The National Organ & Tissue Transplant Organisation (NOTTO) has issued an urgent directive to all Regional and State Organ and Tissue Transplant Organisations (ROTTOs/SOTTOs) and State Appropriate Authorities, calling for immediate action to establish robust systems for promoting tissue and bone donation. This notice was dated October 17, 2025.
The directive, signed by the Director of NOTTO, highlights the gap between national demand and the current supply of human tissues.
Critical Shortage and Need for Tissues
NOTTO emphasized that tissues are often not harvested from deceased donors, despite tissues like corneas, skin, bones, and heart valves being viable for donation from cases of brain-stem death, cardiovascular deaths, and natural deaths occurring up to six to ten hours after death.
Cornea Demand: India requires nearly one lakh corneas annually, but the current supply meets only about one-third of this national demand.
Bone Donation: Bone donation is critical for treating patients suffering from trauma, non-union of bone fractures, congenital abnormalities, and various bone-related disorders.
Mandatory Hospital Protocols Instituted
To address this shortfall, NOTTO has instructed all hospitals involved in organ and tissue donation to implement the following mandatory systematic changes:
- Tissue Donation Teams: Hospitals must constitute an organ and tissue donation team. This team should involve brain-stem death committee members and a transplant coordinator/counselor.
- Mandatory Notification: A system must be established for the mandatory notification of all deaths occurring in the hospital (including ICU, wards, and the emergency department) to the designated donation team.
- Timely Counseling: Efforts must be made for timely counseling of potential donors’ family members, emphasizing the option for tissue donation even if the family declines organ donation.
- Retrieval and Storage Linkages: Hospitals must make proper arrangements for tissue retrieval, processing, and storage by creating linkages with registered tissue banks.
- Staff Training: Training of healthcare staff in tissue retrieval, transplantation, and banking activities is deemed crucial for strengthening the overall system.
The Director of NOTTO requested an Action Taken report in due course, underscoring the potential for promoting tissue and bone donation to “significantly transform lives and improve the quality of life” for many patients.