Daijiworld Media Network – Bengaluru
Bengaluru, Apr 8: In a landmark decision set to benefit patients awaiting kidney transplants, the Karnataka Government has issued guidelines permitting multi-pair kidney paired swap transplantation, moving beyond the traditional two-way system.
The Karnataka Multi-Pair Kidney Exchange Transplantation Guidelines 2026 were issued via a government order on April 4, laying out a framework for swap donations involving three or more donor-recipient pairs.
“A significant number of donor-recipient pairs in Karnataka are unable to undergo transplantation on account of biological incompatibility. Applications have been received from registered transplant hospitals in Karnataka seeking approval for multi-pair Kidney Paired Exchange Transplantation involving three or more donor-recipient pairs,” the order said.
Until now, under the Transplantation of Human Organs and Tissues Act (THOTA) 1994, kidney swaps were limited to two incompatible donor-recipient pairs. Each donor had to be a near relative of their intended recipient, and the swap was confined to a simple two-way exchange. This restriction left many patients unable to undergo transplantation due to incompatibilities such as ABO blood group mismatch and others.
Swap donation works by allowing two families, each with a donor and recipient, to exchange kidneys when the donor is incompatible with their own relative. The donor from one family gives a kidney to the recipient in the second family, and vice versa. Under section 9(3A) of THOTA, such exchanges were previously permitted only between two pairs.
The new guidelines now allow multi-pair kidney swap transplantation, subject to eligibility conditions. In this process, three or more donor-recipient pairs are linked in a group.
Each donor who is incompatible with their own relative donates a kidney to another patient in the group, while their relative receives a compatible kidney from a different donor in the same group.
The guidelines further detail the approval mechanism, mandatory documentation processes, ethical safeguards, and operational protocols to ensure transparency, accountability, and patient safety.
Health experts have welcomed the move, emphasising its potential to save lives.
“By enabling multi-pair exchanges, patients previously unable to find a compatible donor now have a real chance at a life-saving transplant,” said a senior transplant surgeon in Bengaluru.
Officials stated the initiative will also encourage more families to come forward for organ donation, reduce waiting lists, and provide hope for patients with end-stage renal disease facing urgent medical needs.
The Karnataka government’s move is expected to significantly strengthen organ transplantation infrastructure in the state and serve as a model for other regions looking to expand kidney donation programmes.