Youngest Donor, Biggest Legacy: Kerala’s Changing Organ Donation Story

“We lost our baby who was with us for 20 months — ten months in the womb and ten months on earth. But when my son told me about their decision to donate her organs, I agreed,” said Reji Samuel, struggling to contain the unbearable grief that has engulfed his family.

More composed, yet carrying a quiet resignation, he said the family is finding solace in the thought that four children have been given a new lease of life. “We gained four children. Our baby fulfilled her duty. God took her back after she completed her purpose on earth,” he said.

Reji Samuel, the grandfather of Aalin Sherin Abraham, who died following an accident in Kottayam, spoke with a mix of sorrow and indifference. The child was declared brain dead on Friday. Her parents chose to donate her organs to four other children, making Aalin the youngest organ donor in the state.

Aalin gifted her kidneys, liver, heart valves and corneas to four children, offering them a renewed chance at life. In recognition of the extraordinary decision taken by her family, the state government accorded her full state honours, with ministers and senior officials attending the funeral.

Among those who came to pay their last respects was Chandran, a relative of one of the recipients. “I can feel the excruciating pain the family is going through. I am here to share their grief,” he said.

According to hospital sources, all four children who received her organs are recuperating at different hospitals and responding well to treatment.

The willingness to take a  decision to donate the organs of the beloved to the needy has been on the increase in the state in recent years. The family’s decision is the latest one in this.

Chief Minister Pinarayi Vijayan lauded the parents decision to donate their daughter’s organs, as a monumental act of compassion that reflects the true spirit of Kerala.  
 The accident occurred while Aalin Sherin Abraham was travelling with her mother and parents when a vehicle rammed their car. The girl condition deteriorated and was shifted to Kochi. Despite best efforts her life could not be saved.

After her parents agreed to donate organs, the donation procedures were coordinated through the Kerala State Organ and Tissue Transplant Organisation (K-Sotto).

The baby’s donated heart valves will be sent to the Sree Chitra Tirunal Institute for Medical Sciences and Technology in Thiruvananthapuram, the liver to KIMS Hospital in Thiruvananthapuram, and the kidneys to Thiruvananthapuram Government Medical College. In addition, the child’s eyes will be donated to the Amrita Hospital Eye Bank, according to officials. 

Recently, Kerala State Organ and Tissue Transplant Organisation officials have noted a steady rise in the number of people willing to donate organs, attributing the shift largely to sustained awareness campaigns. “Whenever stories of organ donation appear in the press, we see a surge in the number of people coming forward to pledge their organs,” said an official with K-SOTTO.

Between 2012 and 2024, 83 heart transplants were performed in the state. Of these, 72 were conducted in private hospitals, while only 11 were conducted in government-run institutions. Authorities say improved communication by doctors and healthcare workers about the concept of brain death has played a crucial role in changing public perception.

“Once a person is declared brain dead, doctors clearly communicate this to the relatives. Now people understand that brain death is irreversible. If the family consents to organ donation, ventilation is continued and the procedures for organ retrieval are initiated,” the official explained.

In the last six months, around 6000 people have pledged to donate their organs.

“Though more and more people are coming forward to pledge their organs, brain-death donations continue to face significant logistical hurdles,” said Dr. Noble Gracious, Executive Director of Kerala State Organ and Tissue Transplant Organisation.

“Because of the laborious process involved in declaring a person brain dead, the protocol is often not fully followed,” he explained. Under the guidelines, a patient can be declared brain dead only after a medical board constituted by the hospital conducts at least two examinations, six hours apart.

If the family consents to organ donation, the hospital must continue to maintain the patient on ventilatory support in the ICU and make arrangements for an operation theatre for organ retrieval. “For private hospitals, these requirements pose significant logistical and financial challenges,” Dr Noble Gracious added.

Now, the Kerala State Organ and Tissue Transplant Organisation is working on a responsibility matrix to be shared with hospitals across the state. Dr. Noble Gracious believes that clearly defining the roles and responsibilities of each stakeholder could help address the logistical bottlenecks involved in brain-death organ donation and streamline the process.

In a major step to strengthen public healthcare, the Kerala government recently laid the foundation stone for the Kerala Institute of Organ and Tissue Transplant in Kozhikode. The institute is set to become India’s first public-sector hospital dedicated exclusively to comprehensive organ transplantation.

Currently, nearly 90 per cent of organ transplants in the state are conducted in the private sector, making this initiative a significant move toward improving accessibility. Once commissioned, the dedicated transplant hospital is expected to substantially reduce the cost of surgeries and make advanced care more affordable for patients.