Organ donation provision on license not yet implemented

Brain Death Donor Central Transplant Coordination Unit of HOTC Dr. Kalpana Shrestha said that even though she repeatedly requested the transport department to arrange organ donation in the license, it was ignored. The attention of the Ministry of Health has also been repeatedly drawn to this matter. But no one has taken it seriously," she said. "Due to accidents, 4-5 people die of brain death every day. There is no need to die prematurely due to organ failure if there is a legal provision for organ donation in the license.

More than 30,000 kidney sufferers are waiting for organ transplants in the country, while 3,000 new patients are added for dialysis every year, according to the data of the Ministry of Health. According to HOTC, if the government agencies address this issue, the kidney disease sufferers will get a new life, and the government's annual expenditure of more than 4 billion rupees on dialysis will be saved.

According to Dr. Rishikumar Kafle, a kidney disease specialist, in developed countries such as the US and the UK, arrangements for organ donation have been made in licenses and passports. He says that if there is a legal system in Nepal that allows organ donation in license and passport, it will be easy to harvest and transplant organs of brain dead people, except for those who disagree that they will not donate organs while they are still alive.

Now, if the organ of a brain-dead person has to be removed, written consent must be obtained from the family of the deceased. However, even if there is a legal provision for organ donation in the license, the consent of the deceased's family must be obtained for harvesting and transplanting brain dead organs. However, HOTC says that if there is a provision in the license itself, the family of the deceased will agree to harvest and transplant organs in the belief that the last wishes of the deceased should be fulfilled, and social service will be provided.

A separate unit to coordinate brain death is yet to be formed amid complaints of delays in voluntary organ donation arrangements in driving licences. Because of this, it is difficult to harvest and transplant the organs of people with brain death even though there is a legal system. At present, there is no coordination unit with the police administration, including the doctors who perform organ harvesting and transplantation, even if the family of the brain dead person gives their consent in writing. In 2072, the Ministry of Health amended the Human Body Organ Transplantation (Regulation and Prohibition) Act 2055 and made a legal provision for the transplantation of brain dead persons, but according to the provision in section 17 (b) of the Act, organ removal, preservation of the removed organs, organs Arrangements have not been made to keep records of patients to be transplanted and to distribute the received organs according to the priority order as specified. Also, there is no clear legal provision as to who will bear the expenses of treating brain dead people, putting them on ventilators, doctors, nurses, etc.

The ministry has not been able to create a 'national waiting list' of organ recipients. In the absence of this, the patient undergoing dialysis has to go to the Human Organ Transplantation Center Bhaktapur and register to receive the brain dead organ. At present, all the organs of a brain-dead person are taken by the Human Organ Transplant Center, so only its patients can receive such an organ transplant. Other hospitals complain that patients from other places do not get it.

However, Shrestha of HOTC says that even after repeatedly drawing the attention of the Ministry of Health to designate a separate coordination unit for organ transplantation of people with brain death, they have been ignored. "Now, the work of the organ transplant monitoring coordination unit has been entrusted to the Human Organ Transplantation Center Bhaktapur. But, we are busy with our own work,'' she said.

Ministry of Health and Population spokesperson Dr. Prakash Budhathoki said that the Dharmabhakta Human Organ Transplantation Center did not take enough care. The Ministry is also aware of the correspondence with the Department of Transportation. However, it has only been a matter of removing weeds by correspondence once," he said. "There are many legal hurdles in this. Fukaon should go together to the Prime Minister's and Cabinet Office, Law, Justice and Parliamentary Affairs, Home Affairs and other ministries. However, the center has not been able to take the initiative.

Ishwaridatta Paneru, the spokesperson of the Transport Management Department, said that they will understand which of the Vehicle and Transport Management Act, 2049 or the Regulations, 2054 should be amended to provide organ donation in the license. "For this, it is necessary to discuss with the relevant ministries such as law, finance, and health," he said. Kafle said that top leaders of political parties should be interested in this. "Political instability is also causing problems," he said, "Due to government neglect, kidney sufferers are forced to die prematurely." Those with brain death can be transplanted with at least 8 organs, including kidneys, liver, lungs, heart, and small intestine. In the 8 years since the law was passed, only 10 kidneys and 2 livers have been transplanted from 5 people. Brain death usually occurs in car accident victims. According to the police head office, 21 thousand people have died in road accidents across the country from 2072/73 to 2080 February.