The Indian Society of Organ Transplantation (ISOT) held its mid-term meeting on 11^th and 12^th May 2019 at Hotel Crowne Plaza, Ahmedabad. The theme of the meeting was ‘Expanding the Donor Pool through Deceased Donor Organ Transplantation and Kidney Paired Exchange.’ Dr. Sandeep Guleria, President, ISOT and Dr. Vivek Kute, Secretary, ISOT invited Dr. Sumana Navin, Course Director, MOHAN Foundation to speak on the ‘Role of social media in organ donation and transplantation.’

The international faculty included Nobel laureate Prof. Alvin Roth, Professor of economics at Stanford University and Dr. Michael Rees, Urologist, University of Toledo Medical Center, Ohio. Both of them have done pioneering work in Kidney Paired Donation (KPD). Prof. Roth said that some lessons could be learnt from market design. According to him, to achieve efficient outcomes market places needed to make markets sufficiently thick, uncongested and safe, and this was true of the field of organ donation and transplantation as well. Dr. Michael Rees spoke about the work being done by the Alliance for Paired Donation - KPD, Non-simultaneous Extended Altruistic Donor (NEAD) Chain, Deceased Donor-initiated NEAD Chains, Kidney Exchange Matching Software, and Global Kidney Exchange.

In his keynote speech, Dr. Sandeep Guleria, President, ISOT compared the pros and cons of ABOi kidney transplantation and KPD. Dr. Vivek Kute, Secretary, ISOT elaborated on the ISOT Guidelines (2017) for KPD to increase living donor kidney transplantation in India. The guidelines include –

• DRP (Donor-Recipient Pair) to be counselled about KPD in an easy-to-understand format as early as possible in the process of CKD care
• Transplant team members trained for counselling about risks and benefits of KPD, non-KPD options, consent process
• DRP screened for pre-transplant immunological risk, infections, coronary artery disease to prevent and reduce post-transplant unequal outcome
• Better HLA match counteracts effect of higher DR age difference
• Simultaneous > sequential surgery, 3-way exchange optimum
• Donor travel > kidney transport

(Reference – Kute et al Indian J Nephrol2018;28:1-9)

There were sessions on the law, National Organ & Tissue Transplant Organization (NOTTO), deceased donor organ transplantation, and various aspects of kidney transplantation. Eminent faculty from across the country shared their experiences.

Dr. Vasanthi Ramesh, Director, NOTTO said that while swap transplant between two pairs of near relatives was permitted under Indian Law, legal opinion must be sought regarding longer chains of kidney exchange. Dr. Bharat Shah through case studies explained the need for clarification of certain aspects of the Transplantation of Human Organs Act (mentally challenged donors, status of No Objection Certificate in case of living related transplants when near relatives are from different states).

Dr. Sumana Navin spoke about the role of social media in organ donation and transplantation. She said that with its vast reach social media could be leveraged for collaboration. Her suggestion was that ISOT and other like-minded societies could form an ‘Organ Donation and Transplantation Collective’ on the lines of the Neph Collective for Free Open Access Medical Education (FOAMed) and creating novel content, research, mentoring, advocacy, and social support.