The National Organ & Tissue Transplant Organisation (NOTTO) has issued revised national guidelines for COVID-19 testing requirements for both organ donation and transplantation, effective immediately from November 11, 2025. These guidelines, issued with the approval of the competent authority, are based on recommendations from NOTTO’s Apex technical committee.
Rationale for Change
The revised guidelines acknowledge several factors:
Decreased Magnitude of COVID-19: The overall number of COVID-19 cases in India has significantly declined and the total number of cases being reported is very few.
Low Organ Donation Rate: The organ donation rate in India remains very low.
Organ Discarding: There have been many instances where organs from asymptomatic donors were discarded due to a COVID-19 positive report, leading to the loss of organs and tissues that could have saved lives.
Delay in Allocation: Waiting for COVID-19 test reports can sometimes delay the deceased donor organ allocation process.
Vaccine Status: The vaccine status of the donor or recipient has not impacted the transplant outcome and is not being implemented under the Government Programme.
Revised Testing Requirements
NOTTO has established the following uniform recommendations for implementation across the country:
- Uniform testing for COVID-19 will not be mandatory for asymptomatic donors and recipients in most organ transplantation cases (both living and deceased donor transplant).
- COVID-19 RTPCR testing remains mandatory for both the donor and recipient in lung transplantation cases, recognizing that COVID-19 primarily affects the lungs and can cause damage even in asymptomatic patients.
- For symptomatic donors, recipients, or both, the decision on COVID-19 testing may be taken by the treating doctor/clinician based on their professional assessment of the case.
These revised guidelines specifically address the requirement for COVID-19 testing in transplant procedures. However, other COVID-19 related guidelines recommended by the PH division of the Ministry of Health and Family Welfare remain applicable. The guidelines will be reviewed as per the situation of COVID-19 from time to time.