3 surgeries in 38 days: How success stories are resuscitating Kerala’s transplant game

On October 17 this year, tears of joy trickled down the cheeks of Dr Sirin from Ponnani in Kerala’s Malappuram, when she spoke to the media at the lobby of Lissie Hospital in Ernakulam. Her brother, Ajmal, had just undergone a successful heart transplant. The donor was 25-year-old Amal Babu from Thiruvananthapuram, who lost his life in a road accident.

Heart-warming tale, success story

The story had already moved many, a heart-warming tale of humanity that transcended faith, as Amal and Ajmal came from different communities. Ajmal’s wife, Jasla, was visibly emotional, thanking Amal’s family, especially his mother, a homemaker, and his father, a retired policeman.

Also read: Tamil Nadu revamps organ transplant framework amid kidney sale allegations

But it was Dr Sirin’s words that stayed with everyone. “It was the news of the last few heart transplants and the way the media highlighted them that gave us the courage,” she said. “My brother is alive today because someone chose to donate — and because others before them showed us it was possible.”

Kerala saw three heart transplants in just 36 days, one of them being a paediatric surgery and marking a hopeful turn after years of slowdown in the state’s organ transplant activity. The operations, carried out at major hospitals in Kochi and Thiruvananthapuram, have renewed confidence in Kerala’s medical capability. But behind the revival lies a quieter, troubling fact, despite its celebrated healthcare system and high literacy, the state remains a laggard in deceased organ donation.

Laggard in deceased organ donation

According to the National Organ and Tissue Transplant Organisation (NOTTO) Annual Report 2025, Kerala recorded only 11 deceased donors in 2024, a steep fall from 76 in 2015. However, the year 2025 till September has recorded an increase of 15 donors.

Across India, the southern states continue to lead the country’s transplant efforts, but Kerala’s contribution has steadily shrunk. The contrast with Tamil Nadu, Telangana, and Andhra Pradesh is striking. These states have made organ donation a structured part of hospital practice, a process that begins in the ICU and ends in a seamless transplant chain.

Also read: How Telangana turned organ donation into India’s most inspiring life-saving movement

“There were several reasons behind the decline,” says Dr Jo Joseph, a cardiac surgeon at Lissie Hospital who has been part of many heart transplant teams in recent years. “At one point, a few court cases, including one filed by a doctor from Kollam, made many surgeons hesitant to certify brain death,” he said.

Why transplants didn’t pick up

Dr Joseph also pointed to the alleged role of Malayalam cinema in painting a negative picture of organ transplantation.

“Around the same time, commercial Malayalam films began portraying organ transplants alongside stories of organ harvesting mafias, creating deep public mistrust. Popular actors like Sreenivasan even went on a public campaign claiming that transplant patients rarely live long and that their quality of life is poor. Together, these factors had a serious negative impact on both organ donation and transplant procedures in the state,” he said.

On the other hand, in Tamil Nadu, the Cadaver Transplant Programme ensures that every brain-death case is promptly reported, families are approached by trained coordinators, and logistics are handled with clockwork precision. Telangana’s Jeevandan initiative runs on similar lines, combining public trust with efficient coordination between hospitals and the state registry. Andhra Pradesh, too, has built a network where donation is no longer dependent on coincidence.

Also read: Surgeon salutes brain-dead man whose organs saved 6 lives

The decline in Kerala’s organ transplantation has puzzled many in the state’s medical community. Kerala’s hospitals are world-class, its people highly literate, and its social indicators among the best in India. Yet its organ donation rate remains stubbornly low. Doctors say the reasons are layered — a mix of administrative gaps, infrastructure limitations and lingering social hesitation.

Litigations, brain death transplants fears

Health Minister Veena George acknowledged the decline in numbers and said the government has launched an intensive awareness campaign to promote organ donation and transplants.

“The fear of litigation and public accusations has discouraged doctors and institutions, and this concern has not been adequately addressed in the past. Many hospitals also worry about social media backlash over brain death certification and transplants, even though the living donor programme in the private sector continues to function robustly,” she told The Federal.

Also read: Namakkal kidney racket exposes gaps in Tamil Nadu’s transplant regulation

“Yes, we are seeing positive changes now, thanks to strong government interventions. We have intensified efforts to promote brain stem death-related organ donation and have tightened the regulation of unrelated, so-called altruistic donations. Members of the Cabinet and senior political leaders are also openly supporting donor families and acknowledging their noble act, which makes a big difference,” added the minister.

Organ retrieval a tricky affair

Only a handful of hospitals in the state are authorised or equipped for organ retrieval. Smaller district hospitals often lack trained transplant coordinators who can identify brain-death cases and speak to families at the crucial moment. Without that human link, many potential donors are lost. Even when individuals register as donors, their families sometimes refuse consent at the time of death, unsure of the procedures or fearful of disfigurement.

Religious and cultural inhibitions also play a role. While no major faith explicitly forbids organ donation, the topic remains uncomfortable in many households. Tamil Nadu overcame that resistance through sustained public messaging. Kerala’s early enthusiasm around 2015 faded without similar follow-through.

Also read: More donors, fewer transplants: Why TN govt hospitals trail private ones

The consequences are visible in the numbers. Fewer than 6,000 people in Kerala have voluntarily registered as donors, compared to Maharashtra’s 51,000. In Tamil Nadu, the figure runs into tens of thousands.

Need for coordination, public confidence

Yet, the recent run of transplants shows that the machinery can still work when all parts move in sync

Doctors who participated in these recent surgeries hope the renewed visibility will help change public attitudes. They point out that Kerala’s medical teams are second to none; what’s missing is consistent coordination and public confidence. “People have to believe that the system is transparent and ethical, and the government has to acknowledge and honour the families,” said Dr Joseph. “Once that trust is rebuilt, donors will come forward.”

Efforts are underway to restore that trust. KNOS officials say training programmes for new transplant coordinators have been restarted, and hospitals are being encouraged to report potential donors more systematically.

Govt on resuscitation mode

“The government has launched several initiatives to revive public confidence. We are creating wider awareness among the public and honouring donor families in public spaces. Strict directives have been issued to doctors involved in brain death declaration, and we conduct monthly audits through video conferencing with all stakeholders to track progress. Dedicated organ donation teams are being set up in every district, supported by strong media and social media outreach,” said Veena George.

Also read: Unequal lives: More women than men donate organs, fewer receive when in need

For now, the three transplants of the past month have given the state something tangible to build on, proof that the system can deliver when families, doctors, and administrators pull in the same direction. Each successful surgery revives not only a patient but also a faint public memory of what Kerala once led in: innovation, empathy, and civic participation in health.