In the face of ever growing need for organs the focus has shifted to peripheral centres, which  get a large number of brain death cases. Unfortunately, organs cannot be retrieved from these hospitals , as they are not registered under the  THO Act . The THO Act clearly states  that “ no  hospital unless registered under this act , shall conduct or associate with, or help in the  removal  storage or  transplantation of any human organ” Chapter III;10;1a). It also  goes to say  in that “no hospital shall be registered under this act  unless the Appropriate Authority is satisfied that such hospital is in a position  to provide  such specialized services and facilities, possess such skilled  manpower and equipment s and  maintain such standards as may be prescribed,” (chapter V;15;1). The specifics are listed in the prescribed application forms (Form 11) of the THO Act.  The interpretation of this particular segment has created a lot of confusion amongst clinicians with respect to recognizing centres only for retrievals. These are two views  on this as the Maharashtra Confederation for organ Transplantation (MCFOT)  found out. Dr. S.M. Sakpal, Ex- Asst. Director, Cadaver Transplant Cell, GOM, says that hospitals can get recognised retrieval alone. He points out that the Pune Institute of Neurology has been recognised for retrieval because of the high number of brain death case, one the basis on minimum requirements like ventilator, lab, OT and central oxygen. He feels the hospital must take the initiative, a point with which   Dr. Vidya Acharya, member MCFOT agrees. She adds, “World over, the practice is to allow recognised teams to visit hospitals to perform retrievals. In the countries like Denmark and Sweden, there are not more than 5 recognised transplant centers. Even then, the transplant cases are high because there, aren’t any restrictions of retrieval. However, the chair person of MCFOT, G.S Gill says that the norms are so strict that smaller centres opting for only retrieval cannot meet the requirements. He feels separate standards should be instituted for hospital that need recognition only for retrieval.  In addition, there is a clear need to educate not only the public but also the medical and paramedical people on the diagnosis of brain death and cadaver organ donation.

The MCFOT has called for amendments in the THO Act to enable timely organ retrievals and also to authorized the transplant team from a recognised hospitals to carry out organ retrievals at smaller peripheral centres.