The transplantation of human organs and tissue act 1994(TOHOTA)

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.

1. The Transplantation of Human Organs and Tissue Act , 1994(TOHOTA ) Dr Faiz Ahmad

2. 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. The Act was amended in 2011

3. Till 1994 there was no comprehensive nationwide legislation to regulate the removal of organs from deceased or living persons. There were only some state level legislation and that pertaining only to specified organ In Delhi The eye act 1982 The ear drum and ear bone act 1982 In Maharashtra The Bombay corneal grafting act 1957 The Maharashtra kidney transplantation act 1982

4. Some important definition under act Brain stem death- means the stage at which all the functions of brain stem have permanently and irreversibly ceased. Human organ Under this Act 'human organ' means any part of a human body consisting of a structured arrangement of tissues which, if wholly removed, cannot be replicated by the body.

5. Human Organ retrieval centre Means a hospital Which has adequate facilities for treating seriously ill patients who can be potential donors of organs in the events of death Which is registered U/s 141 for retrieval of human organs Near relatives In the original act there were following seven relations Father Mother Spouse Brother Sister Son Daughter

6. By the 2011 amendment following four relations were added Grand father Grand mother Grand sons Grand daughter Tissue- means of a group of cells except blood performing a particular functions in human body. This sub section has been added by 2011 amendment and brings bone marrow within the purview of the act. Tissue bank- means a facility registered u/s 14A for caring out any activity relating to the recovery, screening, testing processing, storage and distribution of tissues, but dose not include blood bank (added by 2011 amendment)

7. Transplant coordinator- means a person appointed by the hospital for co-ordinating all matters relating to removal or transplantation of human organs or tissues or both and for assisting the authorities for removal of human organs in accordance with the provisions of Act. Appropriate authority(AA) Central government and state governments should appoint AA comprising of one or more persons and functions of AA are-

8. To grant registration and renew registration to hospital. To suspend and cancel registration. Enforce high standard for hospital and tissue bank. To investigate complaints into irregularities take action. To periodically inspect hospitals and tissue bank.

9. Authority for removal of human organs Any donor (> 18 years of age) may authorize the removal before his death of any organ of his body for therapeutic purposes . If any donor had in writing (in presence of 2 or more witnesses ) authorized the removal of any organ after his death for therapeutic purposes, the person lawfully in possession of dead body should allow the doctor all reasonable facilities for removal.

10. When no such authority is there, person lawfully in possession of dead body can authorize the removal of any organ of the deceased person. When human organ is to be removed, the medical practitioner should satisfy himself, that life is extinct in such body or where it is a case of brainstem death

11. T he death has been certified by : The doctor in-charge of hospital in which the brainstem death has occurred. An independent doctor, being a specialist nominated by the above in-charge from the panel of names approved by Appropriate Authority. A neurologist or a neurosurgeon, nominated by the in-charge from the panel. The doctor treating the person whose brainstem death has occurred.

12. Under any circumstances, brainstem death tests should not be performed by transplant surgeons or any doctor in the transplant team or a member of the Authorization Committee.

13. Removal of human organs cannot be authorized wherein An inquest may be required to be held in relation to such body. A person who has been entrusted the body solely for the purpose of cremation.

14. Authority for removal of human organs in case of unclaimed bodies in hospital or prison If not claimed by any near-relatives within 48 h from time of death, the authority lies with the management of hospital or prison or by employee of the hospital or prison authorized by management If there is reason to believe that any near-relative of the deceased person is likely to claim the body even beyond 48 h, no authority should be given.

15. postmortem or pathological examination Person competent under this Act can give authorization, if such organ will not be required for the purpose for which the body has been sent.

16. Restriction on removal and transplantation of human organs Human organ should not be removed from the body of donor before his death and transplanted into recipient , unless the donor is a near-relative ( spouse, son , daughter, father, mother, brother or sister). When donor authorizes the removal of his organs after his death , these organs may be transplanted into the body of any recipient . If any donor authorizes the removal of his organs before his death to such recipient not being near relative by reason of affection or attachment towards the recipient , the organs should not be removed and transplanted without prior approval of Authorization Committee .

17. Regulation of hospitals conducting the removal, storage or transplantation of human organs Hospital not registered under this Act should not be engaged in transplantation activities. Medical practitioner should not conduct transplantation at any unregistered place under this Act. The eyes and the ears may be removed at any place from dead body of any donor for therapeutic purposes by a doctor. The doctor is also prohibited from removal or transplantation of human organs for any purpose other than therapeutic purposes.

18. Punishment for commercial dealings in human organs Punishable with imprisonment for a term from 2-7 years and fine of ` 10,000–20,000.

19. Duties of the Medical Practitioner Regarding Organ Transplantation In case of live donation , the doctor should satisfy himself before removing an organ from the donor that: a. Donor has given his authorization. b. Donor is in proper state of health and fit to donate the organ. c. Donor is a near-relative of the recipient and sign a certificate after carrying out following tests on donor and recipient

20. i . Tests for the antigenic products of HLA-A, HLAB and HLA-DR using conventional serological techniques. ii. Tests to establish HLA-DR and HLA-DQ gene restriction fragment length polymorphisms. iii . When the above tests do not establish genetic relationship , tests to establish DNA polymorphisms using at least two multilocus genes probe. iv . When (iii) do not establish genetic relationship, further tests to establish DNA polymorphisms using at least five single locus polymorphism probes . In case recipient is a spouse of donor, record the statements of both and sign a certificate.

21. In case of cadaveric donation , the doctor should satisfy himself that: Donor has authorized before his death, the removal of his organ for therapeutic purpose after his death, in presence of two or more witnesses, at least one of whom is a near-relative. Person lawfully in possession of dead body has signed a certificate as specified under the Act.

22. iii. A doctor, before removing organ from a brainstem dead person, should satisfy that: Certificate regarding the brainstem dead from the Board of medical experts is present. In case of a person < 18 years, a certificate has been signed by either of the parents of such person.

23. THE WORKMEN’S COMPENSATION ACT, 1923 The Workmen’s Compensation Act, 1923 [WCA, 1923] is one of the earliest labor welfare and social security legislation enacted in India . This Act provides for the payment of compensation to workmen for injuries sustained by them in an accident, arising out of and in the course of employment.

24. Aims and objectives Provides compensation to workmen and their dependents - in case of accidents arising out of and in the course of employment causing death or disablement of workmen. The amount of compensation depends upon whether the injury has caused death, permanent total disablement or permanent partial disablement.

25. The employer will not be liable to pay compensation in respect of any injury which results in death or permanent total disablement caused by an accident, if the workman at the time of sustaining injury was under the influence of drink or drugs or willfully disregarded or removed any safety guard or other device provided for his safety.

26. THANKS