WHAT IS ORGAN

TRANSPLANTATION?
Organ transplantation is the moving of an organ from
one body to another or from a donor site on the patient's
own body, for the purpose of replacing the recipient's
damaged or absent organ. The emerging field of
regenerative medicine is allowing scientists and
engineers to create organs to be re-grown from the
patient's own cells. Organs and tissues that are
transplanted within the same person's body are called
autografts. Transplants that are performed between two
subjects of the same species are called allografts.
Allografts can either be from a living or from a cadaver.
Organs that can be transplanted are the heart, kidneys,
eyes, liver, lungs, pancreas, intestine, and thymus.
Tissues include bones, tendons (both referred to as
musculoskeletal grafts), cornea, skin, heart valves, and
veins. Worldwide, the kidneys are the most commonly
transplanted organs, followed closely by the liver and
then the heart.

HISTORY IN SHORT
Scientists have long thought about the idea of
replacing a diseased organ with a healthy one
from a donor. The problem at first was that the
human body is not particularly receptive to foreign
tissue. Immune system sees it as a foreign
invader.
Eventually, scientists realized that the problem of
rejection didn't occur when the organ donor and
recipient were identical twins. The genetic
similarity appeared to prevent the immune
response.
Dr. Murray's surgery was a major breakthrough,
but it wasn't a solution. After all, very few people
have an identical twin they can rely on for organ
donation. In the late 1960s, doctors figured out a
way to perform transplants between nonrelatives
by suppressing the recipient's immune response
with drugs like cyclosporine.
By the 1980s, anti-rejection drugs had improved
to the point where transplantation surgery
became pretty routine and far less risky than it
had been a few decades earlier. Survival rates
rose.
An Act to provide for the regulation of removal, storage
and
transplantation of human organs for therapeutic purposes
and for the
prevention of commercial dealings in human organs and
for matters
connected therewith or incidental thereto.
It applies, in the first instance, to the whole of the States of
Goa, Himachal
Pradesh and Maharasthra and to all the Union territories
and it shall also
apply to such other State which adopts this Act by
resolution passed in
that behalf under clause (1) of article 252 of the
Constitution.
THE Transplantation of Human Organs Act, 1994 is meant to "provide for the
regulation of removal, storage, and transplantation of human organs for
therapeutic purposes and for the prevention of commercial dealings in
human organs.

The Central Act illegalizes the buying and selling of human organs and
makes cash-for-kidney transactions a criminal offence

The law establishes an institutional structure to authorize and regulate
human organ transplants and to register and regulate, through regular
checks, hospitals that are permitted to perform transplants.

It recognizes, for the first time in India, the concept of brain-stem death,
paving the way for a cadaver-based kidney transplant programme.




The Act defines two categories of donors. First, it permits a near relative, defined
as a patient's spouse, parents, siblings, and children, to donate a kidney to the
patient. Secondly, live donors who are not near relatives but are willing to donate
kidneys to the due to attachment or any other reasons are permitted to do so,
provided that the transplantations have the approval of the Authorization
Committee, established under the Act.


Section 19 of the Act states: "Whoever (a) makes or receives any payment for the
supply of, or for an offer to supply, any human organ; (c) offers to supply organs for
payment; (d) initiates or negotiates any arrangement involving the making of any
payment for the supply of (e) takes part in the management or control of a body of
persons, whether a society, firm or company, whose activities consist of or include
the initiation or negotiation of any arrangement referred to in clause (d); or (f)
publishes or distributes or causes to be published or distributed any advertisement
shall be punishable with a term of imprisonment ranging from two to seven years or
with a fine not less than Rs.10,000 and not greater than Rs.20,000."

1. To empower Union Territories, specially Government of
NCT of Delhi to have their own appropriate authority
instead of DGHS and / or Additional DG (Hospitals).

2. To make the punishments under the Act harsh and
cognizable for the illegal transplantation activities to
deter the offenders from committing this crime.

3. To provide for registration of the centres for removal of
organs from the cadavers and brain stem dead patients
for harvesting of organs instead of registration of
centres for transplantations only.

4. To allow swap operations between the related donor and
recipients who do not match themselves but match with
other similar donors / recipients.
PROPOSED AMENDMENTS
1. The current age limit of 60-years should be removed for cadaver donors.
Improved health and longer life expectancy means some older people
could be suitable donors, upping the organ donor count to an extra 10 or
12 a year.

2. It has also been proposed that paired matching should be permitted i.e. if
patient A's donor does not match A and likewise for patient B, then donor
switch should be allowed, if it results in a match. Swaps or exchanges
between families unable to fulfill the need of their family member in need
of a transplant due to incompatibility, are known to take place. However,
this is not legal and is mostly done under cover. The proposed
amendment seeks to convert the de facto into de jure, encouraging more
families to swap organs amongst themselves, to be vetted by an
authorization committee.

3. Direct costs should be given to donors for a donation, including indirect
losses like lost earnings and future expenses. The compensation
framework should be in line with international and local ethical
recommendations.

4. Higher penalties should be imposed for deterring organ trading
syndicates and unscrupulous middlemen.


IMPACT OF TRANSPLANTATION
ON PATIENTS
Infections
Attempts to suppress the immune response to avoid graft rejection and GVHD weaken the
ability of the body to combat infectious agents (bacteria, viruses, fungi). More rarely, the
donated organ may be infected and transmit the agent to the recipient. Tuberculosis, rabies,
syphilis, hepatitis B, HIV, and several other diseases have been transmitted in this way.
Potential organ donors are now routinely tested for evidence of infection by HIV, HTLV,
hepatitis B and C (HBV, HBC), human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV)
as well as by Treponema pallidum (syphilis).
Cancer
Suppressing the host's immune responses also increases the risk of cancer. (Evidence
supporting the theory of immune surveillance.)
Hypertension
Hypertension, or high blood pressure, is common immediately after transplant. Certain anti-
rejection medications, as well as the original disease, all can contribute to hypertension.
Shingles
People with weakened immune systems, such as transplant recipients treated with
immunosuppressive drugs, risk developing shingles. Shingles is a painful infection of the
central nervous system caused by the Varicella virus that causes a blistering rash and severe
burning pain, tingling or extreme sensitivity to the skin and is usually limited to one side of the
body.
Diabetes
Some anti-rejection medicines are known to cause high blood sugar. Although it is typically
a temporary condition after transplantation, it is more common in patients who have a family
history of diabetes and patients who are over weight.

INDIAN POSITION
Ethical Issues
The ethics of transplantation can be expressed in three requirements:
1. Medical integrity: Patients and the public must be able to trust their doctors not to
sacrifice the interest of one to that of another. Individual may make that sacrifice, but
not their doctors.
2. Scientific validity: the basic biology and technology must be sufficiently assured to
offer a probability of beneficial outcome, case by case.
3. Consent: Consent based upon information adequately presented, weighted and
understood, and unforced.

Unregulated medicine practice
Medical councils and organizations have played a passive role on ethical issues.
They have failed to make their stand public or take action even in obvious
malpractice. Although the press has been publishing explicit details on rackets in
kidney transplantation in various cities no medical body has thought it fit to even
conduct an investigation into them.

Illegal organ trade
India's slums are a gold mine for organ traders, full of poor people desperate
enough to sell their organs. But with a healthy kidney fetching approximately 30000
rupees, most donors only make enough to pay off their debts -- and end up even
poorer in the long term.




SCANDALS
This is the list of top five countries where organs
are illegally traded and harvested:

Moldova
China
Egypt
Pakistan
India

CONCLUSION
Organ transplantation is linked with organ donation. It is a worldwide
campaign which urges people to donate. According to unos.org ( United
network for organ sharing) the number of donors in January-July 2011
were 8132, transplants in the same period was 16,416 and as per
yesterday the waiting list of patients who require organ transplants has
112,309 people on it.

When a person in your family, relative, friends expire.. all you need to do
is call the donor bank, and they come to your place, take 5 minutes time,
issue a certificate, and two people get eyesight... how difficult is that???
Please keep the telephone number of your city handy.

Call Toll Free number across India for any information on organ donation
or to donate organ at: 1919

THANK YOU

ANURAG KHUNGER
ARJUN KRISHNAN
HEER KHANT
KRITI KRISHNAN
SAACHI KANJANI