Ready, Steady, Go!!! A brief on Green Corridor activation in Organ Transplantation

K. Kumaravel

Emergency Care Technician, Ambulance and Emergency Services, Kauvery Hospital, Chennai, India

Go Green!

That is what they say in organ transplantation as soon as the team receives a live alert for organ harvesting and transplantation.

A day like no other

On a routine day, as a paramedic, I received a call from Mr. Shanmuganathan (the Transport Manager), regarding a live alert for an organ transplant. The pick-up was from Stanley Medical College Hospital, and the drop at Kauvery Hospital, Chennai!

Studies have suggested that the chances of success in transplantation are enhanced by reducing the time delay between harvest and transplant of the organ. Therefore, timely transportation of the organ is a critical factor.

For this purpose, there has to be a well-coordinated integration between the transplant team of the hospital and the ambulance & emergency services department of that hospital, as they work very closely with the institute/hospital donating the organ for transplantation.

Continuing the story

As soon as we received the call alert, we immediately initiated the pathway for harvesting the organ and its transportation by ambulance. We got all things ready that would be required to ensure safe organ harvesting and transportation to our hospital.

The members of the transplant and transport team responsible at Kauvery Hospital Chennai for harvesting and transportation of the organs on that day were Mr. Ruban (Transplant Coordinator), Dr. Sujith, Dr. Arjun (Transplant Surgeons), Mr. Saravana Perumal (Perfusionist), Mr. Sri Ram (Anaesthesia Technician), Mr. Mohan (Pilot) and myself (Mr. K. Kumaravel, Paramedic).

The Clock Starts Ticking

On activation of the live alert, we knew that the clock has started ticking and that saving the organ is of prime importance so that it can be used to save a life. “Time is organ” is what was running in our minds and we started our journey towards the hospital where the organ was to be harvested. In our case, the organ to be harvested was at Stanley Medical College Hospital, Chennai. The pilot started the ambulance, and we were promptly wailing our way with the siren on, and traveling swiftly through the crowded roads of Chennai city. We were soon at our destination.

Our Transplant team of doctors carefully examined the organ from the donor at Stanley hospital by conducting the required tests and were satisfied with the results. Then they decided to harvest the organs from the donor for transplantation at our hospital.

The Green Corridor

In order to achieve the goal of safe transportation of organs within the stipulated timelines set to salvage the harvested organs, “Green Corridors” have been created in many parts of India. A “green corridor” refers to a route that is cleared out for an ambulance carrying the harvested organs to ensure its delivery at the destination in the shortest time possible. The hospitals involved in transplantation, city traffic authorities, and in certain cases, airport authorities collaborate to transport an organ from one hospital to the next. The formal name of ” Green Corridor” was given in July 2014 when the hospital and police department in Chennai collaborated and coordinated in the transportation of a heart from one hospital to another in half the usual time. The system has been used effectively in cities such as Mumbai, Gurgaon, Hyderabad, Bengaluru, Kolkata and Indore ever since its inception. Green Corridors are generally used for transporting heart and liver, which have the shortest preservation times of four to six and twelve to fifteen hours, respectively. The means of transportation is often by road, but air ambulances are also employed when the organs require transportation to different cities or states. Usage of Green Corridors expedites organ transplantation while also ensuring that there is no organ wastage. But the process of setting up a green corridor is complex, since it requires coordination of multiple stakeholders. Due to the inconvenience to the public when using roads for this purpose, usage of air ambulances or drones has been suggested to the government.

Back to Our Story

Despite the complexity of the process involved in establishing a green corridor for organ transplantation, Our AGM, Mr. Jessu Balu, got things organized well in advance by informing the Tamil Nadu Police and receiving a green card to shift the organ safely to our hospital. Meanwhile, the transplant team back at the hospital was ready, on full alert, to start the surgery as soon as we arrived.

The police were at Stanley Hospital and discussed with the pilot of the ambulance which route was the fastest to reach the hospital at the earliest.

The team of doctors harvested the organs from the donor patient and kept it safely in an ice box maintaining the temperature which is vital to preserve the function of the organ and its viability until it reached our hospital and was transplanted.

Once the harvested organ was transferred to our ambulance, the ambulance kick-started in few seconds, and with the help of green card given by the Tamil Nadu Police, we reached Kauvery hospital, which is around 12.5 km from Stanley hospital, in a record time of 6 minutes and handed over the organ to the transplant team at hospital.

Another such Green Corridor activation took place when we travelled 450 km in 7 hours to Vijayawada, where the organs harvested from Capital Hospital, Vijayawada were transported to the Vijayawada airport for airlifting by air ambulance by our team in a record time of 7 min covering a distance of 15.2 km.

Kauvery hospital, Chennai is now an emerging destination for organ transplantation like Heart, Lung, Liver and Kidney. Therefore, the establishment of this transplantation team for harvesting and transportation of the organs in record time, maintaining the vitality and viability of the harvested organ, that improves the outcome of the transplant surgery by the expert team of transplant surgeons and technicians, is crucial.

We, at the ER are Ever Ready.

We, as paramedics and experienced drivers working in the Emergency and Ambulances Services department, have a key role to play in the whole process. We shall train and strive hard to ensure that this process would suffer no delays from any humanly avoidable reasons.

Hope is Life

The life of a dying patient with organ failure is like being in a traffic jam, where he/she just needs a green corridor to go through and emerge with new hope for life. I hope I would be a part of many such Green Corridor missions in the future and add hope to someone’s life and loved ones!!!