“In 2012, almost half of organ donations from dead donors in India were from the State - the game changer”

Tamil Nadu has had a tenuous link with organ donation. Once known as a “world centre” for the transplant tourism industry, the State has now reformed itself to lead the country in conducting its best cadaver transplant programme. The British Medical Journal has paid rare and rich praise to the State for achieving this turn around.

In the April edition of the BMJ, Sandya Srinivasan writes (Has Tamil Nadu turned the tide on the transplant trade?) of the numbers that showcase the rather swift transformation from crime to achievement. “Between the programme’s launch in October 2008 and February 2013, at total of 573 kidneys, 286 livers, 52 hearts, and 15 lungs from 317 dead donors were retrieved and transplanted in the State. The number of dead donors rose from 59 in 2009 to 83 in 2012.

“In 2012, almost half of organ donations from dead donors in India were from Tamil Nadu. The State’s cadaver kidney donation rate has gone up from 0.3 per million population to 1.3 per million population, compared with the national average of 0.08 per million population.”

Tamil Nadu has been the game changer, the author argues, and today, hospitals in the State still conduct up to 20 per cent of all transplant operations in the country. “Tamil Nadu has shown that it is possible to run a publicly-supported programme of deceased donor organ retrieval, sharing and transplant, with transparency,” said Sanjay Nagral, transplant surgeon at Jaslok Hospital, Mumbai, and joint secretary of the non-profit Zonal Transplant Coordination Committee in the city.

The State’s programme was verily kicked off as a result of media coverage of the Asokans’ (a doctor couple near Chennai) decision to donate the organs of their young son who had died in a traffic incident.

The article also goes on to examine the progress of the State, according hat tips to strong bureaucratic support, participation of various committed NGOs, appointment of a transplant co-ordinator to ensure that the distribution of organs is fair, and transparent.

A total of 10 government orders were issued since 2008 in the State to “make organ donation from cadavers procedurally and structurally possible.” Exploring the anatomy of the intricate structure at work, the article states that hospitals doing transplants are registered with the State authority, they run counselling departments, and employ transplant co-ordinators. They submit records of the transplants they conduct, and are supposed to make their charges public.

All cases of brain death must be certified, and organ retrieval permitted before post-mortem examination if necessary. There is an intricate network between hospitals, private and public, and the Transplant Co-ordinator works to keep the sharing fair and equitable.

The article quotes transplant co-ordinator J. Amalorpavanathan, “We work with two-and-a-half people, a couple of computers, and a budget of just Rs. 10 lakh a year, yet we are able to generate half as many donations as a typical organ procurement organisation in the West does, with more than 100 staff.” The work of two other key NGOs - MOHAN Foundation and National Network for Organ Sharing - has been accorded due acknowledgment.

“The Tamil Nadu programme works because it has strong government support, it serves the poor through public hospitals, and possibly because of the commitment and abilities of the individuals involved. It is an example for other States to follow,” the commissioned article concludes.

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