Since its inception in 1995, the cadaver organ transplant programme in our country has so far failed to achieve its objectives. One of the major hurdles has been the unrelated transplants that have been happening rampantly with the permission of the “Government Authorization Committee”. Under these circumstances, there is no pressure on the government or the hospital machinery to push the cadaver programme and it takes a back seat. An occasional scandal tightens this unrelated “authorized programme” for a short span of time.

 In this dark scenario, a few committed NGOs have been working very hard to keep the cadaver programme alive and give it some meaning and it is in this context that the role of Mohan Foundation in starting an ‘Initiative for Organ Sharing’ (INOS) group in Tamil Nadu is worth discussing. INOS was started as a pilot project by the Foundation in November 1999 between a group of five hospitals in Tamil Nadu. Hospitals included Apollo Hospital, Sri Ramachandra Hospital, Sundaram Medical Foundation and Madras Medical Mission – all from Chennai and Christian Medical College, Vellore. The essence of forming the group was so that “organ could be shared between different hospitals and not wasted”. A core committee was formed and it was decided to hold a monthly meeting to discuss and resolve various issues involved in organ sharing and transplantation. Since its inception twenty-one such monthly meetings have been held and 54 organs have been shared (see table below) between the INOS group of hospitals. So far there has been no money transaction between hospitals and the system has worked more on a mutual barter basis. The criteria for organ sharing have been drawn up. In the event of a donor being available in a hospital one kidney remains in the hospital and the other goes to the general pool of waiting list patients. Similar sharing criteria have been drawn up for sharing of heart and liver.

                                    Kidney                          50

                                    Heart                            3

                                    Liver                             1

            (INOS Tamil Nadu figures from Jan 2000 to Dec 2001)

In August this year, other hospitals from Tamil Nadu doing cadaver organ transplant were invited to join the group. The doctors of Govt. Hospitals expressed their inability to share organs with private institution unless a ‘Government Order’ was issued. The INOS group hopes to resolve these issues in the future. The inception of INOS is no coincidence. It all started in October 1999 when Mohan Foundation invited over 60 cadaver donor families to a function and honoured them. (See Indian Transplant Newsletter Feb.2000/Vol. II/Issue No.5) .  During the function a survey of the donor families was done by questionnaires. This showed that none of the families regretted having donated the organs of their loved ones. However there was apprehension about organ allotment, distribution and commercialization of donated organs. It was following this function that Mohan Foundation members felt that a group like ‘INOS’ was urgently needed. Whenever difficulties have been encountered in running INOS, the Foundation members remember the evening of 30^th October 1999 and it gives them a reason to continue their pursuit in making INOS a success.