Manikandan Ayyappan, a 39-year-old spice merchant, established 'langars' in jhuggis in eastern Delhi during Covid-19. He distributed cold water stalls and food to poor kids, promoting the principle of 'karma'.

Ayyappan, unmarried and living with his mother and elder brother in the US, fell unconscious on February 22, requiring an emergency at Dharamshila Narayana Superspeciality Hospital.

“Intracranial bleeding and seizures were identified as the cause of his fall,” Dr Ashutosh Bhardwaj, director of critical care at the hospital revealed.

Ayyappan was brain-dead.

“Upon understanding that he has lost his brain function among others, the family was informed about his condition,” the doctor said.

Family refusal remains a major factor in India's lower organ donation rates, but Ayyappan's family chose to proceed.

“The decision to take him out of life support was difficult but we were not confused about organ donation,” said Ramakrishna, who himself has registered for organ donation.

“We knew he would also have wanted to donate organs if he was put into the same situation,” he said. “My brother would have cherished our decision of (donating his organs and…) giving life to other people even after his death.”

Use of Ayyappan’s Organs

Doctors facilitated Ayyappan's liver, kidneys, pancreas, and heart donation, potentially saving lives of four to five individuals with organ failure, according to NOTTO.

On February 28, they performed a liver transplant on a young girl studying in Class 11, who had been battling liver failure for about five years.

Additionally, one of his kidneys was successfully transplanted into a government teacher in Dharamshila, who had to quit her job due to kidney failure and had been relying on dialysis for the last 1.5 years.

“The other organs were transferred through NOTTO with the help of a green corridor to different hospitals with the support of traffic police and authorities in east Delhi, among others,” Bhardwaj, Ayyappan’s doctor, said. “This is how organ donation from one donor has given hope of life to multiple other families."

Organ Transplant Scenario in India

In India, there exists a significant disparity between the number of patients in need of transplants and the availability of organs.

Although India performs the third-largest number of transplants globally each year, only a meager four percent of patients requiring heart, liver, or kidney transplants actually receive timely donations.

Government data indicates that approximately 1.8 lakh people suffer from kidney failure annually. However, the number of renal transplants performed is only around 6,000.

India faces liver failure or cancer, claiming two lakh lives annually. While 30,000 liver transplants are needed annually, only 1,500 are currently performed, saving 10-15% of these patients.

In February, the Union Health Ministry announced significant changes to the organ transplant rules, signaling the government's determination to address the issue. Some of these changes include eliminating the age cap that previously restricted the number of potential organ donors and removing domicile-related restrictions.