Frequently asked questions (FAQ)

Why Deceased Donor (or Cadaveric) Transplantation?

  • Because it saves lives
  • Because it can eliminate illegal organ trade
  • Because India lags far behind world average in such transplantation
  • Because technology and physical infrastructure are available
  • Because most people are willing to donate cadaveric organs when aware

How much does India lag?

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As one can see here, India’s economic prosperity is not as far behind other countries (in purchasing power parity terms) as its record is in cadaver donation – one twentieth that of Thailand. But this is changing rapidly in Tamil Nadu. In the first quarter of 2009, the state has had 14 cadaver donors that works out to a rate of 0.8 per million population per year, several times that of the country as a whole.

How did this happen?

In early 2007, a kidney scam surfaced, as a result of which, the government decided to arrest commercialization of live kidney transplants and to promote the growth of deceased donor organ transplants in the State. With this object in view, the Health & Family Welfare Department of the Government of Tamil Nadu organized a Workshop in March 2007, co-sponsored by NNOS Foundation. Representatives and senior doctors from several transplant hospitals all over Tamil Nadu participated in this day-long workshop. To highlight the importance attached to this exercise the Hon'ble Minister for Health and Family Welfare and the Principal Secretary to Government, Health & Family Welfare Department participated in both the inaugural session in the morning and the valedictory session in the afternoon.

The Workshop participants were organized into four Working Groups that deliberated on these issues: 1. Live donors 2. Transplantation Formalities 3. Cadaver Transplant 4. Coordinating Organization. At the valedictory session the moderators of the Working Groups presented a total of 33 recommendations for follow up action.

The Government gave serious consideration to these recommendations and held frequent consultations with the stakeholders. As a result of this, a series of Government Orders were issued to lay down a set of norms that would supplement the Transplantation of Human Organs Act (THOA) and its Rules and establish a framework through which organs can be allotted in a fair manner to the potential recipients that await organ transplantation.

By the time these government orders were in place, the case of a doctor couple donating the heart of their young son who died in a traffic accident to save the life of a young girl, got wide publicity and made an emotional connection with the people at large. This, as well as the publicity some more donations got, spurred voluntary offers from relatives of brain stem dead persons. These two worked together to create a momentum for organ donations. To sustain and increase the momentum, it is necessary that hospitals in the state become fully aware of all the government orders and cooperate fully with the system to achieve its goals.

Is it really necessary to have so many G.O.s and a laid down system for this?

To quote from G.O. (Ms) No.288 dated 05.09.2008: “Considering the fact that cadaver donation is done with altruistic motives and in a generous charitable manner as a willing contribution to society, it is necessary that cadaver donation be governed by transparency on all fronts to ensure that the sentiments of the donor’s relatives are adequately respected. Hence, it is considered necessary that a certain degree of accountability is also insisted upon.”

The other reason is that the THOA (Annexure 4) is but an enabling legislation as far as deceased donor transplantation is concerned. It only regulates how an organ can be donated from a deceased donor, and has nothing to say on who will get that organ. Some more steps need to be clarified to make it easier for hospitals to follow the rules and to share organs amongst themselves from the time brain-stem death (also called brain death) is identified in any hospital.

Is brain death legal death?

Yes, while brain-stem death – “the stage at which all functions of the brain-stem have permanently and irreversibly ceased” (THOA) - is recognized as death in most countries of the world, the THOA is the only legislation in India that confirms it as legal death, and provides a procedure for certifying it. This procedure is made easier to follow by the G.O.s mentioned.

How is brain death to be certified?

By filling in Form 8 of THOA Rules – see Annexure 2 or G.O. (Ms) No. 75 of 03.03.2008 in Annexure 3. Four doctors should sign this certificate:

1.RMO, ARMO, Duty RMO, RMP in charge of the Hospital or RMP Head of the Institution.

2.RMP (Physician, Surgeon or Intensivist) from a panel of names nominated by the Hospital and approved by the Appropriate Authority

3.Neurologist or Neuro-Surgeon from a panel of names nominated by the Hospital and approved by the Appropriate Authority

4.RMP / Doctor on duty treating the patient Of these, Doctor 2 or Doctor 3 should carry out the First and Second Medical Examinations specified in Form 8, with a time gap of minimum six hours between the two examinations. A guideline for carrying out one of the specified tests, the Apnea test, is provided in G.O. (Ms) No. 75 of 03.03.2008 (Annexure 2).

Hospitals need to send a list of names, along with the medical registration certificates of the doctors to be approved as Doctors 2 and 3 to the Director of Medical Services and Rural Health (DMS) who is the Appropriate Authority for the State. The DMS will respond quickly approving the panel of names. There is no need to get approvals for Doctors 1 and 4. Transplant hospitals that do not have their own Neurologist / Neuro-Surgeons can use the services of an approved Doctor 3 from any other hospital for purposes of Form 8.

Do recent changes made to the THO Rules affect this procedure or Form?

No, they do not. The Central Government has amended the THO Rules effective 4-8-2008 and the State Government has notified it vide G.O. Ms. No. 179, Health and Family Welfare dated 18-6-2009, but these changes mostly concern live donation and the Forms connected to that. The procedures and Forms 6, 8 & 9 relating to deceased donor transplantation remain unchanged.

Have changes been made to the THO Act itself? What are they?

Yes, a Bill to amend the Act was introduced in Parliament on December 18, 2009. This was referred to the Parliamentary Committee on Health and Family Welfare on January 25, 2010. The Committee called for views on the Bill, held hearings and submitted its Report to Parliament on August 4, 2010. The Ministry revised the Bill in the light of this Report and this Bill was introduced in Parliament, got passed and received Presidential assent on 27 September, 2011, as the Transplantation of Human Organs (Amendment) Act, 2011. However, this is not yet operational in Tamil Nadu. THO Act, 1994 (Annexure 4) is what prevails in this State.

I am a transplant hospital registered as such with the DMS.
       What are the things I should look out for in the context of deceased donor transplantation?

Please ensure that your registration is kept renewed every five years for each organ you transplant. Send your renewal request three months before the date of expiry. Maintain transplant surgery records for a minimum period of ten years.

Set up a counseling service for individuals involved in organ transplant and designate a Transplant Coordinator to coordinate all aspects of transplantation on behalf of the hospital. Avoid media publicity on transplantation till the discharge of the recipient. Even then do not give details of the recipient and follow the ethics of the medical profession. Post the approximate cost range of transplant surgery on your website and on Health Department designated website. Post total number of transplantations done in your hospital along with details of each transplantation on your website and make such data available to State and Central Governments for compilation, analysis and further use.

Is there any other registration I need to do apart from that with the Appropriate Authority?

Yes, there is, if you wish to engage in deceased donor organ transplantation. It is mandatory for you to enroll your institution with the Transplant Authority of Tamil Nadu (TRANSTAN) if you wish to do cadaver organ transplant. (See G.O. (Ms) No.87 dated 26-2-2011.) This enrolment makes you a part of the organ sharing network of the State. This will enable you to receive deceased donor organs from other transplant or non-transplant hospitals for your patients and to share organs with others. For this, if you are a private hospital, you have to send an initial admission fee of Rs.10,000 (Rupees ten thousand) by way of D/D drawn on “Transplant Authority of Tamil Nadu’’ and send it to the Member Secretary, Transplant Authority of Tamil Nadu, Tamil Nadu Government Multi Speciality Hospital, Room No 1045 & 1046, First Floor Omandurar Government Estate, Anna Salai, Chintadripet, “Opp The Hindu”, Chennai, Tamil Nadu 600002, Land line – 044-25333676. This will enable you to register your hospital online at the website and participate in the total networking.

Please ensure that the password access to the website is restricted to only one or two key persons in your organization and the access is handled with full responsibility and confidentiality.

Please make sure that there is a single point of contact at your hospital for the Member Secretary and at least two telephone lines are available 24x7 for purposes of organ sharing communication, some of which will happen in the middle of the night.

Is there any further annual fee or any other fee for participating in this Program?

No. There is no annual fee. However, effective February 2012, each private transplant hospital will pay a fee of Rs.1,000, in the same manner as the admission fee, for every patient registered through it in the recipient registry maintained by the Member Secretary, TRANSTAN. Government hospitals need not pay this fee. Participating hospitals are free to contribute towards the costs of state level coordination, training programs, awareness generation programs and all other activities that will make this program a success by sending cheques or D/D drawn on “Transplant Authority of Tamil Nadu’, Tamil Nadu Government Multi Speciality Hospital, Room No 1045 & 1046, First Floor Omandurar Government Estate, Anna Salai, Chintadripet, “Opp The Hindu”, Chennai, Tamil Nadu 600002, Land line – 044-25333676.

What steps should I take up after I join this network?

First, prepare a waitlist of your patients that await transplantation for each organ you are authorized to transplant. Upload details of the Kidney waitlist through an online form on the website making sure that all persons on the waitlist have been on dialysis for at least two months and have been counseled and are ready for transplant surgery at very short notice. Make sure that additions, deletions and modifications are made promptly and see that the list is kept up to date all the time.

For Liver please prepare your waitlist of patients, establish your own criteria based on which you wish to prioritize allocation of the organ available to you, arrange the waitlist in that order of prioritization and send to the Member Secretary the criteria as well as the prioritized list for the organ by filling in all this information in a spreadsheet format that the Member Secretary will send to you. Whenever any change is effected to that list, please communicate the new list to him promptly. You need to also enter the recipient data online after sending a demand draft for Rs.1000 for each recipient, as explained in the previous answer.

For Kidney too, while the Member Secretary maintains the combined waitlists of all hospitals, you too need to maintain your hospital waitlist. You are free to evolve your own criteria for recipient prioritization on your hospital list for use whenever there is an in-house donor and you get automatic allocation of one Kidney – denoted as Local Kidney - as explained later. But you should keep the Member Secretary posted of your criteria and the updated prioritized hospital list in the same manner as for the organ explained above, in the format you can obtain from the Member Secretary. It would be advisable for you to alert and maintain communication with top three on your waitlist to be available for surgery when an organ becomes suddenly available.

Ensure that the recipient is registered with only one transplant hospital at a time. The recipient registered through one transplant hospital is free to shift to another transplant hospital; when this happens, the patient to write a letter in his/her own hand writing stating willingness to shift the hospital and the hospital to send an email attaching the patients letter and also stating that it is ready to accept the patient for the transplant. Patient so transferred will maintain their original date of registration in the registry.

When a brain stem death occurs at your hospital, ensure that the family is counseled for organ donation and the brain stem death gets certified following the procedure described above.

What should I do when the family agrees to donate?

Make sure that Form 6 of THO Rules gets signed – Form 9, if the donor is below the age of 18 – by the donating family to authenticate the consent. This is necessary even if the patient had earlier expressed a desire to donate organs.

Inform the Member Secretary, or his representative, over the phone immediately with information on name, sex, age, weight and blood group of the donor and any other information he asks for and keep him posted of the cadaver maintenance status.

One Kidney, Liver, Heart & Lung get automatically allotted to your hospital’s patients and are called Local organs. The other Kidney - and Liver, Heart and Lungs, if you do only Kidney transplant – become Share organs and will be allocated to patients in other hospitals by the Member Secretary. Local organs are to be allocated by you, strictly following the prioritization of your Hospital List that has been sent to the Member Secretary. Inform the patient on top of your Hospital List the time of surgery and alert the next on the list. If your hospital waitlist prioritization is not adhered to, for any reason, explain this to the Member Secretary straightaway.

When an organ from the deceased donor is allotted as Share by the Member Secretary to other hospital/s, please cooperate fully with the recipient hospital/s by providing all information on the donor, blood sample and tests if needed and schedule the organ retrieval to suit all concerned.
Please also ask the family to donate cornea, skin and arrange with a local eyebank to utilize it. Skin will be allocated by the Member Secretary to a skin bank If, for any reason, heart cannot be used, heart valves can be utilized and will be allocated by the Member Secretary.

There could be rare cases where the relatives of a Deceased Donor request that an organ of the Donor be allotted to a near relative – spouse, son, daughter, father, mother, brother or sister or Non near relative of the Donor - suffering from failure of that organ. In such cases, please verify the facts of the case and accede to it with the approval of the Member Secretary.
Please keep the donor family posted of the organ utilization procedure and assist them with all formalities, including police liaison in road traffic accident or such medico-legal cases.

How does one handle medico-legal cases?

Nearly four fifths of cadaveric organ donations in TN arise from road traffic accident victims. All of them are medico-legal cases and the donating families suffer considerable delay in getting the body back because of the procedures involved. There is also some lack of clarity in the THO Act on this issue. Hence the TN Government passed G.O. (Ms) No.259 on 14-09-2010, laying down a comprehensive procedure for this purpose. Based on consultations held with all transplant hospitals in a Workshop during October 2010, an amended G.O. (Ms) No.86 dated 26-02-2011 was issued.

According to this procedure, as soon as the first test for certification of brain stem death is done in an organ donation situation, the concerned police officer to conduct inquest will be asked to come to the hospital, using Form 1 specified in the G.O. so that he can start the inquest as soon as the second test is completed and death is certified. He should be provided the formal death intimation and copies of Form 8 (brain stem death certification) and Form 6 (family consent for organ donation). If that officer finds that post-mortem is not required for the purpose of the inquest, he will inform the family and organ retrieval can proceed.

Should the police officer decide that a post-mortem examination is needed, the hospital should provide him an ‘Organ Functional Status Certificate’ issued by any one of the doctors authorized by the Medical Superintendent of that hospital, per Form II given in the G.O. The police officer will then forward this Form as also copies of Forms 6 and 8 along with a post-mortem requisition to the Medical Officer designated to conduct the post-mortem. That Medical Officer will then issue an ‘Organ Retrieval Authorization Form’ permitting organ retrieval. Organ retrieval will then be done, after which the body will be handed over for post-mortem examination.

A significant feature of the G.O. is that it makes it possible for your hospital to utilize the services of any one of the following Medical Officers for conducting this post-mortem examination on your premises itself, immediately after organ retrieval, saving substantial time and worry for the donor family:

  • a) Medical officer from the Forensic Medicine Department of any Government Medical College
  • b) Qualified Forensic Medicine Expert
  • c) Government medical officer or pathologist posted in the Forensic Medicine Department
  • d) Government Medical Officer (serving or retired) who has/have had experience in post-mortem work.

(It is not necessary to refer to G.O. (Ms) No.259, since all procedures and forms are given in the revised G.O. (Ms) No.86 itself.)

What happens if the accident had taken place at a distant location and the police officer of that                 jurisdiction has to come for inquest?

This could cause considerable time delay. To avoid this, the Police Department has sent a circular on 13-07-2009 stating that in such accident cases, the hospital’s local jurisdiction police can conduct the inquest and one need not wait for the investigating officer from where the case was registered or the occurrence took place. This facility can be used to minimize delays and inconvenience to the donor family.

What should I do after organ retrieval?

Do send the information report on donation to the Member Secretary as early as possible, within 48 hours of organ retrieval, through the online form at the website . Fill in separate forms for donor and for Local organ recipients. Send him also a monthly statement of donations and transplants done in the format asked by the Member Secretary. The Member Secretary will also send you a form for post transplant study and analysis of long term clinical results of transplant surgery. Send periodic information on that format as well.

What about the costs involved in this exercise?

If you are a private hospital where organ donation takes place, you are entitled to be reimbursed of all costs incurred by you on the donor cadaver from the time the donor family consents to donate, including assistance in removing, transporting and preserving the organs, as determined by you, subject to a ceiling amount of Rs.75,000. This cost will be allocated equally to all major organs such as kidney, liver, heart and lung removed from that cadaver by private hospitals, including organs removed by your hospital; the private recipient hospitals of those organs will reimburse their share of the cost to your hospital on requisition made to them by you. Government donor hospitals and Government recipient hospitals are excluded from this procedure. (As example, if your total cost amounts to Rs. 60,000 and you utilize a local kidney and share the other kidney and liver with two other private hospitals, you can ask those two hospitals to reimburse you of your costs by an amount of Rs. 20,000 each. If, by chance, one of the two share organs went to a Government hospital, you can ask the other private hospital to share your cost to an extent of Rs. 30,000.)

What is the procedure when I get allotted a Share organ?

Share organ is the second kidney from a donor hospital and any other organ it is unable to utilize, that gets allocated to another hospital. Please ensure that there is 24 hour availability of your transplant coordinator to interact with the Member Secretary. When a Share organ is offered to a particular recipient on your list, contact that recipient immediately, arrange all logistics and convey your acceptance of the offer within forty five minutes. Offer would expire if not accepted within this time. If the Member Secretary alerts that one of your recipients shows up as second in the priority for allocation, alert that person and be ready to accept the offer within 45 minutes should a firm offer be made subsequently. (Not accepting an offer will not detract the Recipient from prioritization in subsequent offers.)

It is your responsibility to interact with donor hospital to obtain all information, blood sample etc.,that you need to assess the suitability and match of that organ with your recipient. It is also your responsibility to send a team to the donor hospital to retrieve organ, preserve it and bring back for transplantation.

If you are a private hospital and receive the Share organ from a private hospital, you need to defray the costs incurred by the donor hospital, if asked by them, in the manner described earlier.

Inform the Member Secretary as soon as the surgery is over and send a fuller recipient report to him through the online form at within 48 hours of discharge of patient. Send him also a monthly statement of the transplants done as well as periodic reports on long term clinical results of transplant surgeries in formats provided by the Member Secretary.

How is the Share Organ allocation made by the Member Secretary to my patient, if I am a Kidney            transplant hospital?

For Kidney allocation, a procedure was devised and adopted to start the waitlist. The Kidney transplant hospitals were asked to send their Initial List of recipients to the Convenor through online posting on the website during a specified time window that ended on November 30, 2009. Recipients should have been on dialysis for a minimum period of two months at the time of registration. Date of starting dialysis was the priority determining parameter in this Initial List.

For Kidney allocation, a procedure was devised and adopted to start the waitlist. The Kidney transplant hospitals were asked to send their Initial List of recipients to the Convenor through online posting on the website during a specified time window that ended on November 30, 2009. Recipients should have been on dialysis for a minimum period of two months at the time of registration. Date of starting dialysis was the priority determining parameter in this Initial List.

North Zone – Chennai , Kanchipuram, , Cuddalore, Thiruvallur, Thiruvanamalai, Vellore, Villupuram
South Zone – Trichy, Perambalur, Ariyalur, Thanjavur, Pudukkottai, Nagapattinam, Tiruvarur, Dindigul, Madurai, Sivaganga, Virudhunagar, Thoothukudi, Tirunelveli, Kanyakumari
West Zone – Theni, , Karur, Krishnagiri, , Dharmapuri, Coimbatore, Erode, Salem, Nammakkal, Tiruppur, Udagamandalam

What are the prioritization norms for Kidneys?

The first stage of allocation is to the Lists. The norms for this go as follows:
One Kidney (called ‘Local’) goes to the Hospital List of the transplant hospital where the organ donation happens. If the donor hospital has no recipient for that Kidney, both Kidneys become Share Kidneys.
Second Kidney (called ‘Share’), if it arises in a Government Hospital, will be allocated to Lists in the following order, moving to the next if no match is found in the earlier list

  • Combined Government Hospitals List.
  • Combined Private Hospitals List.
  • Government Hospitals outside the State.
  • Private Hospitals outside the State.
  • Foreign National in or out of State.

Should Share Kidney arise in a Private Hospital, the order will be as follows:

  • Combined Government and Private Hospitals List.
  • Government / Private Hospitals outside the State.
  • Foreign National in or out of State.

The second stage of allocation is to the specific recipient on the allotted List. Subject to blood group match this goes as follows:

For Local Kidney that gets allocated to the Donor Hospital List, the hospital’s own priority criteria, as intimated to the Member Secretary will apply. For Share Kidney, priority will be based on seniority of registration with the Member Secretary, and where this seniority is the same, seniority of period on dialysis will apply. All those on the Initial List registered on or before November 30, 2009 are treated as having registered simultaneously on that day. This effectively means that for all those in the Initial List, the period on dialysis will determine priority.

Recipients below 12 years of age will have priority to be matched with donors below 12 years. Recipients above the age of sixty can also be registered and will be considered for allocation of kidneys from donors above the age of sixty or of other kidneys not matched or accepted by recipients below the age of sixty. O group recipients will have priority to be matched with O group donors.

Is there any way one can estimate how long a waitlisted patient may have to wait to get a Share                 Kidney?

Yes, it is feasible for a registered hospital to assess this to a reasonable extent. Please contact the Member Secretary for information on the average number of donors per month in each blood group in the recent past and using this information along with the priority rank of a particular patient, as seen in the online list of your hospital available online, you will be able to approximately estimate the wait time.

How are Liver / Heart / Lung allocated?

The transplant hospitals are to prepare their hospital waitlists for liver and provide them to the Member Secretary along with their prioritization criteria in the format specified by him. There will, however, be two kinds of lists – Urgent and Standard.

The criteria for Urgent Liver Transplantation are:

  • Hepatic Artery Thrombosis following a liver transplant.
  • Primary non-function of a graft.
  • Fulminant hepatic failure.

At the heart and lung transplant meeting dated 03/11/2015 it was decided to modify the criteria for urgent allocation of Heart [as specified in GO No.287 dated 05.09.2008 ] as follows:

Urgent Listing for Heart - Criteria
1. Hyper Acute Rejection
2. Primary Graft Dysfunction

Urgent Listing for Lung (same as existing)
1. Mechanical Ventilation
2. Ecmo
3. Primary Graft Dysfunction

The hospitals will also keep the Member Secretary posted of multi-organ failure recipients.
Given the above, the Urgent list of severely ill patients gets the highest priority. As for Standard Lists, organs (liver, heart, lung) from a Local Donor automatically get allocated to the List of the hospital where the donation arises. These are called Local Organs. If no recipient match is found in the donor hospital or the organs are not taken by that hospital for any other reason, they get into the Share Pool. These Share Organs would get allocated to Standard Hospital Lists by hospital turn (Liver turn system, Heart and Lung by waitlist) This is done by arranging the participating hospitals in a random order - which order will be revised once in six months – and offering an available Share Liver first to the hospital next in line to the one that took the earlier Share Liver; if it is not taken by that hospital, it will be allotted to the one next in line and so on. If no hospital in the network can take that liver, it will be offered to other state networks feasible. Share Organs donated in a Government hospital will be offered first to other Government hospitals.
In the event of a hospital (Hospital A) flagging an Urgent List patient for Liver, it will be circulated to other liver transplant hospitals in the network and if there is no dissent, that patient in Hospital A will be allotted the next available Share or Local Liver of same or compatible blood group. If it is a Share organ allotted out of turn to this case, Hospital A will give up its next allocable Local or Share organ of non-marginal quality – of same or any other blood group as decided by the Convenor - to the share pool. If, on the other hand, it is a Local Liver of another hospital (Hospital B) - automatically allocable to that Donor Hospital - that gets diverted to this Urgent List patient of Hospital A, Hospital B will, at that time, specify the blood group of the recompense offer; in this case, the next Local or Share Liver of that blood group (of non-marginal quality) allocable to Hospital A will, instead, get allocated to Hospital B.
Multi organ recipients matched with multi organ donors can get priority over others in the Hospital List in the allocation of Local Organs, subject to the priority norms of that hospital. In case where a hospital gets allotted Share Liver from a donor in another hospital and happens to have a combined liver and kidney recipient in its Hospital List to whom that Liver would suit and the hospital finds the need to allot it to that patient, it is free to make a request for the allocation of that donor's share kidney too to that patient for the purpose of combined transplant and the Convenor may accede to this, subject to the condition that the next available Local/Share Kidney in that hospital will be placed in the share pool.
When a Share Liver is offered to a hospital, it has to be allocated to a recipient of the same blood group in the Hospital List. Local livers can be allocated to compatible blood groups.
A hospital alerted about a Share Liver offer should accept it only if it is in a position to schedule organ retrieval within 10 hours of alert or 6 hours of brain stem death certification, whichever is later and should communicate its acceptance of the offer within 45 minutes of offer. A donor hospital finding a Local Liver medically unsuitable for its use, should provide access to at least two more hospitals to evaluate that organ and decide on acceptance; if the organ is rejected after retrieval, it should be made possible for at least one other hospital to evaluate it.
All allocations made to hospitals as described above are made to the Hospital Lists of those hospitals and each hospital should follow the prioritization in its List as communicated earlier to the Member Secretary. The reasons for any exceptions made to this should be explained to him. Within Hospital Lists, a Liver recipient should have registered for more than 24 hours to qualify. When an organ is allotted to the hospital list, it is to the Indian nationals on the list. If no match is found for the organ in that hospital, followed by other hospitals in the State and in the Country for Indian nationals, it will then be allotted to foreigners in the hospital list, followed by State and Country lists.
Organ allocation procedures are still being evolved, learning from experience. Liver transplant hospitals need to provide to the Member Secretary data relating to past and future transplant surgery outcomes in prescribed format – including MELD Scores and mortality on waitlist – so that alternative methods of more patient-centric allocation can be examined.

If I am a non-transplant hospital, what is my role?

You can, of course, become a transplant hospital, if you wish to. See the THO Rules, particularly Rule 9, to see if you qualify. Form 11 of the Rules is the format for applying for registration, but write to the DMS, 7th Floor, DMS Complex, 359, Anna Salai, Teynampet, Chennai- 6, with Rs.300 D/D drawn in favour of “The Director of Medical and Rural Health Services” to get the application form formally.

If you are not a transplant hospital and suspect brain stem death in a particular case, but do not have the facilities to properly assess or certify brain stem death, please shift the patient to a nearby transplant hospital for further diagnosis. You can contact the Member Secretary for guidance in this regard.

How is this entire exercise co-ordinated?

The anchor for this coordination is Dr.P.Balaji, Member Secretary TRANSTAN. He can be contacted at or Tel: 044-25333676 /, His mailing address is: Member Secretary, TRANSTAN, Tamil Nadu Multi Super Speciality Hospital, Room No.1045 & 1046, First Floor, Omanduar Government Estate, Anna Salai, Chintadripet, Opposite to The Hindu, Chennai 600 002.

His role is to maintain the waitlists and allocate organs, call meetings of the Advisory Committee, Executive Committee of TRANSTAN, collate data on transplantation and take up awareness generation programs. The detailed steps he would take have already been explained in the narration above.

His effort is supported by the Advisory Committee, Executive Committee that has been formed to establish formats and procedures, to oversee compliance with procedures, to ensure stability of functioning of the program and to recommend a Coordinating Body to institutionalize and streamline the program.
The members of the Advisory Committee are:

  • Secretary, Health or his nominee-Chairman
  • Sri P.W.C. Davidar, IAS
  • Member Secretary, TRANSTAN
  • Director of Medical Education or representative
  • Director of Medical and Rural Health Services or representative
  • Managing Director, Tamil Nadu Medical Services Corporation or representative
  • Managing Director, ELCOT or representative
  • Officer from Department of Finance, Tamil Nadu
  • Transplant team member, Government Stanley Hospital, Chennai
  • Transplant team member, Kilpauk Medical College Hospital, Chennai
  • Transplant team member, Government General Hospital. Chennai.
  • One senior police officer of DIG rank or above as nominated by the Director General of Police, Chennai.
  • Member from MOHAN Foundation, Chennai.
  • Member from National Network for Organ Sharing, (NNOS), Chennai.
  • Nominee, Apollo Hospital, Chennai.
  • Nominee, Christian Medical College Hospital, Vellore.
  • Nominee, Global Hospital, Chennai.
  • Nominee, Kidney Care Centre / Galaxy Hospital, Thirunelveli.
  • Nominee, KG Hospital, Coimbatore.
  • Dr George Thomas, Medical Ethics Specialist.

The Advisory Committee has set up certain Sub-Committees to provide inputs to the Advisory Committee, and to be available for consultation and help in decision making by the CCTP.

The members of the Executive Committee of TRANSTAN are :

  • (i) Secretary to Government, Health & Family Welfare Department
  • (ii) Principal Secretary to Government or his nominee Finance Department, Govt of Tamil Nadu
  • (iii) Expert Advisor, Transplant Admin and Policy
  • (iv) Special Secretary to Government, Health and Family Welfare Department
  • (v) Director of Medical and Rural Health Services
  • (vi) Managing Director, Tamil Nadu Medical Services Corporation
  • (vii) Director of Medical Education
  • (viii) Member Secretary, TRANSTAN
  • (ix) Dean, Madras Medical College
  • (x) Dean, Stanley Medical College
  • (xi) MOHAN Foundation Representative, Chennai
  • (xii) NNOS Foundation Representative, Chennai

The entire structure and norms described above are still evolving and have a long way to go to achieve full results. All participating hospitals have a crucial role to play in this. Please let the Member Secretary know of improvements or changes you think would make the whole process more effective.

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