One Waiting List Instead of Twelve Hundred: e-Pratyaropan and the Allocation Problem in Organ Transplant
Summary
The National Organ and Tissue Transplant Organisation launched the e-Pratyaropan portal along with a NOTTO mobile application on 3 August 2026, creating a unified digital system for organ donation and transplantation.
●Where hospitals previously maintained largely separate transplant databases, the portal brings hospitals, State authorities and NOTTO onto a common platform covering registration, waiting-list management, organ allocation and monitoring.
●It automatically generates waiting lists at hospital, State, regional and national levels, enabling organs to be matched and allocated in real time, and strengthens coordination between NOTTO, the Regional and State Organ and Tissue Transplant Organisations and around 1,200 registered hospitals.
●The platform is live though some modules remain to be rolled out over the following two months.
●India has crossed 20,000 transplants in a year and more than five lakh Aadhaar-verified donation pledges, ranking third globally in transplant numbers.
Organ transplantation in India is governed by the Transplantation of Human Organs and Tissues Act, 1994, which permits donation from living donors, largely restricted to near relatives, and from deceased donors after brain-stem death certification, while criminalising commercial dealing in organs.
●Brain-stem death certification is central, because it is the legal basis on which organs can be retrieved from a heart-beating donor whose organs remain viable.
●The institutional structure is three-tiered: the National Organ and Tissue Transplant Organisation at the apex under the Directorate General of Health Services, Regional Organ and Tissue Transplant Organisations at the regional level, and State Organ and Tissue Transplant Organisations in the States.
●Allocation follows a sequence from local to State to regional to national, so an organ is first offered within its own area before being shared more widely.
●India's deceased-donation rate has remained low by international standards even as absolute transplant numbers have risen, which is the central paradox of the sector.
India's transplant shortfall is a deceased-donation problem: absolute numbers are large because the population is, while the donation rate per million people remains among the lowest of major countries.
◎ In Simple Words
When someone donates an organ, doctors must find a patient whose body will accept it, and quickly, because organs do not stay usable for long. Until now each hospital kept its own list of waiting patients, so a suitable match elsewhere in the country might never be found. The new system puts everyone on one list so an organ can be offered to the best-matched patient anywhere in India.
Factual Pointers
Practice · 2 questions
Which body sits at the apex of India's organ transplantation coordination structure?
Under the Transplantation of Human Organs and Tissues Act, 1994, deceased-donor organ retrieval is principally enabled by:
Health & Nutrition Policy
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