Kerala’s saga of organ donation; K-Sotto and Kerala Police are making a difference

Thiruvananthapuram: Kerala’s youngest organ donor, 10-month-old Aaalin Sherin Abraham, saved four lives after her death in February this year. Her young parents, Arun Abraham and Sherin Ann John, mournfully stood beside their daughter’s body, leaving a profound impression on Kerala’s public consciousness. The state’s organ donation efforts earned it the Union Government's award for outstanding performance in implementing protocols for deceased organ donation. From confirming brain death to transplanting organs into recipients, the dedicated staff of the Kerala State Organ and Tissue Transplant Organisation (K-Sotto) and the police undertake a meticulous and demanding process that extends beyond a single day.

Till July this year, 22 organ transplants were done in the state. The corresponding figures were 11 in 2024 and 25 in 2025. The process begins with certifying the brain death of a person. For this, a four-member medical board will be formed to follow the protocol. The tests to confirm brain death are done twice, at least six hours apart. In the case of young donors like Aalin, it has to be done twice, 24 hours apart. The medical board comprises a government doctor and three doctors of the hospital where the death was declared. After declaring the brain death comes the most challenging part- informing the deceased’s family and getting their consent during unbearable grief.

“The resistance among the people for organ donation is lower than we anticipated. The challenge is certifying brain death,” Dr Noble Gracious SS, Executive Director and Member Secretary, K-Sotto, told The Pioneer. Once the consent is obtained, the process of organ allocation will begin. The priority goes to the patient at the top of the centralised waiting list. The hospital concerned would be informed. The organ has to match the recipient. After that is confirmed, a collective effort begins among the K-Sotto staff, the police, the media and the public.

A green channel will be established for organ transportation without hurdles. From the police force, the Additional Director General of Police (ADGP) Headquarters is the nodal officer for establishing the green channel. Police personnel will ensure the smooth passage of the ambulance; the media will carry news to alert the public to overcome any hindrance. “The public also cooperates in a commendable manner,” said Dr Basil Saju, a Public Health Specialist, K-Sotto.

Ambulances and air ambulances are used to transport the organ. The Home Department’s helicopter can be used for free for up to 15 hours a month. “K-Sotto has used the Home Department’s air ambulance nine times after obtaining sanction for medical emergency use,” Dr Basil Saju added.

Organs will be transported by road, too, depending on factors including weather, distance, and the golden hour (the time an organ can be preserved; it differs for organs). The shortest distance in organ transportation was from Ernakulam to Kottayam, and from Kottayam to Thiruvananthapuram. K-Sotto had to rely on road transportation from Thiruvananthapuram to Kozhikode during daytime. This was the longest distance covered so far, showing a well-coordinated effort by the police and the K-Sotto staff.