What is NOTTO? - How it Works, Full Form, Login, Registration

Organ donation is a surgical procedure for transplanting an organ or a tissue from a living or dead donor into a living person who requires the organ. Anybody can donate organs. 

There are two types of organ donation:

1. Living Donor Organ Donation: A living donor is any individual above 18 years of age who voluntarily authorises the removal of any of their organs and/or tissue. An individual, during their life, can donate a portion of the pancreas, one kidney, and a part of the liver, intestine, skin, and bone marrow. 
2. Cadaver (Deceased Donor) Organ Donation: A deceased donor is any individual who has suffered a fatal injury on the head or had natural death or brain death. Organs and tissues such as the liver, heart, lungs, eyes, skin, heart valves, cornea, and even bone marrow can be donated from a deceased donor.

The consent of a near relative or an individual in lawful possession of the dead is needed. If the deceased donor is under 18, then consent is needed from one of the parents or any near relative authorised by the parent.

National Organ and Tissue Transplant Organization (NOTTO) is a national-level organisation set up under the Ministry of Health and Family Welfare (MoHFW), the Directorate General of Health Services (DGHS), and the Government of India. 

1. NOTTO’s national network division is the centre for managing all organ donation-related activities. 
2. It attends to networking for procuring and distributing organs and tissues. 
3. It also maintains a registry of organ and tissue donations done and transplantation received in India via the State Organ and Tissue Transplant Organisation (SOTTOs) and Regional Organ and Tissue Transplant Organisation (ROTTOs). 

NOTTO has two divisions:

1. National Human Organ and Tissue Removal and Storage Network: This division of NOTTO is the nodal networking agency that procures, allocates, and distributes organs and tissues.
2. National Biomaterial Centre (National Tissue Bank): This division fills the gap between demand and supply along with quality assurance. It fulfils the demand of tissue transplantation, including activities for procuring, storing, and distributing biomaterials.

1. Every year, around 5 lakh people die due to the non-availability of organs in India.
2. There are fewer donor organs available than people waiting for a transplant. Several people die while waiting for an organ transplant.
3. This is because many medical conditions are incurable e.g. Liver Cirrhosis, End-stage renal disease, Blindness, etc.
4. In such conditions, there is no option apart from receiving a transplant. We never know when any disease could affect a family member, relative, or friend who may require a transplant.
5. For this reason, organ donation plays a significant role in saving someone’s life. Every individual must pledge to donate organs and tissues.

NOTTO are responsible for the following activities to enable safe and quick organ transplants. It collects information to maintain the national registry: 

1. Establish policy guidelines and protocols.
2. Combine, maintain and publish the National Registry.
3. Develop a network with similar state and regional-level organisations.
4. Advocacy and awareness of organ donation and transplantation activities.
5. Coordinating organ and tissue procurement when allocated outside the region and to foreigners and in Delhi.
6. Disseminate information to all the concerned organisations.
7. Monitor the transplantation activities in the states and regions and maintain the databank.
8. Consult on organ donation and transplantation's legal and non-legal aspects.
9. Assist in managing data from organ transplant surveillance & organ transplant and organ donor registry. 
10. Coordinate and organise training for various workers for capacity building. 
11. National Biomaterial centre.
12. State Organ and Tissue Transplant Organisation (SOTTO) for Delhi.

The national registry collects transplant-related data from several hospitals in the country, including organ donation, retrieval, and transplant-related information.  

As per NOTTO, the national registry involves:

1. Organ Transplant Registry: This data is collected from all the transplant and retrieval centres. This includes details about the donor and recipient and the hospital where the transplant was performed. 
2. Organ Donation Registry: This includes in-depth details about the donors all over the country, e.g. cause of death, pledge documents, personal details, hospital where donation took place, outcomes, etc. 
3. Tissue Registry: This includes in-depth details about tissue donation, e.g. 
   1. Demographic information on the tissue donor
   2. Cause of death (if deceased donor)
   3. Donor maintenance details (if brain stem-dead donor)
   4. Medical condition, Laboratory tests
   5. Documents for pledging a donation
   6. Counsellors
   7. Tissues retrieved
   8. Information about the tissue recipient, hospital conducting transplantation
   9. The outcome of transplanted tissue, etc.
4. Organ Donor Pledge Registry: This is a computerised database which records the wishes of people who have pledged to donate organs and tissues. They can pledge to donate after filling out form 7 and submitting it online or on paper to the respective networking organisations. Also, pledgers can withdraw their pledges through intimation.

For NOTTO Registration

1. To register at the NOTTO, you must fill in the following details at “https://notto.gov.in/registration.htm”.
   1. User Type: Select SOTTO, ROTTO, Hospital, Donor, or institution.
   2. Office
   3. Add details - First Name, Middle Name, Last Name
   4. Add Mobile no, Email/user ID
   5. Create a password.
2. Once registered, you will receive an email from NOTTO to verify your email ID. Just click on the link sent in the email and mention the One Time Password (OTP) provided to confirm your email ID. 
3. Then, an OTP will be sent to your registered mobile number for your mobile number verification. 
4. Once your email ID and mobile number verification are complete, you can then login to your account at “https://notto.gov.in/Admin/Login.aspx” 
5. At “https://notto.gov.in/Admin/Login.aspx”, you can also see the hospital user manual, donor pledge user manual and how the donor card looks. 

For NOTTO Login

1. Once registered on the NOTTO, login to your account at the NOTTO login website “https://notto.gov.in/Admin/Login.aspx” using your username and the password as created by you while registering at NOTTO. 
2. Fill in the pledge form.
   1. Pledging for organs is a straightforward procedure. All pledges are registered with the NOTTO. You can also download the donor pledge form from “https://notto.gov.in/Admin/Login.aspx” and fill in all the details mentioned in Form 7 of organ or tissue pledging and send it to “National Organ And Tissue Transplant Organisation, 4th Floor, NIOP Building, Safdarjung Hospital Campus, New Delhi-110029”.
3. You can also pledge online at “https://www.organindia.org/claim-your-donor-card/”. 
4. Once you have submitted your pledge form, you will receive an email from the NOTTO for the successful submission of the pledge form.
5. After which, the NOTTO will accept or reject your pledge form.
6. Once the pledge form is accepted, you will get a donor card with a unique government registration number. 

The concerned hospital registers the recipient via the online registration form on https://notto.gov.in/ after doing all the necessary investigations for their potential patients. 

1. Only patients who have fulfilled all the required data and paid the registration charges are considered on the active waiting list. 
2. The recipient's status is then updated regularly by the hospital to one of the following status:  
   1. Active
   2. Unfit  
   3. Recipient frequently refused
   4. Lost to follow-up  
   5. Transplant done
   6. Death 
3. One patient can only be registered with a single transplantation centre at any time. If the patient needs to shift to another centre, he/she must deregister from the first centre and then register at the second centre. The gap between deregistering and registering at the second centre should be 72 hours.
4. The patient is categorised and prioritised as follows:
   1. Priority 1 (Emergency)
   2. Priority 2 (Semi-emergency)
   3. Priority 3 (Elective)

While registering at “https://notto.gov.in/registration.htm”, you can select Regional Organ and Tissue Transplant Organization (ROTTO) or State Organ and Tissue Transplant Organization (SOTTO).

It is envisaged to create one SOTTO in each state. So far, 13 SOTTOs have been sanctioned:

1. Sawai Man Singh Medical College (SMS), Jaipur, Rajasthan
2. Institute of Kidney Diseases and Research Centre (IKDRC), Ahmedabad, Gujarat
3. Government Medical College, Thiruvananthapuram, Kerala
4. Mahatma Gandhi Medical College (MGMC), Indore, Madhya Pradesh
5. Government Medical College, Patiala, Punjab
6. Goa Medical College (GMC), Bambolim, Goa
7. Pandit Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana
8. Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
9. Sriram Chand Bhanj Medical College (SCB), Cuttack, Odisha
10. Government Medical College (GMC), Jammu, J & K
11. Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP
12. Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar
13. Jeevandan Andhra Pradesh-225003

Note 1: 5 ROTTOs are also SOTTOs for the states where they are located.

Note 2: NOTTO is SOTTO for Delhi.

1. A living donor will undergo various medical tests and examinations to confirm their compatibility with the recipient. Only after the tests confirm that the donor is compatible with the recipient the doctor performs the transplant procedure, where the doctor surgically retrieves the living donor’s organs and stores them in a special chemical until the transplant procedure.
2. In the case of a deceased donor, the donor’s family must consent to the doctor for organ donation before organs can be collected. 
3. Anyone registering for organ donation via NOTTO registration must inform their family and friends. Also, the person should keep their registry up to date, like the current mailing address, etc. 

Important facts about NOTTO:

1. Impact of NOTTO on recipients' health: NOTTO has helped save several lives. People can pledge to donate organs through NOTTO. In 2019, India ranked 3rd in the world with 12,666 organ transplants, per the WHO Global Observatory on Donation and Transplantation (GODT) website. 
2. Number of people registered via NOTTO: People who have pledged for organ and/or tissue donation with NOTTO till 2021 are more than 14 lakh, from which over 3 lakh people have registered online. 

NOTTO is a great initiative taken by the Indian government for organ donation and transplantation. We must all pledge to donate organs. One donor can save more than 75 lives! Spread awareness of organ donation to your loved ones and other people. Your pledge can save someone’s life. 

If you are unsure about where and how to register for organ donation or wish to undergo transplantation, feel free to contact HexaHealth. Our care team will explain to you all the steps you need to fulfil to become a registered organ or tissue donor. Feel free to contact our team for any further queries regarding organ donation or tissue donation. You can also visit HexaHealth to learn more about organ and tissue donation.