Kerala High Court Directs State To Implement Recommendations For Digital Organ Donation Platform, Transparent Pricing

A Division Bench comprising Chief Justice Soumen Sen and Justice Syam Kumar V.M. passed the direction while disposing of a writ petition which raised several issues regarding the organ donation in the State of Kerala.

The petitioner had sought for direction to the official respondents to immediately act in compliance with the directions in WP(C) 33801 of 2017, especially regarding press releases in print and electronic media seeking willing altruistic donors among the community for all patients who are unable to undergo organ transplant surgery owing to unavailability of matching donor.

The Court considered the report of the Advisory Committee meeting held on November 19, 2025, which was placed before it by the State.

One of the key recommendations of the Advisory Committee was the establishment of a digital platform through the Kerala State Organ and Tissue Transplant Organisation (KSOTTO) for individuals willing to donate organs such as kidneys or portions of their liver, as well as skin for therapeutic purposes, on a non-directed altruistic basis.

The proposed platform is intended to connect willing donors with patients suffering from end-stage organ failure and other medical conditions requiring transplantation.

The Committee recommended that only KSOTTO should invite applications from members of the public for unrelated altruistic organ donation. The application process would be handled with strict confidentiality and maintenance of anonymity.

It was also recommended that the expenses incurred towards the medical, psychological and socioeconomic evaluation of donors should initially be borne by KSOTTO, with the possibility of reimbursement by the recipient following a successful transplantation.

The Advisory Committee proposed separate allocation mechanisms for kidneys, livers and skin.

For kidney transplantation, priority would initially be given to the transplantation centre chosen by the donor, followed by opportunities for domino organ donation chains and swap donation pairs. Allocation would also be based on immunological compatibility and the kidney allocation criteria developed by the National Organ and Tissue Transplant Organisation (NOTTO).

Where multiple patients are found to be equally suitable, preference would be given to those who do not have a suitable living donor among their near relatives. The next priority would be patients whose suitable near-relative donors have refused to donate in writing.

Similar principles were recommended for liver transplantation, taking into account KSOTTO's liver allocation policy and the medical suitability of patients.

For skin transplantation, the proposed criteria include the transplantation centre of the donor's choice, medical emergencies and priority based on the waiting list maintained by the transplantation centre.

The Advisory Committee further recommended that the State Government introduce a swap kidney donation programme to expand the pool of available organs.

The programme is to be implemented strictly in accordance with Section 9(3A) of the Transplantation of Human Organs and Tissues Act.

The Committee also recommended that KSOTTO establish a digital platform to assess the patient load relating to end-stage renal disease, end-stage liver disease and heart diseases requiring transplantation. Such data would assist in formulating long-term policies on organ transplantation.

Emphasising the need for accountability in organ transplantation, the Committee recommended that transplantation centres be encouraged to voluntarily disclose, in a clear and accessible manner, the various charges associated with transplantation procedures.

It further recommended that KSOTTO publish an upper ceiling on charges for different procedures and treatments connected with organ transplantation, in consultation with high-volume transplantation centres and experts from both the public and private sectors.

The Advisory Committee also called for simplification of the procedures before Hospital-Level Competent Authorities and District-Level Authorisation Committees.

It recommended moving towards a single-window, time-bound clearance mechanism for organ transplantation approvals to reduce procedural difficulties and facilitate timely decisions.

The High Court also took note of the directions issued by the Supreme Court in Indian Society of Organ Transplantation v. Union of India [2026 (1) KHC 91 (SC)], where the Supreme Court had called for the development of uniform national organ allocation criteria through NOTTO, including safeguards against discrimination based on gender, class and region.

It had also called for national-level swap transplantation guidelines, measures to ensure the welfare and informed consent of living donors, improved transplantation facilities and mandatory reporting of organ donation and transplantation data to the national registry maintained by NOTTO.

The Supreme Court had further directed State Governments and Union Territory Administrations to ensure strict action against hospitals failing to furnish the mandated transplantation data.

Taking note of the Supreme Court's directions and the recommendations of the Advisory Committee, the Kerala High Court observed:

"In view of the directions in Indian Society of Organ Transplantation (supra) and also the recommendations of the Advisory Committee, it is now the duty of the State to accept and implement the said recommendations."

With this direction, the Division Bench disposed of the writ petition.

Counsel for Petitioner: Thomas Varghese

Counsel for Respondents: Biju Meenatoor (Sr. GP), Ajit Joy, Asha Treesa Jose