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NOTTO writes to states, UTs to implement swap organ transplant

Press Trust of india by Press Trust of india
April 18, 2025
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New Delhi: The National Organ and Tissue Transplant Organisation (NOTTO) has written to all the states and union territories for the implementation of SWAP donor transplantation, saying it has the potential to augment the number of organ transplants in the country.

SWAP donor organ transplantation is a process where two or more incompatible donor-recipient pairs swap their organs. It is useful in case of biologically incompatible donor recipient pairs. The exchange is permitted only between near relatives of respective recipients.

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The provision of SWAP donor transplantation already exists in the Transplantation of Human Organs and Tissues Act, 1994 (THOTA), since the last amendment was made to the Act in 2011.

In a letter sent to all the states and UTs, NOTTO director Anil Kumar listed the documents required for approval of SWAP donor transplantation cases by the authorisation committee.

The THOTA 1994 vide Section 9 Sub-section 3A allows swapping of “near relative” donors of biologically incompatible recipients.

“The first donor who is compatible biologically as a donor for the second recipient and the second donor is compatible biologically as a donor of a human organ or tissue or both for the first recipient and both donors and both recipients in the aforesaid group of donor and recipient have entered into a single agreement to donate and receive such human organ or tissue or both according to such biological compatibility in the group, the removal and transplantation of the human organ or tissue or both, as per the agreement referred to above, shall not be done without prior approval of the authorisation committee,” the provision reads.

“Swap transplant/paired exchange has the potential to increase the number of transplants of needy patients and provide better matched donors for biologically incompatible donors (like blood group/HLA mismatched pairs, highly sensitised patients, etc.),” Kumar said in the letter.

During a national-level Chintan Shivir organised to augment organ donation and transplantation in 2024, it was recommended to have a ‘uniform one nation, one swap transplant programme’ with a uniform document list for swap organ donation and transplantation throughout the country, Kumar said.

Accordingly, a list of documents has been recommended for the implementation of the swap donor transplantation programme by registered hospitals.

The process has to be approved by the authorisation committee of the hospital/district/state where the transplant case is taking place.

“Accordingly, the states are requested to disseminate the information to all the registered transplant centres so as to have a uniform and smooth process for approval of swap transplantation across the country.

“I seek your cooperation for the smooth implementation of swap donor transplantation, which has potential to increase the number of transplants and make it more accessible to needy patients,” Kumar said in the letter.

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