New Delhi: India has around 800 government and private medical colleges that could potentially be developed into organ retrieval centres, but only about 150-200 such centres are currently operating, National Organ and Tissue Transplant Organisation (NOTTO) director Dr Anil Kumar told ThePrint Tuesday.
NOTTO is the apex body under the Ministry of Health and Family Welfare that manages organ and tissue donation and distribution. A retrieval centre is a hospital that can identify a potential donor, facilitate brain-death certification and surgically retrieve organs for transportation to a transplant hospital. It does not necessarily perform the transplant itself.
In an interview with ThePrint, Kumar said NOTTO has written to states to identify medical colleges that could be brought into the organ retrieval network, as the organisation looks to expand the number of hospitals capable of contributing organs from deceased donors.
The push comes against the backdrop of the launch of NOTTO’s new digital platform, the e-Pratyaropan portal, and mobile application on 3 August. The platform will create hospital, state, regional and national waiting lists, allow patients to track their cases, enable hospitals to flag critically ill recipients as “super urgent” and help authorities monitor the movement and allocation of organs.
Dr Kumar said the platform is an upgraded version of the national transplant registry that has been operational since 2015.
“It uses newer technologies, including AI integration, and brings patients, hospitals, state and regional transplant organisations and the national regulator onto one digital system,” he said.
The broader aim, Kumar added, is to ensure that organs donated after death are used to the maximum possible extent.
“Whenever the donation happens, no donated organ is wasted, and we are able to utilise the donated organ to the maximum extent,” he said.
The changes come as more than one lakh people are now on India’s transplant waiting list, according to Kumar, up from around 90,000 last year.
NOTTO is also trying to address a gender imbalance in transplantation. Kumar said the organisation has written to states recommending additional allocation points for women waiting for organs from deceased donors, after data showed that women are much more likely to be living donors while men make up the majority of recipients.
Data from the Ministry of Health and Family Welfare and NOTTO show that in 2025, women accounted for 68 percent of living donors, or 11,316 donors, but only about 22 percent of recipients. Men accounted for about 78 percent of recipients, or 12,903 people.
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One system for transplants
The new platform is intended to bring together processes that were earlier handled separately by hospitals and government authorities.
A patient requiring a transplant will continue to be registered by a treating transplant hospital. The hospital enters the patient’s details into the portal, after which the patient’s name is added to waiting lists at the hospital, state, regional and national levels.
Patients will have their own login and will be able to see their position and updates. They will also be able to raise grievances through the platform.
Kumar said the portal is different from the earlier system because several other processes are now being brought online.
For instance, a hospital seeking permission to conduct transplantation or organ retrieval can apply digitally. The application and supporting documents are then available to the relevant state government for processing.
Living-donor approvals can also be initiated online, while foreign patients seeking transplantation in India can apply digitally, allowing authorities to access information about their cases more easily.
“Most of these processes were not digitalised,” Kumar said. “We have tried to digitalise most of these processes and they have been done through a single platform.”
The system, he said, should make transplantation “more transparent”, “more ethical” and “more efficient and faster”.
The portal also allows hospitals to update the condition of patients. If a recipient’s condition deteriorates, hospitals, states or regional bodies can raise a “super urgent” request.
When an organ becomes available, the treating and coordinating network can use the waiting lists and allocation criteria to identify eligible recipients.
India has a three-level coordination system comprising State Organ and Tissue Transplant Organisations (SOTTOs), Regional Organ and Tissue Transplant Organisations (ROTTOs), and the National Organ and Tissue Transplant Organisation (NOTTO).
Kumar said the network currently covers 31 states and Union Territories, with more than 1,200 hospitals connected, including transplant hospitals, retrieval centres and tissue banks.
The hospital where an organ is retrieved gets the first opportunity to use it if it has a suitable recipient. If there is no match, the organ can move to the state pool, followed by the regional and national pools.
However, states continue to follow different allocation rules. Telangana, Maharashtra and Gujarat, for instance, have their own scoring systems, while some states prioritise patients according to how long they have been waiting. Tamil Nadu follows a regional allocation system.
“We cannot force the states,” Dr Kumar said. “However, there is a consultation ongoing to bring them on the same page so that the same allocation criteria may be followed across the board.”
The portal will also enable national matching of swap donors, where patients with willing but medically incompatible donors can be matched with other donor-recipient pairs.
Dr Kumar said matching at the national level would expand the pool compared with the current system, where swap donors are often matched within individual hospitals.
The portal will also allow people to pledge their organs, with Aadhaar being used to establish the identity of the person making the pledge.
Dr Kumar said the Aadhaar information remains encrypted and is not accessible even to the backend team.
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‘Hub-and-spoke model’
While the portal is aimed at improving coordination and transparency, NOTTO is simultaneously trying to expand the physical infrastructure that supplies organs to the transplant system.
Dr Kumar said that the basic requirements for a retrieval centre are an ICU, an operation theatre, a four-doctor committee capable of certifying brain-stem death and a trained coordinator.
“Any medical college which is doing MBBS teaching can easily be converted into a retrieval centre,” Dr Kumar said.
The idea, he said, is to create a “hub-and-spoke system,” with transplant hospitals acting as hubs and smaller retrieval centres feeding organs into them.
The expansion is important because India remains heavily dependent on living donors.
India recorded 20,138 organ transplants in 2025, of which 3,526, or around 17.5 percent, involved organs from deceased donors, Dr Kumar said.
While the deceased-donor share has increased more than fourfold from around 2013-14 levels, Kumar said the country still needs to increase deceased donation because living donors can generally provide only one kidney or part of the liver.
“Many organs cannot be donated by a living donor,” he said. “Living donor only we can have one kidney or a part of the liver from a living donor. The other organs have to be donated from a deceased person only.”
The country continues to have a deceased-donation rate of less than one donor per million population, while the number of people waiting for organs has crossed one lakh.
NOTTO has also issued national brain-stem death guidelines, released on 3 August, aimed at making certification and the process following brain death clearer for hospitals.
Dr Kumar said increasing donation will require more retrieval centres, trained coordinators and greater public awareness.
(Edited by Sugita Katyal)
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