Section 9(3A) of THOTA permits multi-party swap organ transplantations beyond two donor-recipient pairs.

In brief

The question

Whether the Authorization Committee can permit, under Section 9(3A) of the Act, swap transplantations between multiple (more than two) donor-recipient pairs

The court held

The court allowed the petition and set aside the orders of the Appellate Authority and the Authorization Committee

It also directed

It held that Section 9(3A) does not bar inter-se transplantation between more than two pairs

The court directed the Authorization Committee to examine the feasibility of the proposed four-way swap transplant, ensuring all other legal requirements regarding the absence of commercial dealings are met

01Facts

The petitioners (consisting of four donor-recipient pairs) sought permission for a "four-way-swap kidney transplantation"

¶ 1

In each pair, the donor and recipient are "near-relatives" as defined under Section 2(i) of the Transplantation of Human Organs & Tissues Act, 1994 ("Act"), but are biologically incompatible

¶ 2

The Authorization Committee and the Appellate Authority rejected the proposal on the singular ground that Section 9(3A) of the Act only permits swap transplants between two incompatible pairs and does not provide for multi-way swaps involving more than two pairs

¶ 3-4

The petitioners challenged this restrictive interpretation before the High Court

¶ 1

02Issues

i.Whether the Authorization Committee can permit, under Section 9(3A) of the Act, swap transplantations between multiple (more than two) donor-recipient pairs

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03Law Applied

The court primarily interpreted Section 9(3A) of the Transplantation of Human Organs & Tissues Act, 1994, which outlines the procedure for swap donations between incompatible near-relative pairs

¶ 14

Kuldeep Singh v. State of Tamil Nadu [(2005) 11 SCC 122], establishing that the Act’s object is to prevent commercial dealings rather than prohibit legitimate transplants

¶ 10

Indian Society of Organ Transplantation v. Union of India [2025 INSC 1361], which directed the evolution of national swap transplantation guidelines

¶ 20

GP Singh’s Principles of Statutory Interpretation that courts should adopt a reasonable and sensible construction that avoids anomalies or absurdities

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Provisions in the judgment · 7 · Linked ones open on LawLens

Transplantation of Human Organs and Tissues Act, 1994 Section 2 Section 9 Section 13

KARNATAKA SCHEDULED CASTES, SCHEDULED TRIBES AND OTHER BACKWARD CLASSES (RESERVATION OF SEATS IN EDUCATIONAL INSTITUTIONS AND OF APPOINTMENT OR POSTS IN THE SERVICES UNDER THE STATE ACT, 1994. Section 2 Section 3 Section 4 Section 5

04Reasoning

The court reasoned that Section 9(3A) is a remedial provision intended to assist donor-recipient pairs who face biological incompatibility

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It held that the statutory use of terms like "first donor" and "second donor" is illustrative of the procedure rather than a limitation on the number of participating pairs; interpreting it otherwise would border on "absurdity"

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The court observed that as long as the core objective of the Act—preventing commercialization and organ trafficking—is satisfied, technicalities should not impede the saving of human lives

¶ 12-13, 18

The court noted that other states (Karnataka and Kerala) and institutions (IKDRC, Gujarat) have already recognized and facilitated multi-way swaps, proving the scientific and ethical validity of the practice

¶ 22-24

Therefore, the purpose of the Act is furthered by an interpretation that expands the pool of compatible matches for sensitised patients

¶ 19