MOHAN Foundation's one year Post Graduate Diploma course for transplant coordinators commenced in August this year and the first batch of 22 students from nursing, medical and social work background have now finished their first semester examination. This is a milestone of sorts for this region as this is the first such course that is being offered outside of Spain to help with the deceased donation programme. The deceased donation rate for Asia is less than 1 per million populations in comparison to 21 of North America and 16 of Europe. The curriculum has been designed to cater to the needs of India and to a large extent the Asian subcontinent. 

The Transplantation of Human Organs (Amendment) Act 2011 makes it compulsory to appoint a transplant coordinator for a hospital to get an accreditation to undertake transplants. What are the qualities and qualifications that are required for such a person has often been discussed.  

MOHAN Foundation with over 500 deceased donations to its credit has over the last 15 years seen both doctors and paramedical staff performing this duty with success. 

For a successful deceased donation to happen there are two important aspects. The first is related to handling donor families and the second involves completing formalities of certification followed by optimum maintenance of the deceased donor and timely retrieval process. Only if these two aspects are handled successfully can the programme work. But the key to the success of the deceased donation programme is how one approaches the family and introduces the concept of organ donation at the time of extreme grief. This requires knowledge (brain death, its consequences and legal aspects), good counseling skills (breaking bad news) and asking for organs, soft skills (building a reasonable rapport with the family members in a short span of time), empathy with family members of the deceased donor (respecting their decision be it yes or no to organ donation), patience and perseverance as the whole process can take more than a day to complete. On many occasions it has been seen that it is how well trained the person counseling that matters the most and decides between success and failure.  

The course aims at providing the skills required to be a good coordinator. Doctors or nurses are never given any formal lessons on how to break bad news to a patient or their relatives. They learn this over the years and some of them are good at this and some lack the skills despite being in the field for many years. However, if the person concerned is trained through a structured programme, the approach is more professional and the chances of getting a 'yes' increases many fold. This fact has been proved by many studies from various regions of the world. In Tamil Nadu too, trained coordinators from non- medical background (medical social work) have successfully counseled families and have had a 'yes' for organ donation in 60% to 80% of the families.

When deciding what the minimum qualification for a transplant coordinator in India should be, these aspects should be taken into consideration and should include either a medical or nonmedical person who has undergone formal training in various aspects of transplant coordination including counseling. In some quarters, it is felt that only doctors are qualified for this post. This approach would not only restrict the numbers truly applying for the post, but also would mean that some hospitals would just nominate a doctor as a mere formality to apply and preserve their license. This would also mean that the new amended act with transplant coordinator as a compulsory member of the transplant programme would be a non-starter.