be selected from large recipient's pool. The allocation of organ is a complex process, influenced by a number of factors including medical urgency and donor/recipient matching.

Through this draft, the government is taking a major step towards easing rules and procedures to encourage organ donation among the masses. The draft has been posted on www.notto.nic.in and comments/suggestions/views have been invited to fine-tune the guidelines. These may be sent to the director, NOTTO, at dir@notto.nic.in by January 16.

According to the Organ Retrieval Banking Organisation, there is a huge gap between demand and supply of human organs and tissues. In India, 1-1.5 lakh patients require kidney transplantation but only 3,500-4,000 get it. Similarly, 1 lakh patients are in need of corneal transplantation but only 25,000 undergo it. In case of heart transplantation, the scenario is much more dismal in our country.

To get the deceased donor kidney, a patient is required to be registered by the hospital concerned through an online registration form on NOTTO. A kidney advisory committee will approve registration and urgency criteria, if any.

The process will also identify if an individual is in need of a renal transplant, once the need is approved only then will a patient be put on the active list in the system. The scoring and allocation of priority for the patient will be done based on the approved guidelines. The draft guidelines also lists out various parameters under which scoring will be done for each patient.

Another important aspect listed out in the draft guidelines is that a patient should be not more than 65 years old to become eligible for the transplant. The guidelines also recommend that a patient be put on dialysis for a minimum period of three months before being considered for the transplant list. It also indicates that patients who do not have access to dialysis should be given priority on the list.

"This is a very good move by union government, that before finalizing the guidelines they are seeking public opinion including health experts. Because allocation of kidney on priority is a very complex procedure hence there is a real need for standard rules across the country," said, Dr Jayesh Lele, President, Indian Medical Association, Maharashtra.

Certain facts for End Stage Renal Disease (ESRD)
There is always a disparity between number of recipients requiring kidney transplant and the deceased organs available for kidney transplantation.
Some patients need kidney transplant on priority basis because of their medical condition, as delay in transplant may lead to mortality.
For ESRD, maintenance dialysis is an acceptable and reasonably good alternate therapy which means for majority of ESRD patients, renal transplant is not an emergency procedure.