On 19 November 2025, the Supreme Court of India, through its judgment in 2025 INSC 1361, mandated nationwide uniformity in organ transplantation practices. The ruling aimed to address disparities across states, particularly in regions such as Andhra Pradesh, Telangana, and Manipur, where key amendments to transplant legislation introduced in 2011 and 2014 had not been fully implemented.
All states and union territories must adopt the 2011 amendments to the Transplantation of Human Organs and Tissues Act (THOTA) and the 2014 Rules to establish a uniform national organ allocation framework. State Organ and Tissue Transplant Organizations (SOTTOs) must be established in regions where they do not currently exist, including states such as Meghalaya and Nagaland.
Hospitals and transplant centres are required to report transplant-related data to the NOTTO portal in a timely manner, with non-compliance attracting penalties. The Court also directed development of a national equitable organ allocation policy to eliminate disparities based on gender, geography, and socio-economic status, and a national framework for swap transplants with safeguards for living donors including informed consent, donor protection, and post-donation follow-up.
Brain-stem death certification has been made mandatory in death reporting forms to improve identification of potential deceased organ donors and increase organ donation rates.
Applies to: All States and Union Territories
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