India to change donation system to presumed consent, corneas will be first.

The Health Ministry in India announced in early March that it plans to change the nation's donation system from the current opt in system to presumed consent in three months. In the beginning only the cornea will be procured without consent unless the deceased donor has previously declared he or she is against donation, according to News Post India.

"We want people to learn about presumed consent first and that's why we will first start with the cornea. Then we will follow this with other organs," said Health Minister Anbumani Ramadoss.

The primary reason for the change is to prevent the illegal organ trade in India while increasing the number of organs and tissues available for Indian citizens.

After the health ministry busted an illegal kidney racket in Gurgaon, on the outskirts of Delhi on January 24, the ministry began a fact finding tour to countries like Spain, Belgium, France and Singapore to study those countries organ transplant laws. They also considered the US model of required request and the Iran model of compensating donors.

The team, which was headed by Director General Health Services R.K. Srivastava, came to the conclusion that India should follow the Spanish model which has resulted in the highest donor per million rate in Europe, News Post India reported.

"We are hopeful that presumed consent would lead to a huge increase in organ availability. But before we launch it, we would create a lot of awareness among the populace," Ramadoss said. "As we are introducing it first for cornea, people will get to know about the concept."

The health ministry plans to set up 10 Organ Retrieval and Banking Organizations (ORBO), along the lines of the All India Institute for Medical Sciences (AIIMS). The ORBOs will be established in cities like Kilkata, Mumbai, Chennai, Bangalore, Ahmedabad, Guwahati and Lucknow. The centers will coordinate retrieval, storage and transplantation of organs across all hospitals in the country approved to perform transplants.

The country has 109 eye banks. But of the 14,000 eyes that are collected, 30% can't be used because of problems with tissue matching, News Post India reported. With presumed consent the ministry believes the organs and tissues will be procured faster which will make tissue matching easier.

Tanuja Joshi, past president of the Eye Bank Association of India, called the change to presumed consent a positive step. "We will now be able to meet the demand for organs and tissues," Joshi said.

There is a backlog of 1.1 million corneally blind people in India and every year 30,000 new cases are added, Joshi added. "The annual collection of eyes in the whole country is about 28,000. With this concept, there will be an increase in eye donations, which will reduce our problems."