Around six months ago, a shabbily dressed middle-aged man walked into the office of the Superintendent of Police (Ernakulam Rural), Aluva, on a sultry afternoon with an envelope held tight in his hand. The man, who appeared to be in a hurry, was at the police station to obtain a police clearance certificate for an organ donation.

He wanted the police clearance to donate one of his kidneys to a patient, totally unrelated to him. When the inquisitive police officer, who was handling the applications, threw a few casual questions at the applicant, he didn’t have any inkling about what was in store. “How did you meet the prospective recipient?” asked the officer.

The man nonchalantly muttered that he met the patient, who was weeping inconsolably, in the corridor of a private hospital in the city. He stated that he was moved by the suffering of the patient and made the decision to part with one of his kidneys to save the patient’s life.

The officer didn’t believe a word of it, but he gave the requisite clearance. “I knew the man was lying. Now, I am all the more convinced about my intuition,” recalls the officer, days after the police reportedly busted an alleged organ trade racket following a series of raids in different parts of Kerala.

The raids, conducted on May 8, across the State following an intelligence input, reportedly exposed the details of a netherworld that thrived on the plight of patients, who were forced to spend their years in sickbed waiting for organ donors who may never turn up.

3,462 patients till May 12

To put things in perspective, a total of 3,462 patients were awaiting organ transplants in the State, according to the data compiled till May 12, 2026. Most of them, 2,566 patients, need kidney transplants, according to government sources.

“The information we received was about some DTP centres involved in making fake documents, including the letterheads of government officials and people’s representatives. But as the investigation progressed, we stumbled upon a network involved in forging documents to bypass laws that curb illegal organ donations,” says a police officer involved in the investigation.

So far, the police have registered five cases and arrested nine people; six from Ernakulam and three from Kollam. Those nabbed include a 53-year-old Muhammed Najeeb, the suspected kingpin of the racket, and his wife Rasheeda, 37. Najeeb allegedly has around 12 criminal cases against him, including a 2017 murder case registered in Mangaluru, say police officials.

Letterheads of MPs, MLAs

Sunny Varghese, 56, and his wife Sini Varghese, 50, of Kumarapuram who run a DTP centre, and Sanoj Kuzhikkadan, 32, the owner of a photo studio, were also picked up by the police. The police say they recovered forged documents such as letterheads of MPs and MLAs, prominent hospitals in Kochi city, lab reports and fake seals from two shops in Kunnathunad and the residence of Najeeb. The raids also led to the arrest of Sreeja, an alleged agent; Sudheer, her accomplice; and Vinod, a daily-wage worker. Debin Joseph, native of Marayoor and an alleged middleman who lured financially vulnerable people into the racket, was arrested on Thursday.

“We have got evidence that Sreeja was in contact with Najeeb. Vinod was arranged as a donor by her and her aide Sudheer. Vinod has been accused of selling off his kidney,” an officer with the Kilikollur police said.

“Najeeb has allegedly forged documents and committed related crimes across districts. We are examining the documents and other evidence seized from them. The depth of the crime will become clear only after analysing the documents,” Ernakulam Rural Police Chief K. S. Sudarshan, who supervises the investigation, says.

Financially vulnerable donors

According to the police, the group identified financially vulnerable donors, promised them large sums of money and fabricated documents to bypass the stringent legal scrutiny governing organ transplantation.

Kochi City Police Commissioner S. Kaliraj Mahesh Kumar says hospitals could also come under the scanner as the investigation progresses. The case has once again raised troubling legal, medical and ethical questions surrounding organ donation in Kerala. The police suspect the network may have been active for nearly three years.

“So far we have identified around 25 instances of kidney transplants from the documents seized from the accused. The transplants were held in hospitals in different parts of the State as per Najeeb’s statement. The veracity of each document needs to be ascertained,” Sudarshan says.

Investigators equate the network to a “money chain network” which thrives on desperation. “Those in need of transplants find the agents through patients who have already undergone the procedure. Similarly, donors, who need money, are introduced through previous donors known to them,” the officer says.

The rate decided upon

“It is suspected that Najeeb charged around ₹20 lakh from a recipient and offered ₹5lakh-10 lakh to the donor. He is also believed to have borne the donor’s medical expenses and made a profit of around ₹3-₹5 lakh from each case,” another officer associated with the probe says.

The police suspect the network may have forged “non-suitability certificates” and “certificates of altruism” — two key safeguards required under the Transplantation of Human Organs and Tissues Act for organ donations involving unrelated donors. Possible forgery of certificates to prove the relationship between a donor and recipient is also being probed.

The law prefers organ donation from close relatives in a bid to prevent commercial exploitation. If the donor is an unrelated person, one should produce the proof that close family members of the recipient are medically incompatible, unwilling to donate for legitimate reasons or even unavailable for donation. This is established through a non-suitability certificate, according to the provisions of the Act.

At the same time, the unrelated donor must prove that the donation is an entirely voluntary one motivated by affection or humanitarian concern rather than financial gains. A certificate of altruism becomes crucial there.

Dr. Unmesh A.K., Head of Forensic Medicine, Government Medical College, Kottayam and member of Kerala State Organ and Tissue Transplant Organisation, hopes that the probe would bring to light the illegal practices involved in the organ transplantation.

He recalls hearing eerily similar stories of compassion while interviewing donors as part of the District-level Authorisation Committee that considers applications for organ donation in Ernakulam and Thrissur. “The so-called agents might be exploiting loopholes in the existing system,” fears Dr. Unmesh.

The ethical dilemma

He also points to the ethical dilemma over a patient’s situation and the genuineness of a donor, which makes it difficult for the medical panel to take a call sometimes. According to him, the only sustainable solution is to strengthen cadaver organ donation and reduce dependence on living donors, who are vulnerable to financial exploitation.

He also points out that the cumbersome documentation process involved in organ donation sometimes pushes even genuine donors towards middlemen. “Police verification on non-related donors has to be made mandatory as medical panels may not always be able to independently verify the certificates or the identities that come before them,” Dr. Unmesh suggests.

Dr. Mathew Jacob, lead transplant surgeon with a private hospital in Kochi, says the doctors sometimes cannot verify all claims of a donor as “some of them come well-tutored and their stories would sound genuine.”

“There is a huge shortage of organs pledged for donation and patients are desperate to get a transplant done somehow. The authorisation committees can cross-check the authenticity of a document with the authority which issued it, including the police. I’m not sure if that is happening every time,” he notes. On hospitals coming under a cloud every time such allegations arise, the surgeon says, “It is not difficult for the police to find out if any hospital is involved in illegal transplants.”

Hussain Koya Thangal, president of the Kerala Private Hospital Association, maintains that the forum has not discussed the latest allegations and investigations into illegal organ donation.

Vinu V. Nair. State secretary, Liver Foundation of Kerala, a forum of nearly 3,000 organ donors and recipients, believes that more murky deals than the revealed ones are sure to emerge if the cases are deeply probed.

‘Agents, the real culprits’

“The real culprits in the ecosystem are the agents. They often work from the premises of hospitals and reach out to those in need of transplants. While elaborate documentation needs to be complete for the organ donation, strict scrutiny by the police is necessary to detect fake documents and false testimonies,” Mr. Nair says. The foundation also calls for promoting cadaver donation and is planning a State-wide campaign titled ‘Athmanalam’ with that intention.

Shyam Padman, a Kochi-based lawyer, notes that the “‘rackets thrive in the field because the legal requirements for organ donation are stricter.” “It seems the law governing organ donation looks at every case with an element of suspicion. A legislative intervention is required to make the process of donation more transparent and a hassle-free affair. Also, once cadaver donation becomes normalised, there will not be any rackets,” he opines.

For the recipients, who opt for the illegal route, any risk is worth taking when it comes to a life and death situation. And, the illegal operators exploit the urge of the hapless patients to survive.