The Kerala High Court has directed the State government to accept and implement a package of organ donation and transplantation reforms, including a digital platform for altruistic donors, a swap kidney donation programme and clearer disclosure of transplant charges.

Source: LiveLaw

A Division Bench of Chief Justice Soumen Sen and Justice Syam Kumar V.M. delivered the judgment on November 11, 2026, while disposing of the writ petition Advaidh M v. State of Kerala and Others, W.P.(C) No. 4269 of 2025, reported with neutral citation 2026:KER:86455.

What the recommendations say

The reforms come from the Transplantation Advisory Committee, whose report from its meeting of November 19, 2025, was placed before the court by the State's Senior Government Pleader. The committee recommended that the Kerala State Organ and Tissue Transplant Organisation (KSOTTO), in consultation with the National Organ and Tissue Transplant Organisation (NOTTO), build a digital platform through which members of the public can offer a kidney, part of a liver, or skin for therapeutic purposes on a non-directed altruistic basis.

Under the framework, KSOTTO alone would invite applications for unrelated altruistic donation and process them confidentially, keeping donors anonymous. KSOTTO would initially meet the cost of evaluating a donor's medical, psychological and socioeconomic circumstances. Separate allocation frameworks are proposed for kidneys, liver donations and skin, beginning with the transplantation centre chosen by the donor and then considering donation chains and swap pairs alongside immunological compatibility and NOTTO's allocation criteria.

The committee also recommended a swap kidney donation programme, strictly in accordance with Section 9(3A) of the Transplantation of Human Organs and Tissues Act, disclosure of treatment and transplant charges, a move towards a single-window and streamlined approval system, and a digital system to assess how many patients with end-stage kidney, liver and heart disease need transplantation.

What happens next

The court took note of the Supreme Court's directions in Indian Society of Organ Transplantation v. Union of India, which called for uniform national organ allocation criteria through NOTTO with safeguards against discrimination based on gender, class and region, and held that it is now the State's duty to accept and implement the advisory committee's recommendations. The judgment implements the reform framework; it does not grant any individual patient permission for a transplant, and individual applications remain subject to the usual allocation criteria and authorisation process.