The Supreme Court of India has agreed to formulate comprehensive guidelines for organ transplantation to ensure equitable access for the poor and marginalized. This decision, made on Tuesday, November 18, 2025, comes in response to concerns that the current system disproportionately favors the wealthy and influential, as a significant majority of transplant centers are in the private sector.
A senior advocate, K Parameshwar, appearing for the petitioner, highlighted the necessity of a national organ availability data grid. This grid would allow prospective recipients to track their position on the waiting list and understand their chances of receiving a transplant. Parameshwar also emphasized the need for state-wide waitlists to improve transparency and accessibility. He further urged the court to direct the central and state governments to establish at least one hospital in each state and union territory capable of performing affordable organ transplants for impoverished patients.
The issue of gender disparity among organ donors was also raised, noting that women constitute the majority of donors while men are the primary recipients. Solicitor General Tushar Mehta supported the petitioner's suggestions but proposed separate regimes for normal donors and cases involving organs harvested from accident victims. Justice K Vinod Chandran pointed out the disturbing prevalence of "motivated accidents" in the southern region of India, allegedly orchestrated to harvest organs for specific recipients, a phenomenon depicted in a Kerala-based film. Mehta acknowledged these as shocking instances of murder.
The bench, led by the Chief Justice, tasked Mehta, Additional Solicitor General Archana D Pathak, and Parameshwar with drafting common points to be incorporated into the court's order.
This intervention by the Supreme Court aims to address critical issues within India's organ transplantation system. While India ranks among the top countries globally in the number of organ transplants performed annually, it lags behind in transplantation rates per million population due to its large population. A significant portion of these transplants occurs in private hospitals, making them inaccessible to many. The government is promoting deceased donor kidney transplantation to improve inclusivity and equity.
The Transplantation of Human Organs Act (THOA) was enacted in 1994 to prevent organ trading and promote deceased organ donation. Amendments were made in 2011 and 2014 to address loopholes that facilitated illegal organ trading. The Act regulates hospitals and tissue banks, mandating their registration with appropriate authorities and adherence to prescribed standards.
The Supreme Court has previously sought reports from States and Union Territories regarding the implementation of the Organ Transplant Act, also inquiring about steps taken to reduce gender disparity in transplants. The court has sought data on the number of government hospitals equipped for multi-organ transplants, the financial assistance provided to donors or recipients, and the existence of a national-level portal for updating donor and recipient information.
Despite the legal framework, challenges persist, including organ shortages, continued illicit trade, and limited cadaver donations. Factors such as lack of public awareness, religious beliefs, and strict laws contribute to the low organ donation rate in India. To address this, the National Organ Transplant Programme was implemented with a substantial budget to promote deceased organ donation.
The Supreme Court's initiative to establish norms for equitable access to transplants marks a significant step towards making these life-saving procedures available to all, regardless of their socioeconomic status.
