New evidence from court interaction and medical certificate can overturn prior rejection of organ donation approval under transplantation rules.

JUDGMENT

(Dated this the 10^th day of April 2026)

Basant Balaji J., The appellants filed W.P. (C.) No.31048 of 2025 seeking a writ of mandamus or any other appropriate writ or direction to call for the records leading to the passing of Ext.Nos. P4 and P5 and to quash the same. A further direction was also sought to accord sanction to the petitioners (appellants herein) for renal transplantation considering the ill health of the 2^nd appellant.

2. The second appellant, suffering from chronic kidney failure, was advised by medical professionals to undergo a renal transplantation. Due to a long-standing family friendship rooted in their husbands' professional relationship, the first appellant voluntarily offered to donate a kidney when no other suitable donor could be found. Following a pre-transplant evaluation, the appellants submitted a joint application for approval to the second respondent. However, the application stalled because a police verification certificate was not included, and therefore, the 2^nd respondent did not act on the joint application. Therefore, the appellants approached this court by filing W.P.(C) No.18630 of 2025 and this court by judgment dated 23.5.2025, directed the District Level Authorisation Committee for Renal Transplantation to forward the application, along with other supporting documents, without insisting for police verification certificate to the 2^nd respondent, who was directed to take an appropriate decision.

3. Upon interacting with the first appellant and the spouses of both parties, the second respondent issued Ext.P4, rejecting the application on the grounds that the requirements for voluntariness and an altruistic link were not satisfied. The appellants subsequently filed an appeal to the first respondent, who upheld the previous findings and dismissed the request via Ext.P5. Aggrieved by Ext. Nos. P4 and P5, the appellants approached this Court with the present Writ Petition.

4. The learned Single Judge, taking note of the rigor of Rule 22 of the Transplantation of Human Organs and Tissues Rules, 2014, observed that the findings in Ext.P4 and Ext.P5 were derived directly from the parties' own statements. Concluding that these statements failed to establish a genuine altruistic link, the Court found no merit in the challenge and dismissed the Writ Petition.

5. When the writ appeal came up for consideration on 6.4.2026, we directed the first appellant and her husband to appear in person for an interaction the following day. During the proceedings on 7.4.2026, the first appellant's husband submitted that he was unable to donate a kidney to the second appellant due to a past accident and an underlying illness. Consequently, we directed him to undergo a medical evaluation to determine his suitability for organ donation and adjourned the matter to 10.04.2026.

6. Today, when the case was called, the 1^st appellant, along with her husband, appeared in person and a medical certificate issued by Dr.Jose Thomas, Senior Consultant Nephrologist, Rajagiri Hospital, dated 9.4.2026 was made available through the counsel. The certificate reveals that upon evaluation, the husband was diagnosed with Type II Diabetes Mellitus, for which he has been receiving treatment with Metformin (500 mg) for the past two years. In the light of this clinical diagnosis, the medical report concludes that he is not a suitable candidate for kidney donation.

7. Upon further interaction, the first appellant was stood by her decision to donate a kidney despite being the mother of three young children, aged ten, six, and three. She explained that she and her husband share a deep bond with the second appellant and her husband, who has been employed on their rubber estate since