All cases of organ transplants, whether from a living or deceased donor, will be allocated a unique National Organ and Tissue Transplant Organisation (NOTTO)-ID for both the donor and the recipient. It must be generated by the hospital from the NOTTO website (www.notto.mohfw.gov.in). The Union Health Ministry has issued the directive to eliminate commercial dealing in organs, especially those involving foreign citizens.
The latest order, issued to all States and Union Territories, comes following reports of malpractice and a surge in the number of organ transplants related to foreigners in the country, the Ministry said. It has also called for stricter monitoring of such transplants by the local authorities.
In its communication earlier this month, the Ministry had said that the Appropriate Authority of the State, appointed according to the Transplantation of Human Organs and Tissues Act (THOTA), 1994 should investigate transplants in respect of foreign nationals in the State, apart from any complaint concerning the breach of any provision or rule of the Act, with appropriate action to be taken whenever such violations come to light.
“NOTTO-ID is mandatory for considering allocation of organs in case of deceased donor transplant, this ID in case of a living donor transplant, shall also be generated at the earliest, maximum within 48 hours after the transplant surgery is done,’‘ the communication said.
The Ministry has also called for devising a system of regular inspection of the registered hospital for transplant/ retrieval by the appropriate State authority, and to monitor them onsite on the quality of transplantation, post operative follow-up of the donor and recipient, and outcomes.
Any violation of the THOTA, 1994 and its rules have to be probed, and appropriate action includes the suspension of registration for performing organ transplants if hospitals are involved in illegal activities.
“Time and again, letters have been written to states for sharing of data related to organ donation and transplantation with NOTTO. However, complete data is still not being received. It is again requested to ensure regular collection and sharing of data of all transplant cases, including those of foreigners with NOTTO monthly,” the Ministry said.
Meanwhile, according to the provisions of THOTA, in the case of a foreign national, prior approval of the authorisation committee is required before removing or transplanting organ or tissue or both. When the proposed donor or the recipient is a foreigner, a senior embassy official of the country of origin has to certify the relationship between the donor and the recipient in accordance with Form 21 of THOTA, and in case a country does not have an embassy in India, the certificate of relationship, in the same format, should be issued by the government of that country.
The laws also have provision for verifying the authenticity of the documents of the donor and recipient by senior embassy officials. The authorisation committee and senior embassy official are also required to assess and certify that the donation of the organ was made out of love and affection; there was no financial transaction between the recipient and donor; and there was no pressure or coercion on the donor, the Ministry had maintained in its response to a question raised in Parliament earlier this year by MP Mala Roy on the donations of kidneys in private hospitals.
