A court has denied bail to the prime accused in the Kochi organ trafficking case, as the National Investigation Agency (NIA) broadens its investigation internationally.

The case, which involves the trafficking of individuals to Iran and Tajikistan for illegal organ donation, came to light on May 18, 2024, when immigration officials at Kochi airport intercepted Sabith Korukulath, raising suspicions about his involvement in an organized organ trafficking network. Subsequent investigations led to the arrest of Sajith Shyam and Bellamkonda Ram Prasad, natives of Vijayawada, who allegedly facilitated the travel of organ donors and recipients to hospitals in Iran for illegal transplantations.

The prime accused, Madhu Jayakumar, a resident of Ernakulam, had been absconding for over a year. He was apprehended upon his arrival at the New Delhi airport on November 7, 2025. During interrogation, Jayakumar disclosed the names of 27 recipients who underwent kidney transplantation in Iran with his assistance, as well as the names of 11 donors.

The NIA's investigation revealed that the trafficking network extended beyond Iran, with two individuals from Odisha being sent to Tajikistan in 2025 for kidney transplants. The agency is seeking further custody of Jayakumar to trace the money obtained through the illegal organ trade, which was allegedly converted into Bitcoin and USDT through Stemma Club and various bank accounts. The NIA aims to ascertain the details of these cryptocurrency transactions through custodial interrogation.

According to the chargesheet filed by NIA, the racket identified vulnerable youth facing financial difficulties from states like Kerala, Karnataka, and Telangana. They were lured with promises of money in exchange for their organs. The donors were then trafficked to Iran, where their organs were harvested after collecting substantial amounts from recipients from New Delhi, Jammu, and Ghaziabad, among other places. The recipients were charged up to ₹50 lakh by the accused.

The probe revealed that the accused misled victims by claiming that organ donation for money was legal in Iran and facilitated kidney transplants between 2019 and 2024. Madhu Jayakumar is suspected of taking around 20 people, mostly from North India, to Iran.

In August 2024, the NIA filed a chargesheet against four accused in the case, alleging that the racket operated under the guise of medical tourism. While three of the accused – Sabith, Sajith Shyam, and Bellamkonda Ram Prasad – had already been arrested, Madhu had been absconding. In February 2025, an Interpol Red Corner Notice was issued against him while he was residing in Iran.

The Kerala High Court had previously denied bail to Sajith Shyam, another accused in the case, stating the seriousness and gravity of the allegations. The court also noted the monetary transactions and mobile phone conversations between Sajith Shyam and Madhu Jayakumar.