Hyderabad: The Telangana Transplantation of Human Organs Act, 1995, which regulates the commercialisation of human organs for transplantation, imposes strict limitations on the availability of organs from living donors, contributing to recent transplant fraud cases, such as the Alakananda Hospital scandal.
Following the enactment of the Transplantation of Human Organs Act, 1994, by the Centre, undivided Andhra Pradesh adopted it in 1995, and Telangana continued with the same legislation after its formation.
Unlike several other states, Telangana has not yet incorporated key amendments introduced by the Centre to the Act in 2011 and 2014. These amendments would make it easier for living donors to provide organs while also increasing private hospitals’ responsibility in facilitating cadaver donations for the govt’s common organ pool. Currently, under this Act in Telangana, only spouses, siblings, and children within the same family are permitted to be living donors.
A major amendment in 2014, which Telangana has not adopted, introduced family swapping among living donors. Previously, organ exchange between families was not permitted, leaving incompatible recipients reliant on cadaveric organs, often facing years-long waiting periods. The 2014 amendment allows a donor from one family, whose organ is incompatible with their relative, to donate to a recipient in another family. In return, a donor from that second family provides an organ to the original recipient.
Currently, private hospitals are subject to oversight in live donor transplants. However, many bypass regulations by conducting unregistered transplants, offering financial incentives to non-family members to donate. This loophole led to the Alakananda kidney racket, where unrelated donors provided kidneys to recipients, sources revealed.
Gujarat has successfully implemented a family-swapping system involving multiple families in a structured sequence. For instance, if family A donates an organ to family B but lacks a suitable donor in return, family B passes the donation forward to family C until a match is found, ensuring family A eventually receives a suitable organ.
Existing regulations in the state also prevent younger grandparents from donating organs to their grandchildren. In families where early marriages occur, these grandparents could donate organs to their grandchildren, who, in turn, might later donate to them. Expanding family-based exchanges could increase organ availability and reduce the prevalence of unregistered transplants from non-family donors, according to sources.
In 2011, the Centre mandated that private hospitals appoint organ transplant coordinators to promote cadaver donations and contribute to the common pool. “Although the state govt considered implementing these amendments last year, they ultimately decided against it. It is time to bring these reforms forward,” a doctor said.
