The Kerala High Court has directed the State government to accept and implement a series of recommendations aimed at improving organ donation and transplantation, including the creation of a digital platform for voluntary donors and the introduction of a kidney-swap programme.
A Bench comprising Chief Justice Soumen Sen and Justice Syam Kumar VM took note of the recommendations made by an Advisory Committee, whose meeting report dated November 19, 2025, had earlier been submitted before the Court by the State.
One of the key proposals is to establish a digital platform allowing individuals to voluntarily donate a kidney, part of their liver or skin to patients in need, without selecting a particular recipient.
The Kerala State Organ and Tissue Transport Organisation (KSOTTO) is expected to develop the platform in consultation with the National Organ and Tissue Transport Organisation (NOTTO), which oversees organ donation and transportation at the national level.
The committee recommended that KSOTTO alone should invite and process applications from unrelated voluntary donors. This would help maintain the confidentiality and anonymity of donors throughout the process.
It also proposed that KSOTTO initially meet the expenses involved in the medical, psychological and socio-economic assessment of donors. Recipients could reimburse these costs after a successful transplantation.
Another significant recommendation concerns the introduction of a kidney-swap donation programme under Section 9(3A) of the Transplantation of Human Organs and Tissues Act, 1994.
The programme would allow two or more donor-recipient pairs, whose members are medically incompatible within their respective pairs, to exchange donors where compatibility exists with another recipient. The arrangement is intended to expand the pool of available kidneys and improve transplant opportunities.
The committee has also suggested a structured system for allocating kidneys, livers and skin, taking into account medical suitability, donor preferences and the needs of patients awaiting transplantation.
On the financial side, the recommendations call for hospitals to clearly disclose organ transportation charges. KSOTTO has also been asked to consult medical experts and publish maximum permissible charges for different transplantation procedures.
Transplant centres would additionally be required to make details of all charges associated with organ transplantation easily accessible to patients and their families, promoting transparency and informed decisions.
The proposed reforms also include a single-window mechanism for granting transplant approvals within fixed timelines, reducing procedural delays.
The committee further stressed the need to maintain data on patients awaiting kidney, liver and heart transplants. Such information could help authorities assess demand and develop long-term policies for organ donation and transplantation.
After considering the recommendations, the High Court directed the State to accept and implement them.
Advocate Thomas Varghese appeared for the petitioner, while Senior Government Pleader Biju Meenattoor represented the State.