Kerala to do a Miami with Rs 558-cr organ transplant centre, officials say project will bleed state

Thiruvananthapuram: Kerala's ambitious project to establish the country's first organ and tissue transplant centre at Rs 558.68 crore in Kozhikode received the cabinet nod, brushing aside concerns raised by the Finance Department and the Chief Secretary.

According to the cabinet meeting notes, 90 per cent of the transplants are done in the private sector in Kerala and the majority of beneficiaries who are unable to bear the cost succumb to death. The proposed institute aims at organ transplantation at low cost, creation of manpower and providing healthy organs of the deceased to patients. 

According to the concept proposal, only the US and China have dedicated transplant centres in the world and once established the Kozhikode institute will take the state on par with highly developed countries, bring down the cost of transplantation to one-third of the existing cost and will promote medical tourism. The proposal pitches Miami Transplant Institute ( MTI) as the example of a successful model. 

When the file was forwarded to the Finance Department, it remarked that there are limitations in funding the project via KIIFB considering restrictions on the state's borrowing limit and RBI induced restrictions on bank loans. However, it further added that the project can be considered for implementation via KIIFB funds subject to cabinet approval.

The Chief Secretary noted that it will only be known in distant future whether the expenditure shown in the concept note can be met by the institute using own income. The concept proposal showed that the recurring expense from 2028-29 for a year is Rs 180 crore in the first phase and Rs 272 crore in the second phase. ''In case the institute can't function independently, Kerala government will have to take up a huge expense. Even at present, the government has sanctioned many projects funded by KIIFB with huge financial liability,'' the Chief Secretary said, also flagging the concerns raised by the Finance Department. 

The CS goes on to say that the medical colleges in Kerala struggle to provide even emergency care due to lack of sufficient staff and necessary infrastructure. ''Instead of starting a separate institute in Kozhikode, it can be made a part of Kozhikode Medical College which already has super speciality wings for various departments. By doing so, the institute can share the facilities of the medical college and the huge amount required solely for the institute can be utilized for providing better services to majority of patients and for upgrading facilities in medical colleges. It would be sensible to put to use these kind of projects which require huge financial liability and recurring expenditure, this way,'' the CS noted. 

However, the state government gave administrative sanction for the project based on cabinet approval in spite of concerns raised by the Finance Department and the Chief Secretary. 

The centre is proposed to perform 1100 corneal transplants, 500 kidney transplants, 320 liver transplants, 15 intestinal transplants, 15 pancreas transplants, 50 heart transplants, 40 lung transplants, 120 bone marrow transplants and 300 soft tissue/hands/bone/face transplants per year, achievable at the end of 5 years. The revenue generation from these transplants per year is projected at Rs 70.65 crore. A total of 1.16 lakh patient visits are expected a year yielding Rs 130 crore.

The expenditure is projected as Rs 322 crore in phase 1 and 2 while the income is Rs 201.18 crore and the grant in aid required will be Rs 120.82 crore. The project received in-principle sanction in 2022 and in a meeting convened by the Chief Minister in 2023, it was decided to procure funds from KIIFB to establish the institute. HLL infra tech services limited ( HITES) was nominated as the special purpose vehicle for the project. The special officer had initially pegged the project cost at Rs 494 crore, later the SPV revised the cost at Rs 558 crore for two phases and Rs 539.68 crore, if implemented in a single phase.