In a writ petition filed before the Kerala High Court concerning illegal organ transplantation, a Division Bench of Chief Justice Mr. Soumen Sen and Justice Syam Kumar V.M. held that, in view of the directions in Indian Society of Organ Transplantationv. Union of India 2026 (1) KHC 91 (SC) and also the recommendations of the Advisory Committee, it was the duty of the State to accept and implement the said recommendations.
A report of the advisory committee meeting held on 19-11-2025 was placed before the Court wherein the Committee recommended to establish a digital platform for offering live organs such as kidney or a portion of liver to needy patients suffering from end stage organ failure and skin for those requiring skin for therapeutic purposes on a non-directed altruistic basis. It was stated that the Kerala State Organ and Tissue Transplant Organisation (K-SOTTO) would develop such a platform in consultation with National Organ and Tissue Transplant Organisation (NOTTO) and to implement the program as per the guidelines.
The condition imposed was that only K-SOTTO shall invite applications for live unrelated altruistic donation from the general public and process them with utmost confidentiality and anonymity. Another condition was that the expenses of the medical, psychological and socioeconomic evaluation of the donor be borne by K-SOTTO and later reimbursed by the recipient on successful transplantation. The Committee proposed allocation policies for kidney, liver and skin.
For kidney and liver, the donor would choose the transplantation centre, there would be scope for initiating a Dominos Organ Donation chain and Swap Donation pairs, and allocation would then follow NOTTO’s kidney criteria or K-SOTTO’s liver policy, followed by the regional and state lists. Where patients were equally suitable, priority would go first to those with no suitable living donor among near relatives, then to those whose donor had refused in writing, and lastly to those with a suitable donor who had not refused.
The Committee further recommended that the Government introduce a Swap Kidney Donation program in strict adherence to Section 9(3A) of the THOT Act, and that K-SOTTO introduce a digital platform to assess the patient load in End Stage Renal Disease, End Stage Liver Disease and Heart Disease. It recommended that the Appropriate Authority consider revamping the police enquiry on illegal organ transplantation reports in Thrissur district through proper legal manoeuvres. It also recommended that transplant centres disclose their charges suo moto and that K-SOTTO publish an upper ceiling for such charges. Finally, it recommended that the competent authorities and DLACs simplify application procedures and move towards a single-window, time-bound clearance system.
K-SOTTO drew the Court’s attention to the Supreme Court’s judgment in Indian Society of Organ Transplantation (supra), wherein the Supreme Court had requested the Union of India to persuade certain States to adopt the Transplantation of Human Organs (Amendment) Act, 2011 and the 2014 Rules, and had directed the constitution of a SOTTO for Meghalaya and Nagaland. It had requested NOTTO to evolve model allocation criteria, a uniform national policy addressing gender, class and regional discrimination, and to evolve national swap transplantation guidelines under S.9(3) of the 1994 Act, to be implemented digitally through an accessible web portal.
The Supreme Court had also asked for the development of transplantation facilities, a five-year plan, and for guidelines on the welfare of live donors to ensure informed and voluntary consent and to prevent commercialization as well as exploitation. Further, it had requested that hospitals report donor and recipient data to the national registry maintained by NOTTO under S.13D of the 1994 Act, and directed the State Governments and Union Territory Administrations to take strict action against defaulting hospitals.
In view of the Supreme Court’s directions as well as the recommendations of the advisory committee, the Court directed the State’s to accept and implement the said recommendations. Thus, the writ petition was disposed of.
