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Friday, Aug 17, 2007
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Organ transplants: committee liberal in clearing applications

Alladi Jayasri

Only 25 out of 436 cases were rejected between 2002 and now

BANGALORE: The five-member Authorisation Committee that clears unrelated renal transplants in the State under the Transplantation of Human Organs Act, 1994 does not seem to learn. Despite the flak that this body received after the two major kidney scams of 1994 and 2002, it has continued to be liberal in approving applications for transplants. From 2002 to July 2007, 436 cases came before it and the number of rejections was only 25.

Year-wise details of the number of applications seeking permission for donation of a kidney by a non-relative, received by the Authorisation Committee, are available with The Hindu and the picture that emerges is of a rising graph o f both applications and approvals, from 2002.

It is, therefore, not surprising that “kidney agents” are emboldened to continue with fabrication of documents and creation of false identities of donors to facilitate renal transplants. They continue to tout organ donation as a means for the poor “donors” to buy their release from debt traps, says H. Sudarshan, former Chairman of the Task Force on Health and former Vigilance Director (Health) in the Lokayukta.

Dr. Sudarshan, who now represents the non-governmental organisations on the committee, has always advocated effective implementation of the Act. The Act says that unrelated transplants should be the exception and not the rule.

What the law says

Under the Act, only transplants between near relatives (defined clearly in the Act) are permitted, and all unrelated transplants have to come before the committee for approval. An interesting feature of the data available with this newspaper is the categorisation of cases into “relative” and “unrelative” (sic).

Here “relative” probably implies a distant relation, a category that does not find mention in the Act. This re-wording has allowed the committee to be liberal in clearing such applications.

For instance, of the 80 cases taken up in 2007, all the 27 “relative” cases were approved, while four of the 30 “unrelative” cases were rejected. There were four cases of withdrawal or cancellation, and 18 are pending.

In 2006, 102 cases were received. Of the 40 cases under the “relative” category, there were 39 approvals and a solitary rejection. The “unrelative” cases were 52, and they were all approved. Five cases were withdrawn or cancelled, and three were pending, carried over to the current year.

In 2002, the committee received only 47 cases as it was that year that a scam came to light, when it was found that in Holalu village in Mandya district 36 villagers sold their kidneys, and a Corps of Detectives inquiry was ordered. Eighteen of these 47 were “relative” donors, and there was not a single rejection, while in the unrelated category, 11 out of 17 were rejected, and one was cancelled.

When these statistics are considered along with the year-wise number of renal transplants (related transplants that do not come before the committee and the number of unrelated transplants) from 2004 to May 2007, it is clear that 30 per cent of the live renal transplants are unrelated.

The number of renal transplants (related and unrelated) for the past four years are: 2004 - 221; 2005 - 220; 2006 - 149; 2007 (up to May) - 89. Sources, however, declined to give the number of unrelated transplants approved by the committee.

The Authorisation Committee is headed by the Law Secretary, who is its Chairman. Apart from the City Police Commissioner or his representative, the Health Commissioner, and a Director from the Health Department, a nephrologist (or urologist) and a non-governmental member make up the five-member committee.

G.K. Venkatesh, director of the Nephro-Urology Institute in the Victoria Hospital Campus, who is in the committee, advocates restraint in granting approvals for unrelated transplants.

He and Dr. Sudarshan are in the Zonal Coordination Committee of Karnataka for Transplantation (ZCCK) set up by the Government in 2005 to facilitate cadaver organ transplants.

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