Turning 18 can mean different things to different people.
For PP Devanand, a plus two student from Thrissur, this meant growing old enough to donate her liver to her father PG Pratheesh, who was battling liver cirrhosis and needed an urgent transplant. But time was not on her side and she could not wait until she turned 18, as her father’s condition was deteriorating. The family’s attempt to procure organs from one of their relatives failed as the proposed donor backed out citing some personal reasons.
This was the time when Devanand started thinking of donating his liver. “Initially, everyone was against the idea. They said it could cause severe pain. But I was determined to do it to save my father as time was running out for him,” she recalls.
She moved the Kerala High Court for permission to donate organs as the law prohibits minors from donating organs. Eventually, he got a favorable order from the court. And on February 9, 2023, two months before she turned 18, Devanand donated her liver to her father, becoming possibly the first minor to do so. Now 21-year-old Devananda says she did what any daughter would do.
Devanand recalls, “We had to save him somehow. The surgery had to be done immediately and there was no time.”
Pratish says that the family always refused him. “I never knew she had gone to court to get the order. She hid all that from me. I told her not to think about donating; she was too young,” says Pratish.
The 12th grade student had to clear the system – court, medical board, and a psychiatric evaluation. He also had to build emotional strength to fight his opponents. Devanand says, “My father’s case was one of the non-alcohol liver diseases. People assumed it was caused by alcohol consumption and questioned my donation. It was really bad, life-changing. But now we are strong enough to face anything.”
Pratish considers himself extremely fortunate to have received the organ at the right time. Still, more than 3,000 patients are waiting for donors as the life-saving practice of organ donation remains fraught with controversies, misrepresentations and misinformation that the medical community continues to try to fight.
As of January 28, 2025, at least 3,261 people are on the organ waiting list, most of whom need kidneys (2,450), followed by liver (659), heart (85) and other organs.
story of two brothers
In 2014, Akshay Manoj, a resident of Marampalli, Aluva in Ernakulam, was just 13 when he underwent dialysis. A large part of his growing up years was spent in hospitals. He was suffering from kidney failure following a genetic disease.
“Three appointments per week,” Akshay says, reminiscing about his past life. “At first I thought the transplant would happen without much delay. Then about ten years passed; I lost hope and got used to it,” says Akshay.
And then many years later, his elder brother Anandu Manoj also had to be put on dialysis, because he too had become a victim of the same disease. Anandhu says, “Earlier I used to accompany Akshay for dialysis. Then I had to undergo treatment.”
PP Devanand with his father PG Pratish. When Devanand was just 17 years old, she donated her liver to her father, which saved his life and became perhaps the first minor to do so. | Photo courtesy: KK Najeeb
This was not something the family was prepared for; They were waiting for a donor. And then in 2024, Anandu receives a deceased donor transplant. “I don’t know the family who donated the kidney. I asked, but they didn’t want to reveal the identity of the donor,” says the 26-year-old. Finally in 2025, after waiting for more than ten years, Akshay also receives a kidney from deceased donor Biljit Biju.
A young man who was declared brain-dead after a road accident in Kochi had eight organs removed and Akshay was one of the beneficiaries. Incidentally, the donation came less than 24 hours after six organs were removed from Isaac George, a 28-year-old brain-dead restaurant owner in Kottarakara in Kollam district, who was hospitalized following a road accident.
Two back-to-back cases of organ donation went viral and led to a wave of organ donation in the state. Over the next few days, more than 500 people pledged their organs. Thus the year 2025 saw a new impetus in deceased organ donation, with the number of donors more than doubling compared to the previous year.
A total of 25 deceased donor donations have been registered at the Kerala State Organ and Tissue Transplant Organization (K-SOTTO) in 2025. According to K-SOTTO data, the total number of deceased donor organs donated was 75, with kidney being the most donated organs (41), liver (21), and heart (seven).
The total number of organs donated in the last 13 years is 1,171, with the total number of donors being 403. Over the years, deceased organ donation has declined, with only eight deceased donors in 2018. But medical experts say increased awareness among the community has led to an increase in the number of deceased organ donations, with families of brain-dead patients coming forward for organ donation.
Although many advances have been made in the field of organ transplantation globally, it is still in its nascent stage in Kerala. It was not long ago that transplantation was considered as a treatment option for end-stage organ failure, says Noble Gracias, executive director of K-SOTTO and state coordinator of the Mritasanjeevani Organ Transplant Programme.
Dr. Gracias says, “All the challenges are within the hospital community rather than societal. On the medical front we face the challenge of reluctance to certify brain stem death among patients. It has been observed that the organ donation process is often initiated by the donor family rather than the hospitals.”
There are also operational and logistics challenges.
He further said, “There are more than 50 registered transplant centers in our state. Yet, not all of them can actively execute and implement organ transplants. This is because cadaver transplants are unplanned high-intensity activities and the scale of preparation is extensive.”
life after transplant
After organ donation, life is never the same for either the donor family or the recipient. Amal Babu’s father A Babu, whose organs were donated last year, says his son is living with six people even after his death.
For Ernakulam native Jose Jacob, who underwent a liver transplant from his son Rohit Jacob Jose, the decision was not an easy one as his son was in the spring of his life. He says, “Initially, I was opposed to the idea considering his age and the risks this decision would pose to him. However, Rohit was adamant and forced me to accept his decision.”
On his part, Rohit says that he was convinced of the idea of becoming a donor for his father from the beginning. Rohit says, “I was sure that I was the best option for him given my age and health conditions. I was not afraid of the possible risks, although the doctors warned me about it. I know it was the best decision I took for my father.”
Jose, who is writing a memoir covering the days following the transplant, jokes that his relationship with his son has changed a bit after the procedure. “I don’t often find myself able to scold him,” he says with a laugh. He teases me by saying that he has given me everything he could in his lifetime.
Every person who has undergone a transplant talks about finding a new lease of life, changing priorities, families becoming stronger as a unit, pursuing life with passion, and making healthy and intentional choices to move forward.
For TR Manu, a native of Thodupuzha, the pace of life and career itself passed through a sea of change. In 2013, at the age of 27, Manu lost both his palms after being pushed from a moving train. Manu explains, “All I remember is that I fell from the train; when I woke up and realized I had lost both my palms, my first thought was that my life was over. I didn’t want to live any more.”
While prostheses were an option, he was not keen on it for several reasons. “The idea of hand transplantation came to my mind after I watched a TV program on organ transplantation by a cousin,” says Manu.
At that time hand transplantation was an unheard of thing in India. Still, he decided to give it a try. Manu recalls, “When you have no other option, you start believing in the doors that open. I had full faith that this could work.”
Then this happened. A family was ready for cadaver donation. A hand transplant took place in 2015, the first in the country. Zindagi had more surprises for Manu in the hospital. There he met nurse VS Sreeja, who later became his life partner.
Shreeja says shyly, “I saw him in the hospital and I felt like sharing my life with him. So I proposed to him.” “At first he said no. He insisted that the doctor treating him should give permission. I insisted and after a year he said yes,” says Sreeja, as her children play happily around her.
Manu, who reclaimed his life, is now a transplant consultant at the hospital where his procedure took place. “Who better to talk to families about transplants than someone who has had one?” Manu asks.
