The Status of Liver Transplantation in India.

Parmanand Tiwari, Samiran Nundy
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Abstract

Background The passage of the Transplantation of Human Organs Act in 1994 banned the unethical trade in human kidneys and recognized heart beating brain death as a form of death. This enabled liver transplantation to be performed in India. We briefly recount the history of the Act's passage and describe, in some detail, the present status of the procedure. Methods We sent a questionnaire regarding liver transplant services via email to 400 members of the Liver Transplant Society of India requesting them to provide details on liver transplantation at their centres up to 2022. We received information on 3069 of 3920 transplants that had been performed in 2022. Results There were 183 registered centres who had performed a total of 3920 liver transplants, placing India in third position behind the USA (n=9528) and China (n=6053) while it performed the largest number of living donor liver transplants (n=3183) in the world. The most common indication for liver transplantation was non-alcoholic steatohepatitis (NASH)-related cirrhosis (20%). Our teams published 2449 PubMed indexed research papers and 384 foreign trainees came from 52 countries for training in liver transplantation. The concerns were the small numbers of deceased organ donation, the dominance of the private sector (96.7%), corruption in the form of kickbacks and false declarations of relationship and gender imbalance with only 22% women recipients receiving organs from men while 68% women donated their livers to men. Conclusion Liver transplantation has saved the lives of many Indians, made a major impact on Indian healthcare overall, and increased its reputation worldwide. There are problems which we hope will be tackled by increasing societal awareness.

印度肝移植的现状。
1994年通过的《人体器官移植法》禁止了不道德的人体肾脏交易,并承认心脏跳动的脑死亡是一种死亡形式。这使得在印度进行肝移植成为可能。我们简要叙述该法案通过的历史,并较为详细地描述该程序的现状。方法:我们通过电子邮件向印度肝移植协会的400名成员发送了一份关于肝移植服务的调查问卷,要求他们提供截至2022年在其中心进行肝移植的详细信息。我们收到了2022年进行的3920例移植中的3069例的信息。结果印度共有183个注册中心,共进行了3920例肝移植手术,仅次于美国(n=9528例)和中国(n=6053例),居世界第三位,同时进行了3183例活体肝移植手术。肝移植最常见的适应症是非酒精性脂肪性肝炎(NASH)相关肝硬化(20%)。团队共发表论文2449篇,来自52个国家的384名外籍学员参加肝移植培训。令人担忧的是死者器官捐赠数量少,私营部门占主导地位(96.7%),回扣形式的腐败和虚假的关系声明以及性别不平衡,只有22%的女性接受者从男性那里获得器官,而68%的女性将自己的肝脏捐赠给男性。结论肝移植挽救了许多印度人的生命,对印度的整体医疗保健产生了重大影响,并提高了印度在世界范围内的声誉。我们希望通过提高社会意识来解决一些问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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