Executive Summary:
The Ministry of Health and Family Welfare addresses the donation of human organs through the Transplantation of Human Organs and Tissues Act (THOTA), 1994. A three-tiered network (NOTTO, ROTTOs, SOTTOs) facilitates organ and tissue procurement and allocation via a digital National Registry. The initiative prioritizes transparency and equity, focusing on factors like disease duration and severity.
Key Points / Main Content:
Organ and Tissue Transplant Network:
* A three-tiered National Human Organs and Tissues Removal and Storage Network is established under THOTA, 1994.
* The network consists of NOTTO, ROTTOs, and SOTTOs.
* NOTTO maintains a digital National Registry to coordinate organ and tissue procurement and allocation.
Allocation Criteria:
* NOTTO has prescribed allocation criteria for kidney, heart, liver, lung, heart-lung, and cornea transplants.
* Priority factors include duration of disease, waiting list period, severity of illness, children, previous living donors needing transplants, and matching parameters (blood group, age, size).
* Government centers receive priority for donated organs if the donation occurs within a government institution under NOTTO policy.
* States can adopt NOTTO’s criteria or develop their own as per THOT Rules, 2014.
National Organ Transplant Program (NOTP):
* The Government of India implements NOTP, providing grants to States based on proposals.
* Grants support establishing ROTTOs and SOTTOs, infrastructure augmentation, hiring transplant coordinators, donor maintenance, organ transport, post-transplant medicines, and awareness/training activities.
Information and Awareness:
* A dedicated website (www.notto.mohfw.gov.in) and a 24x7 call center (1800114770) provide information and coordination.
* NOTTO, ROTTOs, SOTTOs conduct awareness activities, including Indian Organ Donation Day, seminars, and events.
* A web portal (notto.abdm.gov.in) allows Aadhaar-verified pledges for organ/tissue donation.
* Transplant retrieval centers should display information regarding organ donation in strategic locations.
Transparency and Monitoring:
* States are requested to implement swap donor programs.
* States/UTs must ensure hospitals performing transplants/retrievals are linked to NOTTO’s website.
* Data related to deceased and living donors/recipients must be uploaded to the National Registry.
* Each donor and recipient is assigned a unique NOTTO ID for monitoring.
Impact Analysis:
State Governments:
* Impact: Responsible for augmenting capacity, enhancing transparency, and increasing awareness in organ donation/transplantation, as health is a State subject. They can adopt NOTTO criteria, or develop their own in line with THOT Rules, 2014.
* Action Required: Implement swap donor programs, ensure hospitals are linked to NOTTO, and that data is uploaded to the National Registry.
Hospitals (Performing Transplants/Retrievals):
* Impact: Must be linked to NOTTO’s website and upload data related to deceased and living donors/recipients. They should display boards with information on organ donation.
* Action Required: Link to NOTTO’s website, upload required data, and display informational boards.
Organ Donors and Recipients:
* Impact: Allocation criteria prioritize those in greater need and ensure a fair process. Unique NOTTO IDs are assigned for better monitoring.
* Action Required: Patients needing transplants should register through their treating hospital.
General Public:
* Impact: Increased awareness through various programs and accessible information via website and call center. Can pledge organ donation through the dedicated web portal.
* Action Required: Utilize available resources to learn about organ donation and consider pledging to donate.
Key Entities Referenced
Transplantation of Human Organs and Tissues Act THOTA, 1994: Indian legislation that regulates organ donation and transplantation activities.
National Organ and Tissue Transplant Organization NOTTO: A national-level organization in India responsible for coordinating organ and tissue transplantation activities.
Regional Organ and Tissue Transplant Organizations ROTTOs: Regional-level organizations in India that coordinate organ and tissue transplantation activities within their respective regions.
State Organ and Tissue Transplant Organizations SOTTOs: State-level organizations in India responsible for coordinating organ and tissue transplantation activities within their respective states.
National Organ Transplant Program NOTP: A program by the Government of India to support and improve organ transplantation services in the country.
Ministry of Health and Family Welfare: The Indian government ministry responsible for public health.
Shri Prataprao Jadhav: The Minister of State in the Ministry of Health and Family Welfare.
Indian Organ Donation Day: Annual awareness day event celebrated to promote organ donation in India.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1140
TO BE ANSWERED ON25THJULY, 2025
DONATION OFHUMAN ORGANS
1140.SHRIPARSHOTTAMBHAI RUPALA:
Will the Ministerof HEALTHANDFAMILYWELFAREbe pleasedtostate:
(a) the steps taken/proposed to be taken by the Government in partnership with the State
Governments to establish clear guidelines for ensuring that human organs donated by
volunteersare providedtounderprivileged people;
(b) the steps taken/proposed to be taken by the Government of those people who are missing
out onthe Organs theyrequire due toa lackof awareness andif so, the detailsthereof; and
(c) the actions taken/proposed to be taken by the Government in collaboration with the State
Governments to facilitate the aforementioned process online, as this would enhance
transparency andreduce illegal humanorgantrading?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (c) : Under Transplantation of Human Organs and Tissues Act (THOTA),1994, a three
tiered National Human Organs and Tissues Removal and Storage Network has been
established, consisting of National Organ and Tissue Transplant Organization (NOTTO),
Regional Organ and Tissue Transplant Organizations (ROTTOs) and State Organ and Tissue
Transplant Organizations (SOTTOs). NOTTO/ROTTO/SOTTO network with institutions
and hospitals performing organ/tissue transplantation, organ retrieval, and tissue banking in
the country through a digital National Registry, maintained by NOTTO, with a view to
provide an efficient and organized system of organ and tissue procurement from deceased
donors andtheirallocation towaiting recipients.
The Allocation criteria for major organs and tissues namely kidney, heart, liver, lung, heart-
lungandcorneatransplanthave beenprescribed byNOTTOfor transparencyandequityinthe
allocation system, giving preference to those whose requirement is more. The aforesaid
allocationcriteriagiveprioritytothefollowingfactors:
Durationofdisease,
Periodinwaitinglist,
Severityofillness, Children,
Previouslivingdonornowrequiringtransplantand
Matchingparameterslikebloodgroup,age,sizeetc.forbetteroutcome.
Otherfactorsnamelylocalutilizationoforganandgeographicalproximityofrecipient
Further,allocationofdonatedorganstorecipientsofGovernmentcentresisdone,ifdonationis
happening in a Govt. institution under the NOTTO allocation policy. States may adopt
allocation criteria of NOTTO or can have their own allocation criteria as permitted under
THOTRules,2014.
The Government of India is implementing the National Organ Transplant Program (NOTP).
Under NOTP, grants are provided to States depending upon the proposals received, for
establishing ROTTOs and SOTTOs, augmenting infrastructure in public sector for setting up
Organ Transplant/Retrieval Centers and Tissue Banks, hiring of Transplant Coordinators by
Government Medical Colleges and Trauma Centers, maintenance of deceased donors, organ
transport, post- transplant immune-suppressant medicines, carrying out awareness, training
andcapacitybuilding activitiesetc.
A dedicated website (www.notto.mohfw.gov.in) along with a 24x7 call center with a toll free
helpline number (1800114770)are operationaltoprovide information,tele-counselling andto
helpincoordinationfor organ donation.
NOTTO, ROTTOs, SOTTOs and institutions carry out activities across the country for
generating awareness, such as celebration of Indian Organ Donation Day annually, seminars,
webinars, workshops, debates, sports events, walkathons, marathons, nukkad natak, legal
symposium, etc.
A dedicated web-portal notto.abdm.gov.in for registering Adhaar verified pledges for organ
& tissue donationisoperational.
States have been requested to implement swap donor program as per THOTA1994, which is
likelytoimprove pool of donors andincrease numberof transplantation.
The Transplant/retrieval centers are requested to display the Boards in ICUs, Casualty,
waiting areas and other strategic locations for information regarding legal requirement for
doctors/coordinators toinquire/request familymembersfor organdonation.
Health being a State subject, it is the primary responsibility of the State to augment capacity,
enhance transparency and increase awareness in organ donation & transplantation. NOTTO
maintains a digital national registry of organ recipients and donors. Patients needing
transplant can get registration done through treating hospital in the national registry for
receiving deceased donor organ. States/UTs have been requested toensure thatevery hospital
performingorgan transplantationor retrievalneedstobe linked tothe website of NOTTOand
data related to both deceased and living donors and recipients of transplants is uploaded in
the National Registry. Further, each donor and recipient is allocated a unique NOTTO ID for
bettermonitoring.
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