Kerala HC Directs State to Implement Organ Donation Reforms, Including Swap Kidney Programme [Read Judgment]

Kochi: The Kerala High Court has directed the State to accept and implement the recommendations of its Advisory Committee on organ transplantation, including a digital platform for non-directed altruistic donation of live organs and skin, a swap kidney donation programme, disclosure and a published ceiling of transplantation charges, and a single-window, time-bound clearance system for approvals.

A Bench of Chief Justice Soumen Sen and Justice Syam Kumar V.M. disposed of W.P. (C) No. 4269 of 2025, filed by Advaith M, aged 19, against the State of Kerala, the Principal Secretary (Health and Family Welfare), the Appropriate Authority (Director of Medical Education), K-SOTTO (the Kerala State Organ and Tissue Transplant Organisation) and the State Police Chief. The judgment of 11.11.2026 does not set out the petitioner’s prayers. The exhibits listed in its appendix include news reports, RTI replies from K-SOTTO, a Government Order of 15.02.2018, a Crime Branch enquiry report of 19.10.2020 and a final report of 29.04.2024 before the Judicial First Class Magistrate, Thrissur.

The Senior Government Pleader, Mr. Biju Meenattoor, placed before the Court the report of the Advisory Committee meeting held on 19.11.2025. Its recommendations, as reproduced by the Court, include the following:

First, K-SOTTO should develop, with NOTTO, a digital platform for live unrelated non-directed altruistic donation of a kidney, a portion of liver or skin, with applications invited and processed only by K-SOTTO in confidence and anonymity. The donor’s evaluation costs would be borne by K-SOTTO and later reimbursed by the recipient on successful transplantation. The allocation policy for kidney, liver and skin gives priority to the donor’s choice of centre, domino and swap chains, immunological compatibility, and regional and State lists. Among equally suitable patients, priority goes first to those with no suitable living donor among near relatives, and then to those whose donor has refused in writing.

Second, the Government should introduce a swap kidney donation programme, strictly adhering to Section 9(3A) of the Transplantation of Human Organs Act. Third, K-SOTTO should create a digital platform to assess the patient load for end-stage renal, liver and heart disease, so that long-term policy can be framed.

Fourth, the Committee recommended that the Appropriate Authority consider revamping, through proper legal manoeuvres, the referred police enquiry into illegal organ transplantation reports in Thrissur district. Fifth, transplant centres should be encouraged to disclose charges suo motu, with K-SOTTO publishing an upper ceiling for charges for different procedures after consulting public and private experts. Sixth, authorities and the District Level Authorisation Committees should simplify procedures, moving towards a single-window, time-bound system for approvals.

Counsel for K-SOTTO drew the Court’s attention to paragraph 19 of the Supreme Court’s order in Indian Society of Organ Transplantation v. Union of India (2026 (1) KHC 91 (SC)). The Court reproduced its directions, which include a request to the Union to evolve, through NOTTO, model allocation criteria alleviating gender, class and regional discrimination, and national swap transplantation guidelines under Section 9(3). They also include guidelines for the welfare of live donors to ensure informed and voluntary consent and prevent commercialisation, and reporting of donor and recipient data to the national registry under Section 13D, with strict action against defaulting hospitals.

Taking the Supreme Court’s directions and the Committee’s recommendations together, the Bench held:

“It is now the duty of the State to accept and implement the said recommendations.”

With that direction, the writ petition was disposed of.

Appearances:

For the Petitioner: Mr. Thomas Varghese, Advocate.

For the Respondents: Mr. Biju Meenattoor, Senior Government Pleader, with Mr. Ajit Joy and Ms. Asha Treesa Jose.

Case Title: Advaith M vs. State of Kerala & Ors., W.P. (C) No. 4269 of 2025, 2026:KER:86455

 [Read Judgment]