Context:

On the eve of World Organ Donation Day 2025, the National Organ and Tissue Transplant Organisation (NOTTO) issued a significant advisory to address gender disparity in organ transplantation in India. The move aims to correct a long-standing imbalance: women donate more, but receive fewer organs.

 What the Data Shows:

• According to NOTTO (2019–2023), 63.8% of all living organ donors in India were women, but 69.8% of recipients were men.
• Out of 56,509 living organ donations during the period:
• 36,038 were by women
• Only 17,041 organs were transplanted into women
• 39,447 recipients were men

About NOTTO’s New Directions:

In its recent 10-point advisory, NOTTO proposes the following:

• Priority to women recipients: Especially women relatives of deceased donors, to help bridge the gender gap.
• Permanent posts for transplant coordinators at hospitals handling transplants and retrievals.
• Register all trauma centres as organ retrieval centres.
• Train emergency personnel and ambulance staff to recognize and report potential deceased donors—especially in stroke or road accident cases.

These measures aim to institutionalize equity and enhance organ availability, particularly among vulnerable women patients.

Legal Framework Governing Organ Donation in India

• Transplantation of Human Organs Act, 1994 governs the legal and ethical framework.
• The Act prohibits commercial transactions in organs.
• It allows for live and brain-stem dead donations.
• Amended in 2011 to include tissue donations.

All transplant-related hospitals must be linked with NOTTO, the apex government body under the Ministry of Health and Family Welfare.

 Broader Organ Donation Landscape:

Global Scenario:

• WHO: Only 10% of the global demand for organ transplants is met annually.
• Over 1.3 lakh transplants happen globally, but millions are in need.

India’s Challenge:

• 1.8 lakh patients in India develop end-stage kidney failure annually.
• But only 12,000 kidney transplants take place each year.
• Myths, religious and cultural barriers, and lack of awareness deter donations.

About National Organ and Tissue Transplant Organisation (NOTTO) :

The National Organ and Tissue Transplant Organisation (NOTTO), established in 2011 under the Transplantation of Human Organs and Tissues Act, is India’s apex body for coordinating organ donation and transplantation. It functions under the Ministry of Health and Family Welfare.

 Key Functions:

NOTTO manages the national registry of donors and recipients, lays down ethical guidelines, promotes awareness, and ensures fair allocation of organs. It coordinates with ROTTOs and SOTTOs across India.

Conclusion:

NOTTO’s advisory is a step towards gender justice in healthcare. With women making up a majority of donors but being underrepresented as recipients, this move signals an institutional acknowledgement of bias and a policy response rooted in equity.

However, success depends on:

• Awareness campaigns challenging gender roles and misinformation.
• Hospital accountability and implementation of the advisory.
• Long-term monitoring of how these measures affect gender distribution.