Though governments are increasingly funding (kidney) transplantation through special schemes, Kountz’s dream of transplantation for all those who need rather than those who afford is still a distant pipe dream for those at the bottom of social hierarchy.

Dr. Sanjay Nagral, a GI surgeon by training and a thinker by choice, speaks about organ transplantation in India and the ethical quagmires is could lead to

The recent transplant of a pig’s heart into a man highlights the close connection between species

The absence of registries in India makes it challenging to provide a precise estimate of those developing end-stage organ failure and thus benefitting from transplantation.

Dr. Sanjay Nagral, Co-chair : Declaration of Istanbul Custodian Group, speaks about ‘Transplant Coordination in India - The unique ethical challenges ‘

In any transplant, serious surgical complications are a possibility and the immunosuppressive drugs that are needed have side-effects and can predispose to deadly infections. So, when the transplant is not for a life-threatening condition, the benefits need to outweigh the risks.

Public hospitals must be brought into the loop for deceased donor programmes

India, with its history of organ trade rackets, should be cautious before proposing incentives that may be on the slippery slope towards organ commerce.

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In the last four decades, the concept of "brain death" has been legalised and accepted in many countries. However, in spite of the legal sanction as well as sustained campaigning, the number of such donors is limited.

A majority of transplants are now done with organs retrieved from such brain dead individuals. The need for organs, however, far outweighs their availability and a large number of patients still die waiting for organs.

The Indian kidney bazaar, as it was crudely described at some stage in its history, refuses to die down. The latest expose comes from Mumbai, where a leading doctor from a reputed hospital was arrested for his involvement in a well-organised racket.