The National Organ and Tissue Transplant Organization (NOTTO) is taking significant steps to address gender disparity and encourage organ donation in India. In a recent advisory issued to states and Union Territories, NOTTO has recommended prioritizing women and near relatives of deceased donors in organ allocation. This move aims to create a fairer and more transparent organ donation and transplantation process.

Addressing Gender Imbalance

Studies have revealed that women, despite often being significant organ donors, receive fewer transplants than men. To rectify this imbalance, NOTTO is advocating for additional points to be added to the allocation criteria for women on waiting lists for deceased donor organs. Dr. Anil Kumar, director of NOTTO, emphasized that women are equally vulnerable to end-stage organ failure and should have equal access to transplants. Dr. H. Jauhari, chairperson of renal transplants at Sir Ganga Ram Hospital in New Delhi, supports this initiative, noting that women predominantly donate organs in live-organ transplants but are underrepresented as recipients.

Honoring Deceased Donors and Their Families

NOTTO also suggests prioritizing near relatives of deceased donors who require organ transplants. This provision acknowledges and honors the selfless act of organ donation. Furthermore, the advisory calls for dignified funerals and public felicitation of deceased donors and their families to recognize their contribution.

Revised Allocation Criteria and Transparency

The existing organ allocation system considers factors such as disease duration, waiting time, illness severity, and compatibility factors like blood group and size. NOTTO mandates a unique ID for every organ donor and recipient to ensure transparency. Transplant centers must submit data to a national digital registry, with non-compliance potentially leading to legal action under the Transplantation of Human Organs and Tissues Act, 1994.

Infrastructure and Training Enhancements

To improve organ retrieval and transplantation, NOTTO urges states to establish permanent posts for transplant coordinators in hospitals. It also recommends developing organ retrieval facilities in trauma centers and medical colleges. Training for emergency responders and ambulance staff is emphasized to identify potential deceased donors early.

Public Awareness and Participation

NOTTO launched an Aadhaar-based online pledge system in 2023, resulting in over 330,000 citizens pledging to donate their organs. In 2024, India achieved a record of over 18,900 organ transplants, a significant increase from fewer than 5,000 transplants in 2013.

Legal and Ethical Framework

The Transplantation of Human Organs and Tissues Act (THOTA), 1994, governs organ donation in India. NOTTO's advisory strengthens enforcement and stresses equity and dignity in the transplant process. The policy aims to balance medical urgency with social justice, ensuring organs reach those most in need while reducing bias.

Despite progress, a gap remains between the demand for and availability of organs. It is crucial to increase awareness and encourage more people to pledge their organs to save lives.