This document summarizes the legal framework for human organ transplantation in India. It discusses the key acts and amendments related to transplantation, including the Transplantation of Human Organs Act of 1994 and its subsequent amendments. It provides an overview of the regulatory bodies, types of donors, requirements for hospital registration, and priorities for recipient allocation. It also discusses some of the issues and challenges in the field as well as achievements of the National Organ Transplant Programme in improving access and awareness.
The transplantation of human organs and tissue act 1994(TOHOTA)Dr. FAIZ AHMAD
This Act was enacted for the
Regulation of removal , storage and transplantation of human organs
for therapeutic purposes only
F or the prevention of commercial dealings in human organs.
Transplantation of Human Organ and Tissues law in IndiaIra Gupta
One comprehensive law in India relating to regulating the removal and transplantation of human organs and tissues and for preventing commercial dealings in organs and tissues by providing punishment for such dealings.
The transplantation of human organs and tissue act 1994(TOHOTA)Dr. FAIZ AHMAD
This Act was enacted for the
Regulation of removal , storage and transplantation of human organs
for therapeutic purposes only
F or the prevention of commercial dealings in human organs.
Transplantation of Human Organ and Tissues law in IndiaIra Gupta
One comprehensive law in India relating to regulating the removal and transplantation of human organs and tissues and for preventing commercial dealings in organs and tissues by providing punishment for such dealings.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Duties and obligations of a Doctor as per Medical council of Inida (MCI) / State medical council (SMC), Moral & Legal responsibility of a Doctor, MCI Ethics Regulations 2002 (including amendments), Duties towards patients, Duties towards Public, Duties towards another Doctor, Duties towards Law, Duties towards society, Rights & Privileges of a Doctor in India.
HUMAN ORGAN TRANSPLANT:
Organ transplantation is often the only treatment for end state organ failure, such as liver and heart failure. Although end stage renal disease patients can be treated through other renal replacement therapies, kidney transplantation is generally accepted as the best treatment both for quality of life and cost effectiveness. Kidney transplantation is by far the most frequently carried out transplantation globally.
The legislation called the Transplantation of Human Organ Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. Broadly, the act accepted brain death as a form of death and made the sale of organs a punishable offence. With the acceptance of brain death, it became possible to not only undertake kidney transplantations but also start other solid organ transplants like liver, heart, lungs, and pancreas.
This is a presentation regarding the most salient features of PCPNDT act, India (formerly known as PNDT act). It is made for undergraduate medical students (MBBS). Hope it will help you in your examinations.
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
This presentation shall help you get insights of Basic documents like Birth Certificate and Death Certificate. For any assistance do contact Galaxy4u Legal Consulting Pune
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Duties and obligations of a Doctor as per Medical council of Inida (MCI) / State medical council (SMC), Moral & Legal responsibility of a Doctor, MCI Ethics Regulations 2002 (including amendments), Duties towards patients, Duties towards Public, Duties towards another Doctor, Duties towards Law, Duties towards society, Rights & Privileges of a Doctor in India.
HUMAN ORGAN TRANSPLANT:
Organ transplantation is often the only treatment for end state organ failure, such as liver and heart failure. Although end stage renal disease patients can be treated through other renal replacement therapies, kidney transplantation is generally accepted as the best treatment both for quality of life and cost effectiveness. Kidney transplantation is by far the most frequently carried out transplantation globally.
The legislation called the Transplantation of Human Organ Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. Broadly, the act accepted brain death as a form of death and made the sale of organs a punishable offence. With the acceptance of brain death, it became possible to not only undertake kidney transplantations but also start other solid organ transplants like liver, heart, lungs, and pancreas.
This is a presentation regarding the most salient features of PCPNDT act, India (formerly known as PNDT act). It is made for undergraduate medical students (MBBS). Hope it will help you in your examinations.
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
This presentation shall help you get insights of Basic documents like Birth Certificate and Death Certificate. For any assistance do contact Galaxy4u Legal Consulting Pune
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
contains details about what organs can be donated,who and how it can be done,policies and rules in about organ donation in india, what are the myths about donating organs, how many people are in need of organs(some statistics) and some private organizations working towards encouraging organ donation
Background of organ transplant infrastructure in the US. Some history. Definitions. Nursing Care of the transplant patient in hospital, and home settings. Intended for senior level nursing students in an ADN program
Organ transplant related laws in Pakistan ethical issue related transplant organ and tissue
Transplantation of Human Organs and Tissues Ordinance 2007”
“Transplantation of Human Organs and Tissues Act,2010”.
Donation of human organs or tissues after death
: Donation of organ or tissue by a living person
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
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Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
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Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
2. Transplant – Legal Framework in India
• 1983: The Kidney Transplantation Act – Maharashtra
• 1991: The Singhvi Committee – Brain Death
• 1994: Transplantation of Human Organs Act
• 1995: Transplantation of Human Organs Rules
• 2008: Transplantation of Human Organs (Amendment) Rules
• 2011: Transplantation of Human Organs (Amendment) Act
• 2014: Transplantation of Human Organs & Tissues Rules
• 2015: National Organ & Tissue Transplant Registry launched
3. THE TRANSPLANTATION OF HUMAN ORGANS
ACT, 1994 [THOA]
• Aim –
– regulation of removal, storage, and transplantation of human organs
for therapeutic purposes
– prevention of commercial dealings in human organs
• Major Problem
– Brainstem death not recognized by the Indian law
– Rampant Trade of human organs, esp. Kidney
• Based on the report of the Singhvi Committee 1991
– Conceptualized the legal framework of brain-death
– Methodized legal utilization of organs for transplantation
4. • Authorization in written by ≥18yr with two witnesses of
whom one must be near relative.
• Board of four Medical-experts to certify Brain-death
– RMP in-charge of the concerned hospital
– A member of a panel approved by the Appropriate Authority
– A Neurologist / Neurosurgeon
– The Attending Physician
• Live donor Transplant
– Near relative – Spouse or 1st degree relatives
– Approval from Authorization Committee for all except near relative
• Cadaveric donor – consent of near relative
5. Major Changes in 2011 Amendement
THOTA
• Tissues included along with the Organs.
• Near relative definition expanded to include grandchildren, &
grandparents.
• Retrieval Centre registration for retrieval of organs from
deceased donors.
• Tissue Banks also to be registered.
• Swap Donation included.
• Mandatory inquiry from the attendants of potential donors.
6. • Mandatory “Transplant Coordinator” in all the hospitals
registered under this act.
• Higher Penalties for trading in organs.
• Brain death certification board expansion – to include
Physicians, Surgeons, Anesthetists or Intensivists.
• National human organs & tissues removal & storage Network
and National Registry for Transplant are to be established.
7. • Advisory committee to aid and advise Appropriate Authority.
• Enucleation of corneas permitted by a trained technician.
• Greater caution in case of minors and foreign nationals
• prohibition of organ donation from mentally challenged.
8.
9. Regulatory Bodies
• Advisory committee – To assisst appropriate authority
– administrative expert (Secretary to the State Govt.) – Chairperson
– Two PG medical experts with ≥5y experience in transplant
• State-level Authorization Committee –
– CMO of major Govt. Hospt. – Chairperson
– Two senior RMP’s not part of any transplant team
– Secretary of health or nominee & Director health services or nominee
– Two senior persons of high integrity, credibility, & social standing
• Hospital Authorization committee –
– Hospitals which do >25 transplants per year.
10. Types of Donors
Living Donors
1. Near-related donors – Evidence of relation to be attached.
2. Swap donation –
– Donor & Recipient pair of each family should be near related.
– Donation should be simultaneous to there is no donor reneging.
3. Other than near-related donors –
– Possibility of monetary transaction.
– Permission granted by authorization committee after evaluation –
• Link between donor & recipient with documentary evidence.
• No e/o Financial transaction / Middleman / drug-addict donor.
11. • Foreign donors – all cases dealt by authorization committee
– Indian donor & Foreign recipient and vice –versa – only near relative
– Foreign donor & recipient – confirmation from embassy
Deceased Donors
• consent of near-relative or person in lawful possession of the
body required.
• mandatory to enquire of pledged organs or option to donate.
• MLC – acceptable but ensure that, determination of the cause
of death is not jeopardized
12. Priority of Recipient
1. No suitable near-relative living donor
2. Suitable near-relative donor refused in writing
3. Suitable donor did not officially refuse.
4. Allocation in following order
1) State List
2) Regional List
3) National List
4) Person of Indian origin
5) Foreigner
13. Hospital Registration
• 24hr availability of –
– Medical, Surgical & Nursing staff
– ICU units with equipments & staff
– Operation theater, Blood-bank, & Laboratory services
– HLA lab
– Experts of specialties
• Expertise in each organ transplant clearly defined
• maintenance of minimum standards of hospital as per the
Clinical Establishment Act 2010.
• Valid for 5 years
14.
15. NOTP: National Organ Transplant Programme
• Implemented by DGHS, MOHFW, GOI to enforce THOTA-2011
• Aim – improve access to transplantation by promoting
deceased organ donation
• Objectives –
– Organize a system of Organ and Tissue procurement & distribution.
– Promote deceased Organ and Tissue donation.
– Train required manpower.
– Protect vulnerable poor from organ-trafficking.
– Monitor transplant services and bring policy changes as needed.
16. Issues and Challenges
• High Demand versus Supply gap.
• Poor Infrastructure esp. in Govt. Sector Hospitals.
• Lack of Awareness of concept of Brain Stem Death.
• Poor rate of Brain Stem Death Certification by Hospitals.
• Poor Awareness and attitude towards organ donation.
• Lack of Organized systems for organ procurement.
• Maintenance of Standards in Transplantation, Retrieval and Tissue
Banking
• Prevention and Control of Organ trading
• High Cost (especially for uninsured and poor patients)
• Regulation of Non- Govt. Sector
17. NOTP achievements
• National Organ and Tissue Transplant Organization (NOTTO)
– Establishment of an apex national level organization – NOTTO.
– Functional website (www.notto.nic.in) & helpline number 1800114770.
– Policy for Organ allocation in case of kidney – finalized and approved.
– SOPs for Brain-dead Donor maintenance & Organ retrieval developed.
• Online system of registry and networking
– Online and offline organ donation pledging operationalized.
– Online registration & networking of Transplant hospitals
– National collection of transplant data
18. • Regional Networking centres
– Regional Organ and Tissue Transplant Organizations (ROTTO) – 5
– State Organ and Tissue Transplant Organizations (SOTTO)
• Awareness
– Hon’ble PM highlighted the importance of organ donation in the Mann
Ki Baat Programme Nov. 2015.
– Indian Organ Donation Day – annually since 2010 (Nov 30 – 2019)
– National Organ & Tissue Transplant Registry (NOTTR) – 27 Nov 2015
– IEC activities.
19. • Trainings
– Transplant Coordinator training programmes
– Post Doctoral certificate course in Dialysis Medicine through IGNOU
• Financial assistance
– 100 BPL transplant recipients/y – Rs.6000/m for immunosuppressants
– maintenance Rs.50000/ per deceased donor in a private hospital when
organ is allocated to a Govt. institution.
– providing transplant coordinators at Govt. Medical Colleges, Trauma
Centers and good performing Private Institutions.
21. National Organ and Tissue Transplant
Organization (NOTTO)
• National level organization set up under the aegis of NOTP
• Located at Safdarjung Hospital New Delhi
• It has two divisions –
– National Human Organ and Tissue Removal and Storage Network –
apex centre for All India activities of coordination and networking for
procurement & distribution of Organs & Tissues and Registry of
Donations & Transplantations.
– National Biomaterial Centre (National Tissue Bank) – National level
Tissue Bank for procurement, storage and distribution of biomaterials.
22. National Human Organ & Tissue Removal & Storage
Network
• Functions at National level –
– Lay down policy guidelines and protocols.
– Network with ROTTO & SOTTO organizations.
– Compile & publish all Registry data from Regions & States.
– Creating awareness, promotion of organ donation.
– Co-ordination when organ is allocated outside the region.
– Monitoring of transplantation activities in the Regions and States.
• Functions for Delhi-NCR
– Maintaining Waiting-list & matching of recipients with donors.
– Networking with transplant centres, retrieval centres & tissue banks.
– Allocation, Transportation, Storage & Distribution within DelhI-NCR.
23. National Biomaterial Centre
• National level Tissue Bank –
– Bone, Bone products & Fascia
– Skin graft
– Cornea
– Heart valves and vessels
• Functions –
– Development of Guidelines, Protocols & SOPs.
– Coordination for tissue procurement and distribution.
– Tissue Screening, Sterilization, Preservation, & Quality control.
– Records maintenance, Data Protection and Confidentiality.
24.
25. THANK YOU
Dr M. Mohan Rao – CMC Vellore 1955 Batch
1st successful renal transplant in India – Feb 02, 1971, at CMC Vellore
Editor's Notes
Donor reneging means that one of the donors backs out from donation.
DGHS - Directorate General of Health Services
IEC – Information Education & Communication.
IGNOU – Indira Gandhi National Open University