Organ Donation After Circulatory Death: Strategies For Growth In Emerging Health Systems

This book addresses a critical and real challenge faced by transplant programs in emerging health systems on how to expand deceased organ donation, particularly donation circulatory death (DCD), in settings where resources are limited but patient need is overwhelming. It speaks directly to clinicians and administrators who confront the daily gap between organ demand and availability and offers practical, experience-driven solutions for building DCD programs that are ethical, transparent, and clinically sound. The book focuses on implementation rather than theory, guiding readers through consent pathways, ICU coordination, clinical workflows, legal safeguards, and outcome monitoring, all grounded in the realities of the healthcare system in India. By sharing clinician-led strategies and system-level solutions, it answers a fundamental question: how can deceased donation be expanded responsibly without eroding public trust or clinical standards? This book is especially relevant for transplant physician, transplant surgeons, intensivists, administrators, policymakers, and organ donation coordinators seeking to strengthen deceased donation ecosystems. It offers a pragmatic roadmap for integrating DCD into existing programs, making transplantation more equitable, sustainable, and accessible within emerging health systems.

Dr. Sanjay P. Kolte is Director and Head - Urology and Kidney Transplantation at Max Super Speciality Hospital, Nagpur and Director Professor at Datta Meghe Institute of Medical and Health Sciences, Sawangi. He pioneered the deceased donor transplantation in Central India having performed the first deceased donor kidney transplant of the region in 2013 and first DCD kidney transplant in 2023. Dr. Kolte has mentored and established kidney transplant programs in several Government and private hospitals across Central India. He has noteworthy publications in national and international indexed journals. He has led organ donation awareness, allocation and regulation process through the state allocation body - Zonal Transplant Coordination Center. He is currently the President of the Indian society of Transplantation and "Secretary General" of the Asian society of Transplantation. His contribution in policy, ethics, and system-building underpins his suitability for editorial leadership roles.

Dr. Amol Rameshrao Bhawane (MBBS, MD Medicine, DM Nephrology, FISOT, FRCP) is Associate Professor of Nephrology at All India Institute of Medical Sciences, Nagpur. Trained at UCMS Delhi and SGPGIMS Lucknow, he has been centrally involved in establishing comprehensive nephrology and kidney transplantation services at AIIMS Nagpur. He was a pioneering member of the team that initiated kidney transplantation at the institute, including deceased donor transplantation and donation after circulatory death (DCD), and was part of the founding team that performed early government-sector DCD kidney transplants in India in 2023. He has published original research and reviews in transplantation and transplant immunology and has contributed as an invited expert to NOTTO and ISOT initiatives, particularly on advancing ethical DCD frameworks in India.

Dr. Anil Kumar (MBBS, MD (Community Health Administration), Post Graduate Diploma in Disaster Preparedness and Rehabilitation (PGDDPR)) is Director of National Organ and Tissue Transplant Organization (NOTTO), apex organization established by Government of India, for prescribing policies, guidelines, procedures and establishing efficient and transparent systems for organ donation and transplantation in India. He also heads the National Organ Transplant Program (NOTP) with provisions to support the development of infrastructure, manpower for organ and tissue donation, transplantation, storage of tissues, generating awareness, financial support for poor patients in terms of post-transplant immunosuppressant medications, post donation support etc. Trained at Maulana Azad Medical College New Delhi and NIHFW, University of Delhi. He has been instrumental in the development of the current organ transplant law, rules and program and establishing the country wide network for providing an efficient and transparent system of organ procurement and distribution in India. During his tenure many reforms have been introduced with aim to implement "One Nation One Policy" in organ transplantation, a unified portal by the name of e-¿¿¿¿¿¿¿¿¿¿¿, etc. developed, National Guidelines on Brain Stem Death Certification, Swap donor transplantation, Annual Country Report etc. have been published. He is also spearheading focused awareness campaigns with the latest being "Jug Jug Jiyo Abhiyaan". During his tenure as program officer and as Director NOTTO, the number of transplantation including deceased donor transplantation has increased by more than 4 times. He has been actively involved in various consensus-based papers published on Donation after Circulatory Death in India. He has won numerous awards/honors and published many scientific papers in National and International Journals. He has attended a huge number of conferences as speaker and chairperson.

Dr. Ashish Sharma is a Professor and Head of the Department of Renal Transplant Surgery at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

With more than 25 years of experience in transplant surgery, Dr. Sharma has made significant contributions to the development of kidney and pancreas transplantation in India. His work has helped expand transplant services in government institutions across several states, improving access to transplantation for patients from underserved communities.

Under his leadership, the renal transplant program at PGIMER has developed into a major transplant centre, with substantial experience in living and deceased donor kidney transplantation. He played a key role in establishing the pancreas transplant program and advancement of organ donation including donation after circulatory arrest and assessment of DCD organs with normothermic machine perfusion.

An accomplished academic and author, Dr. Sharma has more than 260 scientific publications, has contributed to book chapters, and has authored books including Biomarkers in Kidney Transplantation, Transplant Surgery Manual etc. He has also contributed to national transplant guidelines and South Asian guidelines on infectious diseases in transplantation.

His contributions have been recognized through several national and international honours, including the Mentor-Mentee Award from The Transplantation Society, the Exemplary Services in Transplantation Award from the Government of India, and the Fellowship of the Indian Society of Transplantation.

Prof. Dr. Vivek Balkrishna Kute (MBBS, MD, FCPS, DM Nephrology - Gold Medalist, FRCP (London), FASN, FISOT, FISN) is Professor and Unit Head of Nephrology and transplantation at Institute of Kidney Diseases and Research Centre-Institute of Transplantation Sciences (IKDRC- ITS).Prof. Kute has published over 300 peer-reviewed articles (265 PubMed-indexed) and contributed to national guidelines, including NOTTO advisories during COVID-19. He currently serves as Treasurer of The Transplantation Society, Treasurer and former Secretary of ISOT, and Associate Editor of the Indian Journal of Transplantation, reflecting strong editorial and policy expertise.

Dr. Manish Ramesh Balwani (MBBS, MD Medicine, DM Nephrology, DNB Nephrology, PGDHHM, FRCP (London), FASN, SCE Nephrology) is a senior nephrologist and transplant physician with recognized expertise in nephrology, kidney transplantation, and organ donation policy. Trained at BJ Medical College, Ahmedabad, and mentored by Prof. H. L. Trivedi, his work focuses on preventive nephrology and public-sector transplantation. He has published over 106 peer-reviewed articles, presented widely at ISN and TTS/ISODP meetings, and received multiple national and international awards, underscoring his suitability for editorial leadership roles.