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11 April 2009
By Jinal Shah,
Mumbai, India

Doctors overseeing organ transplants across the state have found a worrisome detail: a large number of kidney transplants in Maharashtra where the donor is not a relative of the patient involve donation of the organ by a wife’s parent or sibling.

“We have got about 32 to 40 cases a year where male patients have a parent–in–law or a brother–in–law or sister–in–law as donor,” said Dr Pravin Shinghare who heads the state–level authorisation committee for organ transplants. The committee must give its nod to all transplants where the donor is not an immediate relative.

“This amounts to 40 to 50 per cent of cases where the donor is not a relative,” Shinghare said. He added that in most such cases, recipients bring certificates to the committee to prove that their biological parents are medically unfit to donate.

Every year, Maharashtra sees 150 to 175 live kidney transplants, and approximately 80 of these involve donors who are unrelated to the patient. The state authorization committee is entrusted the task of finding the motive behind the transplant. While women’s rights groups said it is alarming if the numbers were accurate, the authorization committee says this is simply an observation, for now.

Doctors began to see how common such a practice is when a recent suggestion from the Maharashtra committee on amendments to the Transplantation of Human Organs Act (THOA), 1994, was turned down by the Centre. The suggestion had been to include uncles and aunts in the list of “Near relatives” who could be donors. Currently, near relatives – mother, father, brother, sister, spouse, son and daughter – can directly donate organs at the hospital level without having to approach the authorization committee.

The suggestion was rejected since experts felt it could expose the wife’s family to undue pressure for donating an organ to a recipient in the groom’s family.

However many nephrologists in the city think otherwise. “There are many in–laws who are altruistic donors. Also, Indian families are very closely knit. Some percentage of undue pressure should not stop the state from widening the ambit of near relatives to uncles and aunts and even to in–laws with altruistic intentions,” said Dr Umesh Khanna consultant nephrologists at Asian Heart Institute and chairman of the Mumbai Kidney Foundation. This would help reduce the instances of commercial transplants, he added.

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