Govt redefines ‘near relatives’ to make availability of organs easier

The amendment also allows the live organ donation from first cousins having common grandparent(s) and their spouses. Also, the amendment includes live organ donation from both maternal and paternal uncles and aunts of the recipient and their spouses

Soon step-father, step-mother, step-daughter or step-son and their spouses can also donate kidney and liver as the Ministry of Health and Family Welfare is set to expand the definition of ‘near relatives’ in the Transplantation of Human Organs and Tissues Act, 1994.

In a circular issued by the Ministry on August 21, it said the decision to expand the definition of ‘near relatives’ was felt due to increased incidents of organ trading. It attributed the rise in organ trading to mismatch between the supply and demand of organs.

The ministry had earlier amended the Act, 2011 and included grandfather, grandmother, grandson or granddaughter in the definition of ‘near relatives’. With the latest circular, it plans to expand the term further to increase the availability of living donors in India.

Interestingly, this time, the Ministry has also included brothers and sisters of the recipient and their spouses, brothers and sisters of the recipient’s parents and their spouses and first cousins [having common grandparent(s)] of the recipient and their spouses.

“It is a very positive step to ease out living donor transplants in India. The family structure in India is very different from that in western countries. The people included in the latest circular on definition of ‘near relatives’ actually reflects the family structure in our country,” said Dr Ravi Mohanka, Liver Transplant Surgeon at Global Hospital and visiting surgeon at KEM hospital, Mumbai.

Transplant surgeons said many of the recipients struggled to get a living donor for transplant while following the earlier definition of ‘near relatives’ and had to send request to the Directorate of Medical Education and Research (DMER) for considering other family members as live donors. “This took long time for the recipient to get a non-objection certificate. The latest circular will ease of the clearance process and benefit the patient,” said Dr Shrirang Bichu, Nephrologist at Bombay hospital.

As per the Union Health Ministry, in India, around 500,000 people die every year because of non-availability of organs. While 200,000 people die due to liver disease, as many as 150,000 people await a kidney transplant, but only about 5,000 get them in a year.

Dr Bipin Vibhute, liver transplant surgeon from Sahyadri hospital in Pune, said, “For liver transplant, there is no need to get Human Lymphocyte Antigen (HLA) matching which is otherwise necessary in the case of Kidneys. HLA matching is found in blood relatives and so as the new expansion includes step relatives it may increase Kidney transplants, but will definitely have a great impact for liver transplant as more donors would be available. With the expanded definition, the pool of available donors will increase and it is definitely a welcome initiative.”

Dr Ninad Deshmukh, multiple organ transplant surgeon from Deenanath Mangeshkar hospital in Pune also welcomed the initiative. “If more and more suitable organ donors are made available no one would opt for illegal methods and curb the menace of organ trading too,” said Dr Deshmukh.

 The ministry has invited opinion of people on the amendment of the said Act e-mail to [email protected] preferably by 25th September, 2017

As per the latest circular, following are the people included in the definition of ‘near relatives’:

  1. Step father, step mother
  2. Step brother, step sister, step son, step daughter and their spouses
  3. Spouses of sons and daughters of recipient
  4. Brothers and sisters of recipient’s spouse and their spouses
  5. Brothers and sisters of recipient’s parents and their spouses
  6. First cousins [having common grandparent(s)] of the recipient and their spouses