By: Akanksha
A KEM professor donated her 18-year-old-son’s organs, after his three year struggle to survive a road accident on the Goregoan-Mulund Link Road.
His organs, including his heart, kidneys, and corneas, have been donated to seven people at the Fortis Hospital, Mulund. This marks Mumbai's 47th cadaveric organ donation of the year.
As Soumil Nadkarni was just 18 years old, questions have arisen about whether such a young person can donate organs. In a conversation with Dr. Sumbul (MBBS, MD Anatomy), from MedBound Times, Dr. Megha Thapa, Transplant In-charge and Coordinator at Chandan Hospital, Lucknow, said, “Age alone does not decide who can pledge for organ donation. For deceased donation, the most important factor is the medical condition and quality of the individual organs and tissues at the time of death.”
Dr. Thapa added that the suitability of organs is assessed at the time of donation, rather than being determined by age alone.
Soumil Nadkarni was the son of Dr. Karuna Nadkarni, an occupational therapy professor. He was a Class XI student at the time of the accident, with a dream of becoming an engineer. He suffered severe brain injuries following a collision of an autorickshaw with the two-wheeler he was riding.
Dr. Nadkarni told Times of India that the accident caused weakness and loss of movement on his right side. He was able to walk a little and was undergoing treatment at Fortis Hospital, Mulund. “He was a fighter who smiled even after multiple surgeries,” she added.
To reconstruct the damaged section of his skull, a cranioplasty plate was implanted during the initial recovery. However, Soumil developed a brain infection earlier this year, requiring the doctors to remove the plate.
Soumil was treated with antibiotics for three months, before undergoing a revision surgery last week. A severe complication post-procedure damaged his brainstem, leading to brain death.
“There were pressure changes in the brain, which it could not handle during the procedure,” explained Dr. Nadkarni.
“He was such a precious child; I could not just let him go. His organs have gone to seven people,” Dr. Nadkarni said. She added that for most organ donor families, it is a solace knowing a part of their loved one is still alive.
As a medical educator, Dr. Nadkarni understood the clinical finality of brainstem death — a reality that remains widely misunderstood by the public.
Dr. Thapa emphasized the importance of family communication in successful organ donations. “Making a donor pledge is an important first step, but your family should know about your decision,” she added.
Dr. Thapar listed the key points families should discuss to ensure a successful organ donation:
Their wish to become organ donors.
Any preferences regarding which organs or tissues they are willing to donate.
The reasons behind their decision.
Their understanding of brain-stem death.
Their wishes regarding donation after death.
Brainstem death can occur from a serious irreversible injury to the brain or hemorrhage that causes brain activity to stop.
When areas of the brain are damaged and no longer function, a person can not sustain their own life, but vital body functions can be maintained by an artificial support system.
A brainstem-dead person has absolutely no chance of recovering. They can only survive with the help of mechanical support.
It is not the same as being in a coma or a prolonged vegetative state — where the patient may be unconscious but still shows brain function.
Even though the media often uses these terms interchangeably, medically and legally, brain death is a different diagnosis from which the individual cannot recover.
Dr. Thapa also clarified that the decision to treat a critically ill patient is separate from the possibility of organ donation. “The first and foremost responsibility of the treating medical team is to save the patient’s life. Opting as an organ donor does not decide the treatment,” she said.
She added that decisions to continue, limit or withdraw life-sustaining treatment are based on the patient's medical condition and applicable medical decisions, rather than the possibility of organ donation. Organ donation is considered only after death has been appropriately established.
According to the provisions of the Transplantation of Health Organs and Tissue Act (THOTA) 1994, the protocol for declaration of brainstem death or brain dead has been defined.1
Any organ donation process must involve the following steps prior to any transplant:
A Panel of four doctors – two of which must be from a panel approved by the government needs to declare the brain stem dead.1
These tests, according to the law, need to be done twice, with a gap of six hours between the two tests.
This Panel must include:
Registered Medical Practitioner, in charge of the hospital where the brain-dead patient is admitted.
Registered Medical Practitioner nominated from the panel of doctors who have been approved by the appropriate authority.
A neurologist/neuro-surgeon.
Registered medical practitioner treating the deceased.
The results of the tests are recorded on Form 10 of the THOT Act 2014. The family’s consent is obtained on Form 8.1
The certifying practitioners must have no benefit or interest in any way from the transplantation of the cadaver donor organs.1
The medical director or medical superintendent of the hospital should countercheck and sign the form.1
Only after all these formalities have been completed should organs from the brain-dead patient be retrieved.1
“Brain-stem death is a medical and legal determination of death. It is not declared because organs are required. Under the Indian system, brain-stem death is certified by an authorized Board/Panel of Medical Experts. The certification involves prescribed clinical testing and is performed independently of the transplant operation,” said Dr. Thapa.
Dr. Thapa's explanation addresses a common misconception around organ donation: that the need for organs could influence the decision to declare brain-stem death. Under India's framework, brain-stem death is certified by the authorised Board of Medical Experts after the prescribed clinical examinations.
The current NOTTO Form 10 specifies that the patient is examined twice, with a minimum six-hour interval between the first and second testing in adults, and that the certification is signed by four members of the Brain Stem Death Certifying Board.1
The Board includes the medical administrator in charge of the hospital, an authorised specialist, a neurologist/neurosurgeon and the medical officer treating the patient. Where a neurologist or neurosurgeon is unavailable, the rules provide for an alternative specialist arrangement.1
The transplant team does not determine whether a patient has died by brain-stem-death criteria.
For deceased donation, the applicable rules also require the prescribed consent and legal procedures to be completed before organs or tissues are retrieved.
References:
1. Kerala State Organ and Tissue Transplant Organization, “Brain Death and Organ Donation,” Kerala State Organ and Tissue Transplant Organization, accessed September 29, 2026, https://ksotto.kerala.gov.in/brain-death-and-organ-donation/
(Rh/APC/MSM/2VrMSM)
