Interview with NOTTO director Dr. Rajneesh Sahai
By Dr. Smriti Sharma Bhatia,
Associate Professor, Miranda House, University of Delhi
smriti.sharma@mirandahouse.ac.in
National Organ and Tissue Transplant Organization (NOTTO) is a national level organization set up under Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. Dadhichi Deh Daan Samiti (DDDS) had the privilege of interacting with the director of Dr. Rajneesh Sahai, Director, NOTTO and discuss about the status of organ and body donation in India.
Dr. Rajneesh Sahai
Completed MBBS (Gold medal in Eye ENT & Silver medal in Medicine) from UCMS Safdarjung Hospital in 1982, after doing post-graduation in Ophthalmology from SJH joined Central Health Service in 1986 & after a brief stint in RML Hospital Delhi was posted in Safdarjung Hospital in 1988, worked in Eye Department till 2019 when was appointed as Additional MS Safdarjung Hospital & was appointed Director NOTTO in 2021.
Dr. Sahai’s enthusiasm is contagious as one hears him talk passionately about organ transplantation and its need and scope in India. Here are some excerpts of his Interview with Dr. Smriti Sharma Bhatia from DDDS.
Sir, first of all I must congratulate you on the great work that NOTTO is doing under your leadership. What is your motivation in this field?
That is indeed very kind of you to say that. The motivation is the smile on the countless patients who get their life back after organ donation.
Sir, what are the challenges in organ donation from Indian perspective?
Main Challenges are lack of awareness, misconceptions, feud among family members and social criticism. The deceased donor donation rate in India is 0.34 per million, which is appallingly low compared to the developed countries. People believe that body should be properly cremated and last rites should be given respect. Superstitions such as being born with a missing organ that has been donated and that tinkering with the body will not free their dead relatives from the cycle of life-death-rebirth create a negative attitude towards organ donation. The next challenge is the lack of awareness among general public regarding organ donation. Unfortunately, there is lack of an adequate number of transplant centers and not enough transplant coordinators who are themselves well versed with the laws and procedures of organ and body donation. People are more open to eye donation but not that receptive to organ and body donation.
How does India compare to other countries in terms of organ donation.
More than two lakh Indians require organ transplantation annually. However, less than 10% are able to get this timely help. Although the number of organ donors and transplantations in India have increased significantly over the last decade, it is not sufficient. Organ donation immediately after the heart stops beating can help increase the organ pool. 36 persons per million of population donated organs in Spain in 2014, 35 donated in Croatia, 27.02 donated in the United States, and only 0.34 donated in India. With a 1 per million-donation rate, India would have 1320 organ donors or 2640 kidneys, 1320 hearts, 1320 livers, 1320 pancreas and 2640 eyes. This should take care of almost all current demands for organs. At a 2 per million-donation rate these figures would double.
That brings us to our most important question as to what can be done to improve the low rate of organ donation in India.
First of all, awareness and sensitization are very important. Government should support campaigns to educate people about benefits of organ donation. Care should be taken to clear all myths and misconceptions about organ donation in general public. We can also make use of mediums like advertising in TV, print, radio, social media, celebrity endorsements, theater & street plays, events to promote organ donation (marathons, concerts etc.) and awareness drives at schools, colleges, corporate offices, clubs etc.
Sir, now some technical questions:
What organs and Tissues can be donated?
The major donor organs and tissues are the heart, lungs, liver, pancreas, kidneys, eyes, heart valves, skin, bones, bone marrow, connective tissues, middle ear, and blood vessels. Therefore, one donor can possibly give gift of life to many terminally ill patients who would not survive otherwise.
How is brain death diagnosed?
It is done by independent advice of a team of doctors whose qualification and experience well defined and mandated by law. Doctors carry out a set of tests to confirm brain death.
How quickly should the organs be donated?
Healthy organs should be transplanted as soon as possible after brain death from the donor to the recipient.
Who can be a Donor?
Anyone, regardless of age, race, or gender can become an organ and tissue donor. Medical suitability for donation is determined at the time of death.
What would be your final message to public?
“Live after death by donating your organs”