In 2024 India did 18,378 organ transplants — around 86% from living donors and 14% from deceased donors (NOTTO Annual Report 2024-25). The waiting list crossed 2.6 lakh patients for kidney alone. The single biggest reason families decline donation at brain-death is “we never discussed it with him/her”. A pledge plus a conversation is what closes that gap.

An organ pledge is your written, recorded consent that, after your death, your organs and tissues may be retrieved for transplantation into a patient on the national/regional waiting list, or for therapeutic, educational and research purposes. It is governed by the Transplantation of Human Organs and Tissues Act 1994 (THOA) and the THOA Rules 2014 (as amended).

What the pledge does:

• Records your wish, with date and time-stamp, on the National Organ & Tissue Donor Registry maintained by NOTTO.
• Issues a downloadable / printable donor card with a unique pledge ID.
• Lets your family invoke your wish at the moment of decision (brain-death certification by an authorised hospital team).

What the pledge does NOT do:

• It does not authorise removal of any organ during your life. Living-donor donation (typically a kidney or part-liver) needs a separate, contemporaneous, witnessed consent, plus Authorisation Committee clearance under §9 of THOA.
• It does not override your family's right to refuse at the moment of death — Indian law requires next-of-kin consent in writing (Form 8) even where the deceased had pledged. This is why telling your family matters more than the card itself.
• It does not affect your medical care in any way before death — doctors are statutorily forbidden from being part of both your treating team and the retrieval team (THOA §13).

The retrievable organs and tissues under THOA are:

• Solid organs: kidneys, liver, heart, lungs, pancreas, intestine.
• Tissues: corneas, heart valves, skin, bone, cartilage, tendons, blood vessels.

Body donation (for medical-college dissection and anatomical training) is a separate process — see Step 7 below.

You can pledge all organs and tissues, or only some (e.g., only corneas, or all except heart). There is no “right” answer; tick whatever you are comfortable with. Most pledgers tick all.

• Talk to your family before registering — not after — so the conversation is calm, not reactive.
• Discuss religious concerns honestly. All major religions practised in India (Hinduism, Islam, Christianity, Sikhism, Jainism, Buddhism) have explicit statements supporting organ donation as an act of charity (daana / sadaqa-jariyah / agape / seva); printable references are linked from NOTTO's “FAQs by faith” page.

• Open https://notto.abdm.gov.in
• Click “Pledge to Donate Organs” on the home page.
• The portal is fully integrated with Ayushman Bharat Digital Mission (ABDM) since April 2024 — login can be Aadhaar-OTP, ABHA number, or mobile OTP.

• Personal info: full name (as per Aadhaar), DOB, gender, blood group (optional but recommended), photograph (auto-pulled from ABHA / Aadhaar e-KYC if you log in with Aadhaar).
• Address (current + permanent).
• Organs to pledge: tick boxes for each — kidneys, heart, lungs, liver, pancreas, intestine.
• Tissues to pledge: corneas, skin, bone, heart valves, etc.
• Next-of-kin details: name, relationship, mobile number, email of two close family members. Crucial — these are the people NOTTO/your hospital will contact at the moment of decision. Tell them in advance.
• Optional: “I am willing to be contacted for living-donor counselling for an immediate family member” — this is a separate scheme; ticking it does NOT mean you have agreed to live donation.

Submit. The portal generates an instant Pledge Number (format INDIA/STATE/YYYY/XXXXX) and a PDF donor card with QR code.

• Download the PDF; save to phone wallet (Apple Wallet / Google Wallet via the QR code).
• Print the credit-card-size version, laminate, keep in your wallet.
• Optional: order a free physical NOTTO donor card to be posted to your address (delivery 3-6 weeks). Click “Request Physical Card” inside your profile.

This step has no portal. Sit down at the dinner table, show the card on your phone, and say it in plain words:

“If something happens to me and the doctor declares brain-death, please say YES to organ donation. I have pledged. The donor card is in my wallet and on the NOTTO website under my Aadhaar.”

Add at least 2-3 close relatives' phone numbers as next-of-kin on your NOTTO profile. Repeat the conversation once a year — silently update the WhatsApp note in your family group with the pledge number.

• Driving licence: at the time of issue/renewal at the RTO, declare yourself as an organ donor → a small “Organ Donor” mark appears on the back of the licence (in most states using Sarathi 4.0).
• Aadhaar: there is no “donor flag” in Aadhaar yet (as of April 2026), but the NOTTO ABDM linkage means a hospital that pulls your ABHA at admission can see your pledge status in the eKYC view.

Body donation (the whole body for anatomical dissection at a medical college) is not done through NOTTO. It is direct with the nearest government medical college's Anatomy Department under the relevant state's Anatomy Act (e.g., Maharashtra Anatomy Act 1949).

• Contact the Anatomy Department of any nearby government medical college; request the body-donation pledge form.
• Fill in two witnesses + next-of-kin consent.
• Submit one copy to the college, keep two copies at home.
• After your death, family informs the college within 6-12 hours; the college sends a vehicle.
• Note: if you have pledged organs to NOTTO and body to a medical college, organs are taken first (if eligible at brain-death); body donation only happens for natural deaths or when organs are not retrievable.

• Login to notto.abdm.gov.in → “My Profile” → “Edit Pledge”.
• You can change the organ/tissue list, change next-of-kin, or withdraw entirely — no questions, no paperwork.
• Withdrawal is instant; old card becomes void; system flags the change to ABDM eKYC.

+-----------------------------------+--------------------------------------+
| NOTTO online pledge (Form 7)      | FREE. Card downloadable instantly.   |
+-----------------------------------+--------------------------------------+
| Physical NOTTO donor card by post | FREE. Delivery 3-6 weeks.            |
+-----------------------------------+--------------------------------------+
| Body donation (medical college)   | FREE. Direct with Anatomy Dept.      |
+-----------------------------------+--------------------------------------+
| Living-donor kidney/liver         | Patient-side cost only. Donor pays   |
| (THOA §9 + Auth Committee clear)  | NIL for surgery in govt hospitals.   |
+-----------------------------------+--------------------------------------+
| Pledge withdrawal                 | FREE, anytime, online.               |
+-----------------------------------+--------------------------------------+
| Family override at brain-death    | Family decision is binding under     |
|                                   | Form 8 — pledge alone is not enough. |
+-----------------------------------+--------------------------------------+
| RTI to NOTTO/SOTTO/ROTTO          | ₹10 by IPO. BPL = free.              |
+-----------------------------------+--------------------------------------+
| Eligible organs (at brain death)  | Kidney(2), liver, heart, lungs(2),   |
|                                   | pancreas, intestine                  |
+-----------------------------------+--------------------------------------+
| Eligible tissues (at any death,   | Corneas, skin, bone, heart valves,   |
| within 6-24 hrs)                  | cartilage, tendons, blood vessels    |
+-----------------------------------+--------------------------------------+

• Aadhaar e-KYC fails on the portal. Often a name-mismatch (Aadhaar has middle name; PAN/NOTTO doesn't). Fix in Aadhaar first, then re-try.
• Donor card download produces a blank PDF. Browser-cache issue; try a different browser (Edge / Firefox) or clear cookies for notto.abdm.gov.in.
• Family doesn't know about the pledge. This is the #1 reason pledged organs never get used. Fix by talking. There is no portal-side fix.
• Multiple registrations under different mobile numbers. The system de-duplicates by Aadhaar but if you logged in via mobile-OTP twice with different numbers, you'll see two pledge IDs. Email info@notto.gov.in with both pledge numbers + Aadhaar last-4-digits to merge.
• State portal (SOTTO) and NOTTO numbers differ. Some older state pledges (Tamil Nadu's TRANSTAN, Andhra's Jeevandan) issue separate registry IDs that haven't fully synced. Both are valid; carry both cards.
• Hospital staff at brain-death not aware of NOTTO pledge. They can verify by scanning the card QR or via the hospital's NOTTO/ROTTO desk. Brief your spouse on this — they may be the one who shows the card.
• Driving licence does not show donor mark even after you declared at RTO. Common in 2-3 states; the Sarathi backend takes 30-90 days to update. Carry the NOTTO card meanwhile.
• Concern that hospitals will “let you die” if they know you're a pledger. Legally impossible — THOA §13 statutorily separates the treating team and the retrieval team. Brain-death is certified independently by 4 doctors over 6 hours.

• Toll-free 1800-11-4770 (24×7).
• Email: info@notto.gov.in / notto.dghs@nic.in
• Best for: pledge corrections, donor-card download issues, family-counselling requests.

• Five ROTTOs cover the country: ROTTO North (AIIMS Delhi), ROTTO South (Madras Medical College), ROTTO East (IPGMER Kolkata), ROTTO West (KEM Mumbai), ROTTO North-East (Guwahati Medical College).
• Best for: regional waitlist disputes, hospital-side retrieval issues, retrieval-vehicle coordination.
• Find your ROTTO: https://notto.abdm.gov.in → “Network”.

• Each state has a SOTTO under the State Health Department.
• Best for: state waitlist transparency, complaints against private hospitals charging undue fees for retrieval, body-donation co-ordination if the medical college is non-responsive.

• Nirman Bhawan, New Delhi 110011.
• CPGRAMS portal: https://pgportal.gov.in → “Department of Health & Family Welfare”.
• Best for: policy violations, large-scale registry irregularities.

NOTTO, every ROTTO, every SOTTO, and every government hospital with a transplant programme is a public authority under §2(h) of the RTI Act 2005.

RTI helps here when:

• Your pledge does not show in the registry despite a confirmation email — RTI to PIO NOTTO for “registry status of pledge ID XXXX as on date”.
• You want statistics on your district / state's deceased-donor rate, brain-death certifications, and family-consent ratio (to advocate for awareness drives) — RTI to PIO SOTTO.
• You suspect a private hospital ran a transplant without Authorisation Committee clearance — RTI to PIO of the State Appropriate Authority for the AC minutes.
• Family of a deceased donor wants the end-use anonymous summary (which 4 patients received the organs, in which states, and outcome at 6 months) — this is shareable in anonymised form by NOTTO; RTI is the formal channel.
• Body-donation pledge form receipt not issued by the medical college — RTI to PIO of the college Anatomy Department.

See: RTI in 12 simple steps.

RTI does NOT help here when:

• You want to know who specifically received your relative's donated organ (recipient identity) — protected medical confidentiality, exempt under §8(1)(j).
• You want to jump the transplant waitlist for yourself or a relative — waitlist priority is clinical (urgency, blood group, antigen match) and cannot be moved by RTI or political reference.
• You want to force a brain-death declaration (or prevent one). Brain-death is a clinical determination by 4 independent doctors under THOA Schedule I; RTI cannot override.
• You want a hospital to disclose the financial details of a private living-donor transplant of a non-relative — disclosure is restricted; complaint to State Authorisation Committee is the right route.

Q. Can I pledge if I have a chronic illness like diabetes or hypertension?
Yes. The fitness of each organ at the time of death is a clinical decision; you don't need to “qualify” to pledge. Many people with controlled chronic illness still donate corneas, skin, heart valves and bones successfully.

Q. What is the upper age limit for pledging?
There is no upper age limit in India. Corneal donation has been done from donors over 90; kidney donation has been done from donors over 70. The retrieval team decides organ-by-organ at the time.

Q. Will donation disfigure my body?
No. Retrieval is a surgical procedure done with full dignity — body is restored before handover, and an open-casket funeral or normal antim sanskar is fully possible. Cornea retrieval takes minutes and leaves the eyes looking normal.

Q. My religion forbids organ donation. Is this true?
No major Indian religion forbids it. Hindu shastras (Bhagavad Gita 2.22 — body as garment), Islamic fatwas (IIFA 1988 — saving life as the highest duty), Christian church statements, Sikh Rehat Maryada, Jain ahimsa as compassion, Buddhist Bodhisattva teaching — all support voluntary donation. Speak to your religious teacher with the FAQs available on notto.abdm.gov.in.

Q. Can I pledge for a specific person (e.g., my friend who needs a kidney)?
Pledging on NOTTO is a deceased-donor pledge for the public waitlist — you cannot direct it. For a living-donor kidney for a friend (non-relative), THOA §9 requires a separate Authorisation Committee approval to rule out commercial dealing — the process is rigorous and usually takes 4-12 weeks.

Q. What happens to my pledge if I die abroad?
The Indian pledge has no force outside India. Most countries (UK, USA, Canada, Australia, Singapore, UAE) have their own donor registries — you'll need to register locally. The card you carry can still inform a foreign hospital of your wish but the consent comes under their law.

Q. My elderly parent wants to pledge but is not internet-savvy. How?
Either help them log in with Aadhaar OTP at notto.abdm.gov.in, or print Form 7 from the portal, fill it offline (with two witnesses), and post to: NOTTO, 4th Floor, Convergence Block, Safdarjung Hospital Campus, New Delhi 110029. Card is posted back in 3-6 weeks.

• RTI in 12 simple steps — for first-time filers
• All Indian government helplines — one master directory
• Voluntary blood donor registration — 2026 guide
• Niramaya disability insurance — apply guide
• Claim disability employment reservation under RPwD
• RTI template for delayed UDID / disability certificate

Last reviewed: 26 April 2026 by RTI Wiki editorial team. THOA rules are amended periodically; verify current procedure on notto.abdm.gov.in or write to admin@bighelpers.in if you spot a stale figure.