9.4k patients kept in the lurch as organ donations in state hospitals remain low
Since 2009, just 80 deceased donors have given 62 livers, 19 hearts, two lungs, one small bowel, and one skin donation at state-run hospitals, according to data from the Regional cum State Organ and Tissue Transplant Organisation (ROTTO-SOTTO).
Only a few government institutions, including Mumbai's JJ, KEM, Sion, and Nair hospitals, Pune's Sassoon Hospital, and AIIMS Nagpur, have retrieved organs over this period.
While awareness has been increasing among donors, a hesitation remains among them. However, organ donors would be more willing to donate if appropriate facilities were available, said Dr S K Mathur, a ZTCC president. In Mumbai, the KEM hospital in Parel is equipped to conduct a multi-organ cadaver transplant. Meanwhile, Sion and Nair hospitals primarily focus on cadaver kidney transplants, according to the ZTCC (Zonal Transplant Coordination Centre) Mumbai.
'The government hospitals have not established high-quality surgical and transplant centres in the vicinity, which has led to the low organ donations we observe,' said Dr Mathur. 'The hospitals have not upgraded the facilities and seem not to be interested in doing so. When a donor agrees to any form of donation, they want to understand where the organs might go. Without a functional transplant centre, it is not possible for the hospital staff to assure the donors.'
Dr Mathur also added that current organ donations only meet the requirements of 10% of patients in Maharashtra, and government hospitals focusing on donations would drastically help save this.
In stark contrast, private hospitals recorded 101 donors in 2022, leading to 290 organ retrievals, compared to just four donors and eight retrievals in government hospitals in the same year.
The gap continued in 2023, with private hospitals reporting 138 donors and 381 organ retrievals, while government hospitals had 10 donors and 30 retrievals. In 2024, private hospitals recorded 142 donors and 416 retrievals, whereas government facilities had 30 donors and 42 retrievals.
ZTCC does not allow retrieved organs to be utilised by private hospitals to avoid poaching. Yet this year, until August 12, the state has recorded 33 cadaver donations, a majority of which were from private hospitals.
Even with a recent uptick in organ donations from government facilities, experts warn that the numbers remain far from adequate to meet patient needs. The waiting list for transplants in Maharashtra has swollen from 8,240 patients last year to 9,423 this year, including 7,271 in need of kidneys and 1,883 requiring livers.
'We have now formed a panel to review the methods, the rules and process of how to conduct organ donation after circulatory death. That will help the condition drastically,' said Dr Mathur.
Despite regular efforts from the government and ZTCC, donation rates are still minimal. Dr Ajay Bhandarwar, dean of JJ hospital, said, 'The patient load and the family's unwillingness to donate organs often lead to a reduced number of donations in government hospitals. There is enough equipment, and a transplant coordinator is already present. However, many people who come to the hospital fail to get convinced of organ donation due to a few beliefs.'
The state public health department has stepped up efforts and is carrying out an organ donation fortnight in the state from August 3 to August 15, with a range of awareness drives and outreach activities. The drives are aimed at dispelling fear and misconceptions around organ donations. The department had also issued directives to state government hospitals to promote and develop organ retrieval capabilities.
'Private hospitals have transplant coordinators and mechanisms in place for brain-stem death donations. However, many government hospitals lack that. We need to start transplant mechanisms as such in government hospitals to increase donations,' said Dr Pradnya Bendre, Professor and Head of the Department of Paediatric Surgery and Division of Solid Organ Transplantation, Wadia Hospital. 'It is a long process to increase awareness, and it must be done regularly. Well-established transplant departments and ICUs are trained in brain stem death certification. Government hospitals need to be developed at par with corporate hospitals.'
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