Kerala government offers to pay for service of professionals during deceased organ donation procedures

The Kerala government has decided to provide professional fees to various categories of health care workers, ranging from medical specialists to technicians and grief counsellors, whose services are engaged during deceased donor organ donation and transplantation procedures in the State.

Deceased donor organ donation is a resource-intensive process that requires the coordinated efforts of numerous professionals, many of whom must work extended hours, often at short notice. Their involvement begins with the declaration of brain stem death and continues through organ retrieval and transplantation.

“Every deceased donor organ donation begins with brain stem death declaration, which is an intensive process in itself. Doctors are required to conduct a series of tests, including apnoea tests conducted six hours apart. Often, these doctors come from other hospitals at odd hours to assist us. Until now, we have not been able to offer them any remuneration, and they have rendered their services purely out of goodwill. However, the absence of compensation for their efforts has long been a challenge in promoting deceased donation activities,” said Noble Gracious, executive director of Kerala State Organ and Tissue Transplant Organisation (K-SOTTO).

The process involves several sequential and highly coordinated activities, including brain stem death certification, grief counselling, explaining the patient’s condition to family members, obtaining consent for withdrawal of ventilator support or organ donation, haemodynamic maintenance of the body until organ retrieval is completed, organ evaluation and allocation, arranging logistics and green corridors for organ transportation, organ retrieval, transportation, and transplant surgery. Each of these stages requires the expertise and involvement of multiple professionals.

Specialists such as intensivists, transplant surgeons, grief counsellors, anaesthetists, ICU technicians, OT technicians, and empanelled doctors responsible for brain stem death certification play critical roles in this process. In many cases, they remain engaged for 24 to 36 hours until all procedures are completed.

“We have been exploring since 2022 the possibility of offering professional fees for their invaluable services, so that deceased donation processes do not become a burden on them. Many have been contributing beyond their regular duty hours, and it is important that we recognise both their goodwill and their expertise,” Dr. Gracious added.

The executive committee of K-SOTTO, at its meeting held in January 2024, approved the proposal to provide professional fees to various categories of professionals involved in deceased organ donation, along with the corresponding rates. The government has now granted formal sanction for the proposal, and the expenditure will be met from K-SOTTO’s annual budgetary allocation.

Medical professionals, including intensivists, organ retrieval surgeons, transplant surgeons, and anaesthetists, will receive professional fees ranging from ₹5,000 to ₹10,000 for specified hours of service. ICU and OT technicians, transplant nurses, organ perfusionists, grief counsellors, transplant coordinators, as well as doctors and nurses accompanying the organ for transportation will also be compensated for the hours they dedicate to the process.