K-SOTO under fire: Legal hurdles and films blamed for organ donation decline in Kerala

Thiruvananthapuram: The deceased organ donation in the state is mired in controversy. Donations have been declining since 2017 due to disputes over the technology used to confirm brain death. New controversies have emerged as the Kerala State Organ and Tissue Transplant Organisation (K-SOTO), which oversees the process, works to overcome the obstacles.

Dr Mohandas, head of the nephrology department at Thiruvananthapuram Medical College, posted on social media that K-SOTO was a complete failure, sparking a fresh controversy. Meanwhile, doctors say that although deceased organ donation has decreased, the system is not a failure. Following Dr Mohandas’ remarks, the teachers’ union has also decided to examine the organ donation system in the medical college.

K-SOTO officials say legal proceedings related to the confirmation of brain death, along with certain movies, have adversely affected the deceased organ donation. Concerns about artificial confirmation of brain death have deterred relatives from consenting to donate organs.

According to K-SOTO, there is no shortage of donations from living donors. To encourage this, the government has decided to provide medicines for organ recipients and donors at reduced prices through Karunya Pharmacy.

Protocol to confirm brain death

The Transplantation of Human Organs and Tissues Act, 1994, and the Transplantation of Human Organs and Tissues Rules, 1995, form the basis for confirming brain death. Special protocols and guidelines have been prepared, taking into account subsequent amendments.

Brain death is confirmed by a team of four doctors. Two of them must be from outside the hospital where the patient is admitted. It is also recommended that one should be a government employee and be on the list of those trained in confirming brain death.

Other procedures include video recording the confirmation process and conducting a peripheral nerve stimulation test to check for neuromuscular blockade.

A person confirmed brain dead can be removed from the ventilator only after relatives give consent in a special form. A state-level technical committee has been formed to hear complaints regarding organ donation. Nodal officers are also appointed at the district level.