Organ Transplantation Plea Cannot Be Rejected Due To Perception Of Existence Of Large-Scale Commercial Transactions: Kerala HC

The Division Bench of Chief Justice Nitin Jamdar and Justice S. Manu stated that the Authorisation Committee while rejecting application for kidney transplantation must consider each application on its merits and give reasons in writing before rejecting application, rather than generalising that all organ transplantations are part of large-scale commercial transactions.

“ Prevention of commercialisation indeed is one of the objects of the Act of 1994. But, each application has to be carefully considered on its own merits based on the parameters specified under the Rules. It cannot be based on a generalised perception of the existence of large-scale commercial transactions. Since the order of the Authorisation Committee gives no reasons, it is also not clear whether the Committee has applied its mind to all the aspects.”

As per the facts, the first appellant is a renal patient who has to undergo Kidney transplantation due to end-stage renal disease. The second appellant who was working in the house of the first appellant has offered to donate one of her Kidney for transplantation for altruism without any commercial benefits.

Their application for transplantation was rejected by the District Level Authorisation Committee for Renal Transplantation constituted under the Transplantation of Human Organs and Tissues Act, 1994 and Transplantation of Human Organs and Tissues Rules, 2014. The appeal before the Secretary, Health and Family Welfare Department and subsequent writ petition was also rejected on the police report that organ donation was for financial interest. Aggrieved by it, writ appeal was preferred.

The Counsel for appellants submitted that the order of the Authorisation Committee did not contain reasons. It was argued that copy of police report was also not given to the appellants.

It noted that Section 9 pertains to the restrictions on the removal and transplantation of human organs. It gives power to the Authorization Committee to conduct an inquiry when the recipient and donor are not near relatives and the donation was made out of love and affection.

The Court noted that when the donor is not a near relative, the Authorisation Committee can reject or approve the joint application filed by the donor and recipient by giving reasons in writing. The Court noted that Authorisation Committee conducts an enquiry to evaluate that there is no commercial transaction, hears the parties and gives reasons in writing for rejecting the application for transplantation, if the applicants have not complied the requirements as per the Act and rules. The Court noted that the evaluation criteria to be followed by the Authorisation Committee is outlined in Rule 7(3) of the 2014 Rules.

The Court observed that the Authorisation Committee follows an objective and transparent procedure while rejecting applications for transplantations.

Court added, “Apart from the statutory mandate, as a matter of fairness and transparency in the decision-making, if the Authorisation Committee comes to the conclusion that the application for organ transplantation is not to be approved, then the applicant is entitled to know the reasons, especially since the decision has serious consequences on the applicant. When a person's request for kidney transplantation is rejected, it directly affects his/her right to life and health.”

The Court referred to Kranti Associates (P) Ltd. and Another v. Masood Ahmed Khan and Other (2010) to state that administrative bodies while making decisions affecting rights of citizens have to give reasons for their decision making process. It said, “The Hon'ble Supreme Court also held that reasons in support of decisions must be cogent and clear and pretense of reasons or “rubber-stamp reasons” is not to be equated with a mere valid decision-making process. This law, expounded by the Hon'ble Supreme Court, applies more stringently when an application for an organ transplantation made by a patient at a critical stage is rejected by the Committee on the ground that the donation is not altruistic.”

In the facts of the case, the Court noted that the Authorisation Committee gave no reasons in writing for rejecting the application. The Court further noted that the report of the police gave no further elaboration and that the copy of the report was also not given to the appellants, which is contrary to the principles of natural justice.

As such, the Court quashed the order of the Authorisation Committee and set aside the order in the writ petition. The Court thus restored the joint application filed by the appellants before the Authorisation Committee to pass a reasoned order.

Case Title: Ismail Kunju M v State of Kerala

Case No: WA NO. 135 OF 2025

Citation: 2025 LiveLaw (Ker) 58