About 25 per cent of potential organs — heart, kidney, liver, lungs, intestine, eyes, pancreas, bones, bone marrow, skin, connective tissue, middle ear, blood vessels — that can be successfully transplanted are lost due to delays in carrying out cadaver organ retrievals. In one-fourth of the cases, precious time is lost while getting patients officially certified as 'brain dead.' Eye donations are somewhat popular, but the rest are just not. Whom do we blame for this? Lack of guidelines on cadaver organ transplant or the society's lack of awareness itself.

    The government seems to be taking steps towards solving the first problem by laying down guidelines for cadaver transplants at all hospitals in the country. Medico-legal hassles that accompany such cases hinder organ retrieval from cadavers in a big way, doctors say. This is where the guidelines can offer help to both the doctors and the terminally ill patients, badly in need of organ replacement.

     The Indian society, mired in traditional beliefs, is not very amenable to the idea of cadaver organ transplants as they want the last rites to be performed without any damage to the bodies at all. What they fail to realise is that in a country with a long waiting list for transplants, they are spoiling the chance of somebody to lead a normal life for, say another few years, just because they want to consign the whole body to flames. In any case, the dead do not make any demands; it is only the living who continue to make demands.

     Organ donation is considered the most noble act; there is no reason why cadaver organ donation should not be seen that way unless the patient himself has strong reservations about it. It is here that the question of awareness comes up. One view is that the government should make it compulsory to donate organs of brain dead patients so that the wastage of organs, and thereby shortage, is solved. One brain dead patient can help twelve patients in critical stages to lead normal lives.

    
     If the number of accident deaths all over the country numbering over a lakh every year is taken into consideration, one can realise the magnitude of loss of vital organs due to lack of awareness and interest in organ donation. The Organ Retrieval Banking Organisation (ORBO) was set up in 1997 to ensure co-ordination between hospitals and terminally ill patients so that transplants could be done without loss of time, a key factor in the fall in quality of transplant organ and tissue. ORBO does not store the organs harvested from cadavers, but maintains a list of potential donors and recipients. The 2011 Amendment of THOA 1994 provided the basis for the establishment of NOTTO, which has been crucial in regulating organ donation and transplantation in India with the setting up of the NOTTR in 2015.

    The malpractice of organ trafficking, misguided religious sentiments, family bondage, orthodox societal views and unavailability of a standardised organ donation ecosystem are the factors that act as a deterrence for the potential organ donors. Moreover, due to the unavailability of a centralized procedure, organ donation has become almost non existant. It needs to be e-networked with all the hospitals and nursing homes in the country to effect speedy action in case of retrieval and transplantation. Cadaver organ donation ennobles the dead through the living.