Posted on: 04/01/2016


Cadaver kidney donation now online?


Cadaver kidney donation

Priority on Cadaver donation for Patients Of Urgent Renal Transplant
In a move to bring in greater transparency and tackle the illegal kidney trade while prioritising those in urgent need of renal transplant, the Centre has come out with draft guidelines that aim to determine criteria for receiving a kidney from a cadaver donor. As per proposed norms, patients requiring a kidney transplant will be registered centrally by the hospital through an online process. The registration will be approved by a kidney advisory committee after evaluating the need for renal transplant. Once approved, patients will be put on “active” or “priority list” based on specific guidelines.

At present, kidney donation is a legal maze and the big demand-supply gap drives a black market. Estimates by Organ Retrieval Banking Organisation (ORBO), which functions under All India Institute of Medical Sciences, says 1-1.5 lakh patients require kidney transplants in India, whereas only 3,5004,000 patients receive it. How ever, experts say these estimates are much lower than the real demand because a lot of cases are either not diagnosed or not registered on time.

The National Organ and Tissue Transplant Organisation (NOTTO), under the aegis of health ministry, will maintain the registry of patients requiring a transplant.

The draft guidelines, issued by the health ministry on January 1 seeking public comments within a fortnight, also stated that allocation will be done first based on city waiting list. "If no recipient eligible in city waiting list then allocation will be done to state and then to other states in the ROTTO (Regional Organ and Tissue Transplant Organization) and then to other ROTTO nationally," the draft said.

Though some states like Tamil Nadu had already constituted such committees, kidney donation from cadaver is largely unregulated across the country. So far, there were no central guidelines to monitor such donations.

The latest move is aimed at putting in place set parameters for kidney allocation across the country to rule out illegal trade and transplants involving the organ. "This initiative reflects our commitment to promote organ donation in the country. We will finalise these guidelines after we receive various suggestions and comments on these draft guidelines. Once finalised, these guidelines will go a long way in promoting organ donation in the country," health minister J P Nadda said. The draft guidelines suggested that patients should be of up to 65 years of age to be eligible for transplant. It recommended patients to go for maintenance dialysis wherever possible and be on the same for more than three months on regular basis before being considered for transplant.

The criteria proposed for urgent listing of a patient for receiving a kidney also include patients who no longer have dialysis access and thus cannot be maintained on dialysis. Besides, patients with end stage renal disease who are unlikely to get a donor with a negative cross-match will also be considered for the priority status. Patients requiring multiorgan transplant will also get priority.

The guidelines mandate review of the priority or urgent list every three months by the state transplant advisory committees.

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