Times of India
25 January 2010
By Sumitra Deb Roy
Mumbai, India

Kidney donations by patients’ in–laws rising
At 28, Mira road resident Vijay Suryawanshi’s kidneys were damaged beyond repair due to high blood pressure, and only a transplant could ensure that he lived long. But, his own brother refused to part with his kidneys and so did most of his other family members.

Vijay’s wife Nandini, 23, could not be a donor as her blood group did not match with his. After undergoing dialysis for a year, doctors suggested the family that only kidney transplant could help. The renal disease also prevented the couple from having a child.

Finally, after a year’s wait, Nandini’s 44–year–old mother Hemlata offered to donate one of her kidneys. “I wanted to see my daughter happy and lead a normal life,” said Nandini. Asked if there was any kind of pressure on her, the answer was no. “It was my own decision,” she insisted.

However, the growing incidence of in–laws becoming donors and saviours for their ailing sons–in–law has left the state pondering. Maharashtra sees about 175–180 cases of live kidney transplants annually, of which 35% to 40% are that of donors who are not relatives as defined under the law. “In Mumbai, in–laws donating a kidney will account for over 10% of unrelated transplants,” said Dr Pravin Shingare, joint director, Directorate of Medical Education and Research and member of authorisation committee.

A senior state official, however, said figures from the state could mean that a whopping 40% to 50% of donations from people not related to the patient are invariably mothers– or fathers–in–law saving their sonsin–law’s lives. In 2009, there were about 75–odd transplants across the state where someone from the wife’s family was a donor, the official said.

Shingare, however, said utmost care is taken to rule out exploitation of any such kind. “We record their statements, interview them individually and ensure that the wife’s family is not under undue pressure,” he said.

This was also one of the main reasons why the state government had rejected the Centre’s recommendation to expand the definition of near relatives and include uncle and aunt under the Transplantation of Human Organs Act, 1994. So far, the law defines a near relative as spouse, son, daughter, father, mother, brother or sister.

Civic–run KEM Hospital has decided to carry out transplants only if donors are related. Professor and head of nephrology, Dr N K Hase, cited an example of a couple that came in for a transplant last week. “The sister–in–law was brought in as a donor, but we refused to carry out the transplant,” he said. He agreed that it was tricky to judge intentions and so they stuck to organ donations by relatives as defined under law.

But, some nephrologists in the city feel otherwise. Head of nephrology at Nanavati Hospital, Dr Sharad Seth, said, “There are cases where in–laws are donors, but most of them do it out of love and concern. Spousal donations are high where, in 90% of the instances, it is the wife donating a kidney to her husband. But, only 10% of husbands donate kidneys to their wives,” he said.