The Supreme Court has called for a uniform, transparent national policy to regulate organ transplantation and ensure that donors receive adequate post-transplant care.
About Organ Transplantation
- Organ transplantation is a medical procedure in which a failing or damaged organ in a patient’s body is replaced with a healthy organ from a donor.
- Commonly Transplanted: Kidney (most common), liver, heart, lungs, pancreas, intestines, and corneas.
- Types of Organ Transplantation:
- Autograft: Transplantation of an organ or tissue from one part of the body to another in the same person.
- Allograft: Transplantation between two genetically non-identical individuals of the same species.
- Xenograft: Transplantation between different species, such as from animals to humans (rare and typically experimental).
- Donor Types:
- Living Donors: Organs donated by a living person, typically a relative or close acquaintance.
- Deceased Donors: Organs harvested from people who have been declared brain-dead or have suffered irreversible cardiac death.
Legal and Institutional Framework
Transplantation of Human Organs and Tissues Act, 1994:
- Overview: The Transplantation of Human Organs and Tissues Act, 1994 is a key legislation in India that regulates the donation and transplantation of human organs and tissues to prevent illegal trade and unethical practices.
- Objective: The primary goal of the Act is to ensure ethical transplantation, regulate organ donation, prevent commercial trade of organs, and provide legal safeguards for both donors and recipients.
- Key Provisions:
- Prohibition of Commercial Trade: The Act explicitly prohibits the sale of organs, making it a punishable offense.
- Regulation of Donor Consent: The law mandates that informed consent from the donor or their family is essential before organ retrieval.
- Cadaver Donation: The Act allows for organ donation from brain-dead patients, ensuring that the family’s consent is obtained for organ harvesting.
- Brain Death: It is defined as the irreversible loss of all functions of the brain, including the brainstem, making the individual eligible for organ donation.
- Penalties: The Act provides for strict penalties, including imprisonment and fines, for those involved in organ trafficking, fraudulent practices, or unethical transplantation.
- 2011 Amendment:
- The Amendment expanded the scope from only “organs” to include “organs and tissues”, thereby bringing tissue transplantation (such as corneas, skin, etc.) under regulation.
- The definition of “near relative” was expanded to include grandparents, grandchildren.
- It mandated the appointment of a Transplant Co‑ordinator in hospitals registered for retrieval and transplantation of organs/tissues, and registration of Tissue Banks
- Regulatory Authorities:
- The National Organ and Tissue Transplant Organisation (NOTTO) and State Organ and Tissue Transplant Organisations (SOTTO) are responsible for coordinating organ donation, maintaining donor registries, and enforcing ethical standards across the country.
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Need for Uniformity in Organ Transplant Mechanisms
- Uniform Mechanism: The Supreme Court highlighted the importance of a transparent and uniform mechanism for organ transplantation across all states in India, free from barriers of gender, region, and class.
- Equal Criteria for All: The court stressed the need for uniform criteria for organ transplants for all individuals, ensuring equity in organ donation and transplantation processes.
- Post-Transplant Care for Donors: The Court emphasized that live donors who give up valuable organs must not be neglected and should receive proper post-transplant medical care. Many donors have been left without follow-up care, which the court condemned.
Key Observations by the Supreme Court
- The court directed the Centre to persuade Andhra Pradesh to adopt the 2011 amendments to the Transplantation of Human Organs Act, 1994 to ensure better regulation of organ donations and transplants.
- States Urged to Adopt Rules: The court urged Karnataka, Tamil Nadu, and Manipur to quickly adopt the Transplantation of Human Organs and Tissues Rules, 2014, to standardize organ transplant procedures across the country.
- National Organ Transplantation Programme: The court directed the Centre to establish SOTOs (State Organ and Tissue Transplant Organizations) in those states that lack SOTOs under the National Organ Transplantation Programme, aiming for a nationwide standardization of organ transplant services
- Strengthening Organ Donation Framework:
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- The government was asked to consult NOTTO to revise death registration forms, ensuring they include an option to record whether families were given the choice to donate organs.
Implications of the Court Directions
- Strengthening the Organ Transplantation Framework: The court’s direction for a national mechanism will ensure that organ transplant policies and procedures are uniform and equitable, while also addressing the rights and health of donors.
- Improved Post-Donation Care: The call for follow-up care for donors will ensure that individuals who contribute organs are properly cared for, both during and after the donation process.
- Sustainable Organ Donation System: The establishment of SOTOs and the modification of death registration forms will strengthen the national organ donation system and improve donor awareness across India.
20 Nov 2025
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