KOCHI: With the state government initiative to promote deceased donor organ transplantation eliciting only a lukewarm response, health department is planning to introduce a slew of confidence building measures to revive it including limiting of brain death certification to government hospitals. They have already issued guidelines for swap donor transplant and live organ donation. Kerala Network for Organ Sharing ( KNOS ) is also planning to depute district coordinators for smooth conduct of deceased donor organ transplantation. “Despite the government taking proactive steps, the deceased donor organ transplantation project did not gain momentum. People are still apprehensive of issues including brain death certification at private hospitals. We are planning to provide special centres attached to government hospitals for brain death certification,” said Rajeev Sadanandan, additional chief secretary and health secretary.The cost of brain death certification is high. “Once the new system is introduced the cost should be borne by the hospital where the transplant is done. Negotiations with hospitals in this regard are on. We expect positive changes once it is introduced,” said Sadanandan.The KNOS will soon start taking care of all processes associated with brain death certification and deceased organ transplantation, he said.The swap donor transplant project, found to be a success in states like Maharashtra, will be implemented in the state with technical advice from Dr Viswanath Billa , founder of Mumbaibased Apex Swap Donor Transplantation Registry. Experts including Dr Billa conducted classes for the doctors here last week. A swap donor registry would have details of patient kin who are ready to donate organ but cannot because of mismatch due to reasons like blood group incompatibility. The data of patients and donors will be pooled in the registry and those with the best match would be identified through automated system.“Technically, swap transplant is like regular transplant. For swap donation, there should be a platform where donor and recipient can meet. It is a question of logistics. More than 100 swap donations have been completed in Mumbai,” Dr Viswanath Billa told TOI.Creating awareness and finding an appropriate match are key issues, he said. “Developing a software to select best matches is important. We are using a software developed by IIT-Mumbai. We are happy to hand it over to government of Kerala free-of-cost,” Dr Billa said.Dr M K Mohandas, secretary, Nephrology Association of Kerala , said swap donations has certain limitations. “Both the hospitals where harvesting and transplant are to be done should be nearby. It can attain the intended results only if the government sector takes the lead. The sector needs to be strengthened by appointing more staff. Private hospitals should also be part of the system. There should be strict regulation and monitoring by government,” said Mohandas.A dedicated team should be in stand-by in case of an alert. There should be a grievance-redressal mechanism as well, he said. “KNOS should be made a permanent body headed by health secretary or director of health education. The recruitment to KNOS should be made by PSC . We should also encourage donations by unrelated persons,” said Mohandas.

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