New Delhi: The Supreme Court on Wednesday directed the Centre to establish a national policy and uniform rules for organ donation and allocation, stressing the need for a transparent, fair, and efficient system across the country. The order came from a bench of Chief Justice BR Gavai and Justice K Vinod Chandran while hearing a PIL filed by the Indian Society of Organ Transplantation.
The Court urged the Centre to convince Andhra Pradesh to adopt the 2011 amendments to the Transplantation of Human Organs Act, 1994. It also instructed Karnataka, Tamil Nadu and Manipur to promptly implement the Transplantation of Human Organs and Tissues Rules, 2014, noting the seriousness of the issue.
The bench asked the Centre to prepare a unified national framework with “model allocation criteria” for organ transplants. This policy must eliminate caste and gender bias and ensure uniform donor standards nationwide, ending the existing variations between states.
Highlighting gaps in infrastructure, the Court observed that Manipur, Nagaland, Andaman and Nicobar Islands, and Lakshadweep still do not have State Organ and Tissue Transplant Organisations (SOTOs). The Centre has been directed to set up these bodies under the National Organ Transplantation Programme after consulting states.
To protect live donors from exploitation, the Court instructed the government to establish welfare guidelines ensuring proper post-donation care and preventing commercial abuse.
The bench also ordered amendments to birth and death registration forms to clearly state whether a death was due to “brain death” and whether the family was given the option to donate organs. These changes must be made in consultation with the National Organ and Tissue Transplant Organisation (NOTTO).
The PIL highlighted the absence of uniformity in applying the 2014 rules, with states like Andhra Pradesh and Karnataka continuing to follow older provisions. Senior advocate K Parmeswar, representing the petitioner, argued that the lack of a consolidated national database for donors and recipients was causing delays and enabling inequality, with organ transplants largely limited to affluent groups.
He noted that nearly 90 per cent of organ transplants occur in private hospitals, leaving public hospitals underrepresented in the national donor registry.
In April, the Supreme Court had instructed the Centre to collect detailed data from all states and Union territories regarding the implementation of the 1994 Act, its 2011 amendment, the 2014 rules, and compliance with NOTTO guidelines. The Court had also sought information on cadaver-to-live donor ratios, gender disparities, awareness efforts, financial aid, swap transplant policies, and the availability of hospitals equipped for complex transplants. The consolidated report was due on July 18, 2025.
