The Advanced Transplant Coordinators’ Workshop – 3rd Consultative meeting was held at the Radha Regent, Chennai on 29th & 30th January 2016. The meeting’s focus was to explore strategies to improve organ and tissue donation in India through Donation after Circulatory Death (DCD) and tissue banking. Many stakeholders and experts from different parts of the country and abroad participated in the meeting.

DCD has helped increase the donation rate in many countries in the West, revolutionised lung donation and some are even contemplating a heart transplant after DCD. The international faculty – Dr. Sanjay Deshpande and Ms. Michelle Hunter from NHS Blood and Transplant, UK and Dr. Vijayanand Palaniswamy from Australia shared their experience in this field. Dr. Deshpande said that UK had the largest DCD programme in the world and that the DCD process is underpinned by a number of policies and documents. He also shared a vision of Organ Donation UK 2020, where one of the aims was to increase the deceased donor transplant rate from the current 49 to 74 per million population. Ms. Hunter spoke about how the Specialist Nurse for Organ Donation (SNOD) was the lynchpin in the DCD process. Dr. Vijayanand Palaniswamy, Intensive Care consultant, Royal Darwin Hospital, Australia said that seamless communication and teamwork were essential for DCD to be successful. Dr. Anand Khakhar, Liver Transplant surgeon, Apollo Hospitals, Chennai gave an overview of DCD in India and Dr. Sunil Shroff, Managing Trustee, MOHAN Foundation, presented some real-life case studies on the subject. Dr. Malvinder Singh Sahi, Senior Consultant, Critical Care, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, spoke about ‘Ethical Issues in end of life care’, which set off an impassioned debate on passive euthanasia and Do Not Resuscitate (DNR) orders. The consensus was that the Transplant law in India does not have any clause against DCD, but guidelines from the ‘Ministry of Health’ were required before hospitals felt comfortable with this type of donation process.

Tissue banking is still in its infancy in India with a few hospitals doing various types of tissue collections. Dr. Alvin Chua, Assistant Director, Transplant Tissue Centre, Singapore gave the audience a perspective on some of the key issues in establishing a state-of-the art tissue bank. Dr. Chua in his presentations – ‘Towards a multi-tissue bank facility: The Singapore experience’ and “Procurement and Sterlisation of Tissues’ Dr. Ajoy S M talking about Quality management in spoke about the stringent AATB (American Association of Tissue Banks) norms that they follow. He also emphasised the need for an integrative approach between various tissue collection centres to optimise resources. Dr. Sunil Keswani, Director, National Burns Centre, Mumbai, Dr. Ajoy S. M., Dept. of Orthopaedics, QCO, M S Ramaiah Tissue Bank, Bangalore, and Dr. R. R. Sudhir, Head, Dept of Preventive Ophthalmology & Senior Consultant Cornea Services, Sankara Nethralaya, Chennai, gave the Indian perspective on skin donation and skin banking, bone donation and quality management, eye donation and eye banking respectively.

Dr. K. R. Balakrishnan’s presentation focused on ex-vivo cardiac care systems and the use of drones in transporting organs. There was a lively panel discussion on ‘Unusual Case studies’ that was moderated by Dr. Sunil Shroff. One of the key issues discussed was about how doctors need to communicate the news of brain death to the family. The panelists were Dr. P. Magesh, Dept. of Neurosurgery and Dr. R. Radhakrishnan, Dept. of Anaesthesiology, Rajiv Gandhi Government General Hospital, Chennai, Dr. Akila Rajakumar, Intensivist, Global Hospitals, Chennai, Dr. R. Kanimozhi and Dr. G. P. Arulraj, Dept. of Anaesthesiology, Govt. Stanley Hospital, Chennai and Mr. K. Prakash, MOHAN Foundation.

Dr. Thomas Mathew, Convenor and Dr. Noble Gracious, Nodal Officer, Kerala Network for Organ Sharing (KNOS) spoke about the success of deceased organ donation in Kerala being due to the support of the government, public and private hospitals, church and the media. Ms. Aneka Paul of the Sir Ratan Tata Trust, Mumbai gave a concise presentation on ‘Getting financial help for transplant surgery.’

The valedictory function was graced by Dr. J. Amalorpavanathan, Member Secretary, Transplant Authority of Tamil Nadu and Dr. Georgi Abraham, Director, Madras Medical Mission Hospital, Chennai. Mrs. Lalitha Raghuram, Country Director, MOHAN Foundation said that all the participants were going back enriched after the meeting. The highlight of the function was the auction of a line of jewellery showcasing the organ donation motif – the green ribbon – designed by Mrs. Bhavna Jagwani, Convenor, MFJCF, Rajasthan.