A 25-year-old mother in Chennai passed every medical test to donate part of her liver to her two-year-old son suffering from acute liver failure. However, a state government order prevented the transplant, and the child died.
The Critical Delay
The child was referred from JIPMER for a liver transplant on Saturday. The state's authorisation committee required genetic tests, a letter from the local tahsildar confirming the mother-child relationship, and extensive personal and medical documents. The family scrambled to comply, but by late Sunday night, the window had closed. The child developed multi-organ failure and irreparable brain damage. By Monday, hospital counsellors were preparing the family for the worst.
State Order and Its Consequences
In September 2025, the Tamil Nadu health department issued an order routing all living organ donations—related or unrelated—through a reconstituted state-level authorisation committee and four zonal bodies. This followed investigations uncovering a network of hospitals and brokers selling organs for profit. However, experts argue this has created a new and deadlier gap.
Dr J Amalorpavanathan, former convenor of Transtan, the state organ transplant network, stated: “In closing those gaps, the state created a new and deadlier one.”
Legal Conflict
The Transplantation of Human Organs and Tissues Act, 1994 distinguishes between donations by relatives and strangers. A mother donating to her child was meant to require only hospital-level clearance from the competent authority, not state-level approval. The state order removes that distinction, treating near-related and non–near-related donations alike, contradicting the Act. Many hospitals are now debating whether they can legally disregard the order.
Impact on Patients
The delays are expensive and medically punishing. Doctors at leading transplant hospitals reported patients waiting over a month for approvals. In one case, the committee sent birth certificates to a civic body in Salem for verification, still awaiting a reply. In another, after genetic tests established the mother-child relationship, the committee requested the father's genetic tests too, costing families up to ₹25,000.
Dr Rajan Ravichandran, senior nephrologist at MIOT Hospitals, said: “Delay in approval increases costs for dialysis patients. Fitness for transplant may also change due to delays.”
The stakes are highest in paediatric liver transplants. Young children have little physiological reserve; their condition can shift from critical to irreversible within days. Dr K Elankumaran, head of liver diseases at Apollo Hospitals, noted: “Many liver transplant patients are critically ill. Transplantation is often a race against time. Delay in a deteriorating patient can potentially affect outcomes.”
This case highlights the urgent need to balance oversight against life-saving procedures.
