Karnataka’s State Organ and Tissue Transplant Organisation (SOTTO) has recorded 198 organ donations in 2025, the highest ever in the State. This beats the previous peak of 178 donations in 2023. Karnataka is now the third-highest state in organ donations, after Tamil Nadu with 267 and Telangana with 205. The rise over five years—from 70 donations in 2021 to 168 in 2024 and now 198 in 2025—is credited to more hospitals joining as non-retrieval organ transplant centres (NTHORCs) and ongoing awareness drives. Principal Secretary (Health) Harsh Gupta told The Hindu, "We are also felicitating donor families on January 26 and August 15 through the Chief Minister and Ministers, which has helped in building awareness and trust around organ donation." Plans are underway to expand the program to taluk-level hospitals. Gupta added, "Doctors also need to be sensitised about declaring brain death. A lot more needs to be done. We are identifying where there is potential for donations and what the challenges are." He noted that centers like NIMHANS see many brain death cases that are not fully utilized for donations. "We had planned to place dedicated counsellors and earmark beds for potential brain-death cases, but these are not being used effectively. We will soon depute two dedicated grief counsellors there," he said. To boost efficiency and transparency, Karnataka SOTTO adopted a software system from Tamil Nadu. The platform tracks the entire donation process from patient registration to transplant facilitation. Gupta said, "Once a patient is registered, the queue system starts. All documents will be uploaded by hospitals and every step will be tracked online." Alerts will notify the top 50 eligible patients and empanelled hospitals when a donation is activated. Cross-matching services have also been decentralized. Karnataka signed an MoU with Bangalore Medical Services Trust to offer testing at hospitals in Mangaluru, Hubballi, and Mysuru, reducing the need for patients to travel to Bengaluru. Despite progress, Karnataka missed 15 potential donations in 2025. Officials attribute this to family reluctance, misconceptions about organ donation, and some clinical exclusions. Family opposition sometimes outweighs donor wishes, blocking donations. Gupta concluded, "Karnataka has considerable untapped potential for organ donation and the recent gains represent only a modest beginning. This trend now needs to be pushed much further."