India organ donation: The Union Health Ministry has asked states and Union territories to step up deceased organ and tissue donation by training first responders, creating dedicated hospital teams, and upgrading trauma facilities for organ retrieval.
In a letter to state health authorities, Dr Anil Kumar, Director of the National Organ and Tissue Transplant Organization (NOTTO), flagged India’s persistently low deceased donation rate, under one donor per million, and a widening gap between patients waiting for transplants and available organs. He noted that thousands die each year while on waiting lists.
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Citing the Ministry of Road Transport and Highways’ report “Road Accidents in India 2023,” the letter points out that about 1.7 lakh people were killed in road crashes last year; many of them young and otherwise healthy, representing a large pool of potential donors who are often missed due to delayed identification and referral.
Training first responders
States have been asked to conduct state- and district-level training for police personnel, ambulance drivers, emergency medical technicians and other paramedical staff. The aim is to help first responders recognise possible donors, ensure timely communication with transplant coordinators, and enable rapid transfer to designated trauma or organ retrieval centres.
NOTTO has suggested that Regional and State Organ and Tissue Transplant Organisations (ROTTOs/SOTTOs), in coordination with state governments, run these programmes and embed basic modules on organ donation, brain-stem death identification, counselling and consent, and standard operating procedures for referrals. State ambulance services, including 108, 102 and private operators, should be directed to ensure staff participation.
Hospital preparedness
The ministry has also called for strengthening trauma centres with infrastructure and manpower required for organ harvesting, and for registering these facilities as organ retrieval centres under the Transplantation of Human Organs and Tissues Act, 1994 and its rules. Mechanisms should be put in place for seamless information flow from first responders to transplant coordinators at nearby trauma centres, medical colleges or hospitals.
While the priority remains saving the lives of accident victims, the letter reiterates that organ donation may be considered in certified brain-stem death cases following due procedure.
Push for tissue and bone donation
In a separate communication, NOTTO urged states and UTs to expand efforts beyond organs to tissues, such as corneas, skin, bones and heart valves, highlighting a substantial unmet need. India requires nearly one lakh corneas annually, but only about a third of that demand is being met.
Hospitals have been asked to constitute organ and tissue donation teams, including brain-stem death committee members and transplant coordinators, set up mandatory notification of all in-hospital deaths (ICU, wards and emergency), and ensure timely counselling of families. Even where organ donation is declined, families should be offered the option of tissue donation. Tissues can typically be retrieved within six to ten hours after death, the letter notes, and facilities should establish links with registered tissue banks for retrieval, processing and storage.
NOTTO said that improving first responder training, streamlining referrals and strengthening hospital systems can significantly increase deceased organ and tissue donation, transforming outcomes for patients awaiting transplants.
