An Indian Air Force (IAF) aircraft flew from Delhi to Pune carrying a heart for a 29-year-old woman on 11th February 2023. The woman had been on the transplant list for six months. To make sure that the heart reached the recipient in time, a full-fledged operation was launched, which included the use of an Embraer aircraft, two green corridors and coordination between military hospitals, the IAF and traffic police.
According to the Ministry of Defence, the whole operation took a little over four hours, including retrieving and transplanting the heart. The donor in this case was a 40-year-old Army veteran. He had suffered serious head injuries in a road accident that took place in Bhind, Madhya Pradesh, on 8th February. Initially, the patient was taken to a local hospital, from where he was transferred to Army Hospital (Research and Referral) in New Delhi on 9th February.
Doctors tried their level best to save the Army veteran, but his condition did not improve, and he was declared brain-stem dead on the morning of 11th February. His family agreed to donate his organs.
A female heart patient from Pune who was suffering from dilated cardiomyopathy, a condition in which the heart becomes enlarged and weak, was found to be a match for the donor’s heart. She was the wife of a serving soldier and had experienced recurrent ventricular tachycardia, which is a potentially dangerous disturbance of the heart’s rhythm. A device had been implanted that repeatedly delivered electrical shocks to control her heartbeat, but that was a temporary solution. She needed a new heart to survive.
The transfer of the heart was coordinated by the Army Organ Retrieval and Transplant Authority (AORTA) in consultation with the National Organ and Tissue Transplant Organisation (NOTTO). The Army’s Southern Command sent a request for urgent assistance to Western Air Command, and an IAF Embraer aircraft was subsequently chosen for the job.
Two green corridors were created to ensure the heart reached its destination in time. The first green corridor was created between the Army hospital in Delhi and the waiting aircraft. The second corridor was created in Pune with the help of military authorities and Maharashtra Police. The transplantation operation took place.
The Army Organ Retrieval and Transplant Authority (AORTA) coordinated the transfer in consultation with the National Organ and Tissue Transplant Organisation (NOTTO). Southern Command sought assistance from Western Air Command, which arranged an IAF Embraer aircraft. A green corridor was created between the hospital in Delhi and the waiting aircraft, while military authorities and Maharashtra Police coordinated another corridor in Pune. The heart was subsequently transplanted at the Army Institute of Cardio Thoracic Sciences (AICTS, Pune). In the statement, the Ministry of Defence confirmed that the heart was functioning post-transplant and the recipient was recovering in intensive care.
When an organ is moved between two distant hospitals, the process involves a series of complicated steps that require medical and logistical decisions. The retrieval team must prepare and preserve the organ. The transport authorities must arrange its movement. And finally, the receiving surgeons must be ready to operate. Organs are not like regular medical supplies that can simply be stored until convenient transport becomes available. The suitability of the organ for transplantation is affected by the time spent without normal blood circulation. Any delay in the process can lead to the organ becoming non-viable for the transplant.
Keeping in mind the importance of protocols for organ transportation, the Union Government introduced National Organ Transport Standard Operating Procedures in August 2024. The aim was to improve coordination between hospitals and transport agencies. The framework designed by the government covers ambulances, aircraft, railways, metro systems and waterways. It must be kept in mind that different organs and geographical circumstances require different arrangements, permissions and coordination, and that too within a stipulated time frame.
Every organ in the body requires a continuous blood supply to receive oxygen and nutrients and to remove waste products. During transplantation, the normal circulation to the donated organ is interrupted by the surgeons before retrieving and preserving it. The cells in the organ remain alive; however, their ability to function begins to change when they no longer receive a proper supply of oxygenated blood.
In medical terms, the condition in which tissues receive an inadequate blood supply is called ischaemia. There are two important periods in transplantation: warm ischaemia and cold ischaemia. Warm ischaemia occurs when an organ does not receive adequate oxygenated blood, but its core temperature remains at or near body temperature. On the other hand, cold ischaemia refers to the period during which an organ is preserved at reduced temperatures without normal circulation.
Notably, when an organ is stored at a lower temperature (cold ischaemia), cellular activities slow down, and the tissues require less oxygen. This allows the organ to remain viable for transplantation for a longer period than under warm conditions. However, it does not mean that biological activities stop completely. When an organ is deprived of oxygen, it can affect cellular energy production, disturb chemical processes and eventually cause irreversible tissue damage.
Furthermore, while restoring circulation during transplantation, surgeons need to deal with another complication. When oxygenated blood returns to the organ, it can trigger inflammatory and chemical reactions that can damage tissues already affected by inadequate circulation. In medical terms, this is called ischaemia-reperfusion injury. It is one of the reasons an organ may not function normally even after reaching the receiving hospital within the stipulated time frame.
Hence, the medical team must consider the condition of the donor organ, the time it has spent without normal circulation, how it was preserved and the recipient’s medical condition together during the operation. Transporting an organ quickly is one of the most important aspects; however, speed cannot compensate for every problem that affects its suitability.
Every organ has different preservation requirements. For example, the heart and lungs need to be transplanted relatively quickly, but kidneys can tolerate longer periods of conventional cold storage.
In a statement issued in 2024, the Indian Society of Critical Care Medicine (ISCCM) recommended that cold-ischaemia time be kept below four hours for the heart, six hours for the lungs, 12 hours for the liver and intestines, 18 hours for the pancreas and 36 hours for the kidneys.
Notably, these are clinical reference limits and cannot guarantee periods during which every organ will remain suitable for transplantation. The condition of the donor, the organ’s quality, preservation technique and recipient-related factors can alter the acceptable duration. Even if the organ is appropriately preserved in cold storage, prolonged ischaemia may increase the risk of complications. For example, in kidney transplantation, it can contribute to delayed graft function, in which the transplanted kidney does not begin working adequately immediately after surgery.
The preservation clock also starts earlier than the journey from the donor hospital. The precise starting point depends on the organ and the clinical circumstances, but the relevant ischaemia period begins during retrieval and continues until blood circulation is restored in the recipient.
A flight lasting one hour does not mean that an organ has spent only one hour without normal blood supply. The organ must first be retrieved, prepared and transported to the airport. After landing, it still has to reach the transplant hospital, where surgeons may need additional time to complete implantation. These stages must all be considered when selecting a transport method.
Once an organ is retrieved, the medical team prepares it for preservation using a specialised solution, following conventional cold-storage procedures that reduce its temperature and slow cellular activity. The organ is then placed in sterile protective packaging before being transferred to an insulated transport container.
Preservation solutions are formulated to help protect tissues during the interruption of normal circulation. University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are among the solutions used in transplantation. The role of these solutions was discussed in an Indian joint position paper published in 2022 on organ donation after circulatory determination of death. Ordinary water or saline alone cannot provide the level of protection that these specially formulated solutions do.
The container in which the organ is transported is also specially designed to ensure that the organ is protected from contamination, leakage and physical damage. Temperature control is particularly important because excessive cooling or freezing can injure tissue. The method of packaging and the preservation solution depend on the organ being retrieved and the medical team’s assessment.
Documentation also plays an important role in the process. A retrieved organ must be identifiable. The records provided with the organ must contain information about its origin, intended destination and retrieval. When several organs are donated by one person, they may be allocated to different hospitals, which makes accurate identification and coordination necessary throughout transportation.
Consider a donor whose heart is allocated to a recipient in Delhi while the liver and kidneys are sent to hospitals elsewhere. Each organ must be prepared and transported separately, according to its preservation requirements. The medical team at the receiving hospital must be able to verify the organ and examine the accompanying records before proceeding with transplantation.
According to Rule 8 of India’s Transplantation of Human Organs and Tissues Rules, 2014, removed organs and tissues must be preserved at registered retrieval or transplant centres or tissue banks using current and acceptable scientific methods to ensure their suitability for transplantation.
On 3rd August 2024, the Ministry of Health and Family Welfare released national SOPs for organ transportation during the 14th Indian Organ Donation Day programme. These SOPs were released alongside NOTTO’s annual report and other publications related to organ donation in the country.
The guidelines were developed in consultation with NOTTO, NITI Aayog and ministries responsible for different transport services. They cover transportation by air, ambulance and other vehicles, defence services, metro and regional rapid transit systems, roads and highways, railways, and ports, shipping and waterways.
The aim was to establish common arrangements for institutions that must work together when organs are transported from one hospital to another. An ambulance travelling between hospitals within a city requires traffic management, whereas a transfer involving an aircraft also needs coordination with airport authorities and airline personnel. Railway transportation and defence aviation introduce their own operational requirements.
On 4th August 2024, the Press Trust of India (PTI) published a report that included a statement by then-Union Health Secretary Apurva Chandra describing the SOPs as a roadmap for organ retrieval and transplant institutions. The procedures included arrangements for priority movement, communication between transport authorities and the appointment of officials responsible for coordination.
However, their implementation depends on the institutions and authorities involved. Some provisions describe arrangements that may be considered rather than systems already functioning uniformly across the country. One such provision concerns the process of requesting green corridors.
A green corridor is a specially coordinated road route intended to reduce delays when an organ must be transported urgently. Traffic police may manage signals and junctions, provide escorts and remain in contact with control rooms as the vehicle travels towards its destination.
These arrangements can be made between hospitals within the same city or for transfers involving airports and railway stations. When an organ crosses district or state boundaries, police officials from different jurisdictions may have to coordinate its movement. A green corridor does not necessarily require an entire road to be closed to other vehicles, as traffic authorities can also facilitate priority passage at selected junctions.
The 2024 SOPs proposed a mechanism called the One Trigger System. Under this arrangement, a request from the relevant organ allocation authority, whether NOTTO, ROTTO or SOTTO, could initiate the process of arranging a green corridor. The guidelines also suggested appointing police nodal officers to address jurisdictional issues, approvals and security concerns.
The PTI account of the procedures stated that the One Trigger System was a measure that might be considered. Its inclusion in the guidelines should not be taken as evidence that a single nationwide request mechanism has already been implemented.
The need for coordinated road movement becomes particularly important when an organ travels by aircraft or train, because both journeys usually involve road transportation at their beginning and end. One operation in December 2024 involved a donated heart travelling more than 1,000 kilometres by air before completing a 20-kilometre journey through Delhi.
On 9th December 2024, a donated heart was transported from Kingsway Hospital in Nagpur to Fortis Escorts Heart Institute in New Delhi for a 59-year-old woman suffering from severe heart disease. The operation involved an air ambulance and a specially arranged green corridor between Delhi’s Indira Gandhi International Airport and the receiving hospital.
According to an official statement published by Fortis Healthcare on 16th December 2024, the donor was a 43-year-old man who had suffered a brain stroke. His family agreed to organ donation, following which the heart was allocated through NOTTO.
The recipient was suffering from dilated cardiomyopathy, which had severely weakened her heart. Although she had received a pacemaker earlier, her health deteriorated during the preceding year. She had become bedridden and was experiencing severe fatigue, while other medical interventions had failed to sufficiently improve her condition.
The hospital’s statement provided a detailed account of the transportation. The heart left Kingsway Hospital at 12:53 am and departed Nagpur by air ambulance at 1:12 am. The aircraft landed at Delhi airport at 3:19 am after travelling more than 1,067 kilometres. The final road journey began at 3:30 am, with the organ covering approximately 20 kilometres through a green corridor before reaching Fortis Escorts at 3:57 am.
Fortis confirmed that the heart was successfully transplanted by a surgical team led by Dr Ritwick Raj Bhuyan and Dr Milind Hote. The hospital also reported that the operation gave the recipient an opportunity to recover from end-stage heart failure after other treatments had proved inadequate.
The journey from the donor hospital to the receiving hospital took just over three hours. That duration, however, should not be confused with the complete cold-ischaemia period. Fortis did not specify the exact time of retrieval or when blood circulation was restored during transplantation, both of which are relevant to calculating the total period without normal circulation.
The final 20 kilometres were particularly important. Although the aircraft covered most of the distance, the organ still had to reach the surgical team through Delhi’s roads. The green corridor allowed that portion of the journey to be completed in 27 minutes.
Air transportation is generally considered when the distance between hospitals makes road travel impractical or too time-consuming. Depending on availability and medical requirements, hospitals may use scheduled commercial flights, charter aircraft, air ambulances, helicopters or military aircraft.
Before an organ is transported by air, the retrieval hospital and accompanying medical team must coordinate the journey with the airline or aircraft operator. Airport authorities and the receiving hospital also require relevant information so that appropriate arrangements can be made at both ends.
The national transport guidelines introduced in August 2024 provide for priority reservations, front-row seating where available and late check-in arrangements for medical personnel accompanying organs. They also envisage communication between departure and destination airports to facilitate timely movement. According to PTI’s report on the SOPs, airlines carrying donated organs may request priority take-off and landing from Air Traffic Control.
Such requests remain subject to aviation safety and operational conditions. The guidelines facilitate priority consideration but do not guarantee immediate take-off or landing, regardless of air traffic.
Airport and airline personnel may also help move the organ container between the ambulance and aircraft. Arrangements can include trolleys, designated movement routes and assistance during boarding or disembarkation. Organ containers require appropriate handling during security checks, while the accompanying personnel must comply with the applicable aviation security procedures.
These arrangements are designed to reduce the time spent outside the aircraft as well as the delays associated with boarding and arrival. For some journeys, direct road transport may still be more practical, particularly when airports are far from the hospitals or suitable flights are unavailable.
Defence medical institutions have participated in several organ retrieval and transplantation operations, including those requiring military aircraft. The Armed Forces Medical Services operate hospitals and organ-sharing arrangements that support transfers between military medical institutions.
The February 2023 Delhi–Pune operation involved AORTA coordinating with NOTTO, Southern Command and Western Air Command. In its account of the operation, the Ministry of Defence also mentioned an earlier heart transplant at AICTS on 30th January 2023, when a donor heart had been brought from Indore.
Military aviation can provide transport support where it is authorised and operationally available, but it is not a service that every transplant hospital can automatically request. Deployment depends on the responsible defence authorities and prevailing operational circumstances.
On 31st July 2026, Indian Railways announced that a donated heart had been transported from Surat to Ahmedabad aboard the Mumbai Central–Gandhinagar Capital Vande Bharat Express. The organ travelled on Train No. 20901 and was taken to the UN Mehta Institute of Cardiology and Research Centre in Ahmedabad.
The Ministry of Railways described the operation as India’s first transportation of a donated heart by train. It involved coordination between Indian Railways, the Railway Protection Force (RPF), Gujarat Police and medical personnel.
A green corridor was arranged from Platform No. 1 at Ahmedabad railway station to the receiving hospital. This allowed the organ to be transferred from the railway station without delays that could affect its preservation period.
Unlike a dedicated aircraft, a scheduled passenger train operates on an established route and timetable. The medical team must therefore consider the journey duration, available services, boarding arrangements and the time required to reach the receiving hospital after arrival. Preservation conditions must also be maintained throughout the journey.
The Railway Ministry confirmed that the heart reached the hospital in time for transplantation but did not provide the recipient’s subsequent medical outcome or a complete surgical chronology. The documented transportation establishes the practical use of a scheduled railway service for a time-sensitive organ transfer.
The national SOPs introduced in 2024 include provisions for metro systems, regional rapid transit networks and waterways. Such services may provide alternative transport connections where they are suited to the distance and preservation requirements involved.
For metro transportation, the procedures describe advance communication, assistance from security personnel and arrangements for moving the organ container through stations. The PTI report on the guidelines stated that metro traffic control may facilitate priority movement for trains carrying donated organs.
Waterways could also be considered where geography makes boats or other vessels a practical form of transport, particularly in coastal and geographically isolated regions. These journeys would still require medical supervision and coordination with road transport at either end.
However, the presence of these modes in the national SOPs does not establish how frequently they are used in India. Their practical application would need to be assessed through documented transport operations.
In January 2026, medical teams from the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, travelled to AIIMS Rishikesh in Uttarakhand to retrieve organs from a deceased donor. The operation involved overnight road travel, difficult weather conditions and arrangements for transporting the organs back to Chandigarh.
The donor was 42-year-old Raghu Paswan, who had suffered serious head injuries after falling from a two-storey building. He was admitted to AIIMS Rishikesh on 16th January and was subsequently declared brain-stem dead. His family agreed to organ donation, allowing the authorities to begin allocating his organs to different transplant centres.
According to a report published by The Indian Express on 24th January 2026, the liver, one kidney and the pancreas were allocated to PGIMER Chandigarh. Another kidney was allocated to AIIMS New Delhi, the heart to Army Hospital (Research and Referral) in New Delhi, and the lungs to Apollo Hospital in Chennai. These were the reported allocations; they should not be confused with confirmation that every allocated organ was ultimately transplanted.
The retrieval teams had to travel through cold weather, rain and strong winds. An IANS report carrying statements from PGIMER doctors quoted Professor L Kaman, Head of General Surgery at PGIMER, as saying that the liver and pancreas teams left Chandigarh at around 9 pm on 22nd January. After nearly six hours on the road, they reached AIIMS Rishikesh at approximately 3 am.
Organ retrieval began at about 9 am and was completed around noon. A green corridor was subsequently arranged for the return journey, and the medical teams reached PGIMER at approximately 3 pm, according to the hospital account reported by IANS. Transplant preparations were already under way when the teams arrived.
The pancreas was transplanted into a 28-year-old woman who had been living with diabetes since childhood and required several insulin injections daily. Professor Ashish Sharma, Head of Renal Transplant at PGIMER, explained that the relatively short preservation period for a pancreas made the operation particularly time-sensitive. Doctors reported encouraging signs of recovery following transplantation. The mission also enabled a liver transplant for another recipient.
The teams had to travel to another state before retrieval could begin and then return with the donated organs while surgeons in Chandigarh prepared their patients. The circumstances also required coordination with traffic authorities across different jurisdictions, adding to the logistical demands of the operation.
On 6th May 2026, the Union Ministry of Health and Family Welfare released details of a multi-organ donation at Command Hospital, Chandimandir, in Haryana. The donor was a 41-year-old woman, the wife of a serving Army Colonel, who had suffered a severe brain haemorrhage.
According to the official ministry statement, she was declared brain-stem dead on 2nd May by a duly constituted medical board. Her husband and two daughters agreed to donate her heart, kidneys, liver and pancreas. The donation enabled transplantation procedures benefiting four critically ill patients, including a 14-year-old boy.
The operation marked the first heart retrieval at Command Hospital, Chandimandir. Several institutions were involved in the subsequent arrangements, including PGIMER Chandigarh, Army Hospital (Research and Referral) in New Delhi and Indraprastha Apollo Hospital.
The IAF, NOTTO, the Airports Authority of India and traffic police authorities in Haryana, Chandigarh and Delhi coordinated transportation. With several organs being sent to different institutions, the receiving hospitals had to prepare according to their respective transplant requirements.
The ministry confirmed the institutions and agencies involved but did not publish a complete transport chronology for each organ. The operation nevertheless involved several medical and transport teams coordinating around a single deceased donor.
While an organ is being transported, doctors at the receiving hospital must prepare the intended recipient for surgery. Once an organ has been allocated and accepted, the patient may be called to hospital for urgent investigations and reassessment of medical fitness.
Doctors must establish whether the recipient remains suitable for transplantation and whether any recent medical development could increase the risks. Depending on the organ involved, the assessment may include blood-group compatibility, laboratory investigations and other tests. The hospital must also prepare its operating theatre, surgical team, anaesthetists, blood-bank services and intensive-care facilities.
For some procedures, preparations may begin while the organ is still in transit. This requires communication with the retrieval team, particularly if a delay occurs or concerns arise about the organ’s condition. The Rishikesh–Chandigarh operation involved such coordination between teams retrieving the organs and surgeons preparing the recipients.
After delivery, the receiving team verifies the organ’s identity, accompanying documentation and preservation conditions before completing the final clinical assessment. Surgeons then proceed with implantation and restore blood circulation. The recipient requires close monitoring afterwards because successful transportation and surgery do not eliminate the possibility of early complications.
Conventional static cold storage remains an important method of preserving donated organs. It involves cooling the retrieved organ and maintaining it in a suitable preservation solution until transplantation. Although cooling reduces cellular activity, the organ remains without normal blood circulation, and prolonged preservation can affect its quality.
Machine perfusion offers another approach. Instead of relying entirely on static cold storage, specialised equipment circulates preservation fluid through the organ under controlled conditions. Depending on the system, this may help protect tissues and allow doctors to assess aspects of the organ’s function before transplantation.
Two important methods are hypothermic and normothermic machine perfusion. In hypothermic perfusion, an organ is maintained at a low temperature while preservation fluid circulates through its blood vessels. Some systems also supply oxygen. Normothermic perfusion operates closer to normal body temperature and uses oxygenated fluid to support cellular activity.
The technology is particularly relevant for selected organs considered at greater risk of complications. It may also provide additional information before doctors decide whether an organ is suitable for transplantation.
In May 2026, Indian transplant specialists published Evidence-Based Recommendations for the Use of Machine Perfusion in Kidney Transplantation in the journal Experimental and Clinical Transplantation. The paper examined different preservation methods, clinical outcomes and the requirements for introducing these technologies more widely into India’s public and private transplant systems.
The researchers discussed experience at Army Hospital (Research and Referral), New Delhi, where hypothermic machine perfusion had been used in kidney transplantation. According to the published findings, selected measures of early kidney function were better among recipients of machine-preserved kidneys, particularly in cases where cold-ischaemia time exceeded eight hours. The authors also reported improvements in delayed graft function and hospital stay, while reviewing wider evidence concerning the technology.
These findings are relevant because advanced preservation methods may help transplant teams use selected organs that could otherwise present greater clinical risks. However, the equipment requires specialised personnel, consumables, maintenance and financial resources. A system used continuously during transportation also creates different logistical requirements from one employed after an organ reaches the receiving hospital.
The wider availability of machine perfusion in India will depend on hospital infrastructure, cost and clinical expertise. It may improve preservation in selected cases, but it cannot eliminate the need for timely transportation or guarantee that a transplanted organ will function normally.
Weather conditions, cancelled flights, traffic congestion, technical faults and difficulties coordinating transport agencies can disrupt an organ’s journey. Delays may also originate within hospitals, including during retrieval or while preparing the intended recipient.
When an unexpected delay occurs, doctors must assess its implications for the organ. The decision to proceed with transplantation depends on the organ’s condition, preservation method, duration of ischaemia and recipient-related factors. A delay does not necessarily make an organ unsuitable, but prolonged preservation can increase the risk of complications.
An organ may also be declined after reaching the receiving hospital because of concerns about its quality or a change in the recipient’s condition. If the original recipient cannot undergo transplantation, the relevant allocation authority may consider whether another eligible patient can receive the organ. Such decisions must account for the remaining preservation period and the time required for any further transfer.
Transport-related problems should therefore be distinguished from other reasons why a retrieved organ may not be transplanted. Medical unsuitability, preservation difficulties and complications affecting the intended recipient can arise independently of the journey.
The national material reviewed for this account does not establish a consolidated number of organs lost specifically because of transportation or preservation failures. Without records identifying the reasons for non-utilisation, it is not possible to calculate a reliable national transport-failure rate.
Organ transportation can involve expenditure on ambulances, commercial flights, medical escorts, preservation equipment and specialised transport services. The amount varies according to the distance, transport method and institutions involved.
Rule 9 of India’s Transplantation of Human Organs and Tissues Rules, 2014 states that the donor’s family must not bear the cost of maintaining a deceased donor, retrieving organs or tissues, or transporting and preserving them. These expenses may instead be borne by the recipient, an institution, the government or a non-governmental organisation or society, according to the arrangements decided by the respective state government or Union Territory administration. The provision is reproduced in the published text of the central Rules.
The Rules do not prescribe a uniform nationwide charge for organ transportation or guarantee that every service will be available free of cost to recipients. Actual expenditure depends on the transport arrangements and available financial support. An ambulance transfer between nearby hospitals, for example, has different cost implications from an inter-state operation requiring commercial aviation or specialised aircraft.
Military support also depends on authorisation and operational availability. An IAF aircraft used for a particular transplant operation cannot be treated as a routinely available transport service for every hospital.
Complex transplantation procedures require specialist surgeons, operating theatres and intensive-care facilities. A hospital capable of identifying a potential deceased donor may not have the infrastructure to perform every type of transplant. Organs may therefore need to be transported to another city where an appropriate recipient and surgical team are available.
Major cities generally have more extensive road, rail and aviation connections, while smaller towns and remote areas may require longer journeys or additional transfers. Hilly regions face further challenges because of weather, road conditions and limited transport services.
The January 2026 Rishikesh–Chandigarh operation illustrated some of these difficulties. In contrast, the Nagpur–Delhi and Delhi–Pune transfers used aviation to cover longer distances, while the Surat–Ahmedabad operation relied on an existing passenger train.
Geographical distance is important, but the choice of transport also depends on medical suitability, preservation conditions, available services and the receiving hospital’s readiness. A direct road journey may sometimes be more practical than flying, particularly when airport transfers or flight schedules would add unnecessary delays.
The national SOPs introduced in August 2024 provide a framework for coordination between hospitals and transport authorities. Their practical effectiveness depends on implementation, the availability of trained personnel and how quickly the relevant agencies can respond when an organ needs to be moved.
In a statement issued on 22nd February 2026, the Union Ministry of Health and Family Welfare said that green corridors and the implementation of transport SOPs had helped facilitate rapid and safe organ movement between cities and states. The ministry also referred to improvements in national organ sharing and coordination.
Assessing the impact of these measures would require more detailed operational information. Records of retrieval, departure and arrival times, preservation conditions, transport-related delays and transplantation outcomes could help establish which arrangements are effective and where improvements are necessary.
The completeness of national transplantation records is another concern. In a Rajya Sabha reply released on 10th March 2026, the Union Health Ministry stated that 217 of 804 registered transplant hospitals had failed to report data on the National Registry Portal during 2025.
Although the disclosure concerned transplantation reporting generally rather than transportation specifically, it identified gaps in the information being submitted to the national system. Better transport records would help establish the frequency of inter-state transfers, the number of green corridors created, the causes of delays and how often retrieved organs could not ultimately be transplanted.
Preservation technology is another area requiring attention. Indian transplant specialists have published research and recommendations concerning machine perfusion, but wider use depends on the availability of equipment, trained personnel and suitable hospital infrastructure.
The documented operations establish that organs can be transported through several modes of transport when institutions coordinate effectively. What remains harder to measure is how consistently those arrangements are available across India and how often logistical problems affect transplantation.
The heart transported from Delhi to Pune in February 2023 reached its recipient through a combination of military aviation and green corridors. The Nagpur–Delhi operation in December 2024 involved an air ambulance and a coordinated road transfer, while medical teams travelling between Rishikesh and Chandigarh in January 2026 relied on inter-state road transport during difficult weather. The Vande Bharat operation later that year added a scheduled passenger train to the documented methods of moving donated hearts.
These journeys involved different hospitals, transport agencies and medical requirements, but they depended on the same essential process. A donated organ must be retrieved, preserved and delivered to a surgical team capable of transplanting it within a medically acceptable period.
India’s national transport procedures provide a framework for coordinating these operations. Advanced preservation technologies may offer additional opportunities, although their availability remains uneven and their clinical use depends on several factors. More detailed public information about transport delays, preservation problems and organ utilisation would help establish how effectively the system functions beyond the individual operations that receive public attention.
Once an organ has reached the intended recipient, questions concerning its preservation and transportation give way to another essential requirement: ensuring that the entire transplantation process has followed the law.
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