Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
Twentieth Congress 
First Regular Session
HOUSE BILL NO. 2226
 Introduced by Hon. Charisse Anne C. Hernandez
EXPLANATORY NOTE
Every week, approximately one person succumbs while awaiting an organ transplant. 
Despite organ transplantation being widely accepted for enhancing patients' quality of life, its 
application is constrained due to financial constraints and donor shortages. The National Kidney 
and Transplant Institute reports kidney diseases, particularly end-stage renal diseases, rank as the 
seventh leading cause of death among Filipinos. 
To promote and manage organ donation, the Philippines implemented the Organ Donation 
Act in 1991, allowing posthumous donation of any or all parts of the human body. However, the 
scarcity of deceased organ donors continues to hinder transplantation efforts. Consequently, some 
individuals resort to alternate sources such as living donors. Yet, ethical concerns, including 
exploitation, abuse, and human trafficking, surround living organ donations. This issue has 
transcended borders, with affluent individuals from developed countries traveling to buy organs 
from vulnerable populations in countries like the Philippines. The World Health Organization 
urged member states in 2004 to shield the most underprivileged from transplant tourism and organ 
July 23, 2025
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trade. In 2008, the Declaration of Istanbul on Organ Trafficking and Transplant Tourism urged 
countries to establish laws and guidelines regulating organ donation, ensuring the safety of donors 
and recipients, and prohibiting unethical practices.
Therefore, it is crucial to enact legislation that safeguards patients' lives by establishing a 
national framework for encouraging organ donation from both deceased and living donors. 
Simultaneously, it must protect living donors from exploitation, abuse, and human trafficking. This 
proposed bill aims to secure organ and tissue availability for those in need while enforcing stricter 
regulations and vigilant supervision in the realm of organ donation.
This legislative measure aims to revamp the current national approach to organ donation 
and transplantation, shifting from the existing "opt-in" system to an "opt-out" model that fosters 
reciprocal altruism and better aligns with societal dynamics.
Under the "opt-in" donation system, only individuals who explicitly consent are considered 
donors. Conversely, the proposed "opt-out" donation model assumes everyone as a potential donor 
unless they specifically object. Both models empower individuals or their next of kin to decide the 
fate of their cadaveric organs. The key difference lies in the default treatment of individuals who 
haven't  expressed  a  preference.  Consequently,  the  opt-out  model  holds  the  potential  to 
substantially increase donation rates by expanding the pool of available organs for patients 
urgently in need of transplants.
In view of the foregoing, the immediate passage of this bill is earnestly requested.
CHARISSE ANNE C. HERNANDEZ
          Representative
          Lone District, Calamba City  


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
Twentieth Congress 
First Regular Session
HOUSE BILL NO. 2226 
 Introduced by Hon. Charisse Anne C.  Hernandez
AN ACT
STRENGTHENING  THE  HUMAN  ORGANS  AND  TISSUE  DONATION  AND 
TRANSPLANTATION PROGRAM, PROVIDING PENALTIES THEREFOR, AND FOR 
OTHER PURPOSES
Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:
SECTION 1. Short Title. - This Act shall be known as the "Human Organs and Tissues 
Donation Act of 2023" 
SEC. 2. Declaration of Policy. - It is hereby declared the policy of the State to promote and 
protect the health of its people and, in line with this policy, the State shall enact measures creating 
programs including but not limited to:
(a) Providing access to human organs for transplantation for patients with end-stage organ
failures in order to prolong and improve the quality of their lives;


(b) Recognizing and regulating the donation of human organs and tissues of living donors 
to prevent their exploitation and, more importantly, ensure their legal entitlement to reasonable 
medical support and other forms of assistance;
(c) Granting patients with end-stage diseases access to human organs for transplantation 
but at the same time ensuring that there is equitable distribution in the allocation of available organs 
among qualified recipients;
(d) Developing and maintaining a national registry and reporting system of donors and 
recipients of human organs and tissues, and the continuous evaluation of the system; 
(e) Enhancing existing Tissue Bank and identifying the hospitals where new Tissue Bank 
should be established. 
SEC. 3. Definition of Terms. - As used in this Act, the following terms shall have the 
following meanings:
(a) Department of Health – Philippine Network for Organ Sharing (PhilNOS) refers to the 
implementing office of the national organ donation and transplantation program of the 
DOH, which oversees and facilitates organ and tissue donation and transplantation 
involving deceased donors in the country. It shall serve as the central coordinating body to 
ensure that all organs and tissues from deceased donors are allocated according to 
established criteria.
(b)  Donation of Organ or Tissue refers to a voluntary act of a person to give his organs or 
tissues gratuitously in favor of another, who accepts it. In this case, the recipient shall have 
no demandable or enforceable right over the organ or tissue donated and may in gratitude or 
acknowledgement of the donation, give anything of value to the donor.
(c)  Related Donors refers to relatives by consanguinity up to the fourth civil degree. 
(d) Donor refers to an individual authorized under this Act who is the source of organs and/or 
tissues for the purpose of transplantation
(e) Non-Related Donors include the following: 
(i) Those who are related by consanguinity beyond the fourth civil degree;
(ii) Those not related within the fourth degree of family;


(iii) Those not related by consanguinity or affinity but bear emotional ties with the 
organ  or  tissue  recipient  (e.g.  friends,  employees  or  employers,  colleagues, 
fiance/fiancee); and 
(iv) Strangers
(f)  Directed Living Donors refer to donors who have a specific recipient in mind whom he 
would want to donate to.
(g) Non-directed Living Donors refer to donors who would donate to whoever matches on a list 
of waiting patients for organ transplants.
(h) Eye Bank Technician  refers to a board-eligible or board-certified nurse or medical 
technologist who underwent training in the science of eye banking which is conducted by 
an organization duly-accredited by the DOH. Provided that, the training is in accordance 
with accepted international standards of eye banking and shall include, but not limited to, 
retrieval, processing, storage, and distribution of eye tissue.
(i) Human Organ or Tissue for the purpose of this Act refers to the kidney, liver, heart, lung, 
pancreas, bone marrow, cornea, eye, bone, skin, nerve, muscle tissue and any other human 
organ or tissue that may be transplanted to another living person.
(j) Indigent  refers to an individual who has been certified by the local branch of the 
Department of Social Welfare and Development of the area in which he/she is a resident to 
be belonging to that sector living or earning below the poverty threshold as determined 
from time to time by the National Economic and Development Authority.
(k) Medical Care refers to medicines and laboratory examinations necessary to be made for the 
purpose of, and pursuant to, transplantation. It however does not include expense for the 
treatment of unrelated medical illness that is discovered during evaluation procedures.
(l) Medical Practitioner – Any physician, dentist, nurse, pharmacist, or paramedical or other 
supporting personnel (including medical and dental technicians, nursing assistants, and 
therapists).
(m) Opt-Out shall mean the positive act of a person categorically registering themselves to the 
appropriate office as indicated herein that he or she does not consent to subject his organs, 
tissues, remains and / or any part of his body to be subject for transplantation to another 
persons.


(n) Tissue Bank refers to a hospital unit where activities of processing, preservation, storage, 
and  distribution  of  human  tissues  are  undertaken.  It  may  also  be  responsible  for 
procurement of testing tissues.
(o) Philippine Organ Donor and Recipient Registry System (PODRRS) refers to the national 
computerized  and  strictly  confidential  database  of  all  organ  transplant  candidates, 
recipients, organ donors, and transplants performed in the Philippines. The system shall 
also contain the list of individuals who chose and expressed to opt-out from donating 
organs and/or tissue, as provided in this Act.
(p) Transplantation – The transfer (engraftment) of human cells, tissues, or organs from a 
donor to a recipient with the aim of restoring function/s in the body.
(q) Transplant Facility refers to a facility or hospital in which the transplant shall whoever 
matches on a list of waiting patients for organ transplant.
SEC 4. Establishment of Organ and Tissue Retrieval Organizations (OTROs). – The DOH, in 
coordination with the DOH-PhilNOS, shall accredit and ensure the establishment of OTROs in 
tertiary hospitals, government and private, as part of the national organ and tissue procurement 
network.
The OTROs shall establish affiliations with facilities/ institutions that provide ancillary/ 
support services such as, but not limited to, laboratory diagnostic capability in virology, tissue 
typing, imaging facility, to include at least an ultrasound machine with Doppler capability, and 
ambulance services for donor/s, organ/s, and tissue/s transport.
Provided that, each OTRO shall have an Organ Retrieval Team whose members are 
licensed and board-certified surgical and medical experts. Provided that, collaborations with other 
retrieval teams of other transplant facilities without an OTRO can be entertained on a case-by-case 
basis.
Each OTRO shall be mandated to serve its designated Donor Service Area (DSA) which 
shall be determined by DOH and DOH-PhilNOS, through population-based designation, in 
coordination with the Philippine Statistics Authority (PSA).


All Tertiary Hospitals and Trauma Centers, with or without OTROs, shall be required to 
have CDC and CTC in order to optimize the identification and referral of donors and/or PMODs.
SEC 5. Retrieval of Organs and Tissue After Death. – The designated medical practitioner of a 
hospital may, subject to and in accordance with this Act, authorize, in writing, the removal of any 
organ and/or tissue of a dead person unless he/she has opted-out to organ and tissue donation, as 
confirmed by DOH-PhilNOS through the PODRRS.
Organ procurement may be performed in any hospital provided that is well-equipped and 
capable of performing such operation while tissue procurement shall be performed by the 
appropriate Tissue Bank, as accredited by the DOH.
Provided that, for possible medicolegal cases and unidentified dead individuals, no 
procurement of organ and/or tissue shall be performed and the OTRO shall immediately 
communicate and inform the Medicolegal Division and Crime Laboratory of the Philippine 
National Police (PNP) and/or National Bureau of Investigation (NBI).
Moreover, no authority shall be given for the removal of organs and/or tissues from the 
body of the deceased if:
1. During his/her lifetime, he/she has registered an objection to organ and/or tissue donation, 
as provided in this Act, after his/her death;
2. He/she is not a citizen of the Philippines. Provided that, Filipinos who have lost their 
citizenship and obtained citizenship in another country, and are residents in the Philippines, 
may also be given authority to donate their organs to a living related transplant recipient, in 
accordance with the Opt-In System provided in Section 8 hereof; unless with explicit 
consent to donate;
3. He/she is below eighteen (18) years of age unless both living parent(s) or legal next-of-kin 
or legal guardian has consented to such removal; or
4. He/she is an incompetent person, unless the living parent(s) or legal next-of- kin or legal 
guardian has consented to such removal.


SEC. 6. Opt-Out System – Upon the effectivity of this Act, any person who objects to the removal 
of his/her organ and/or tissue after his death may register his objection, in respect of that organ 
and/or tissue, with the DOH-PhilNOS at any time or with the following agencies:
a.
Land Transportation Office (LTO) upon driver’s license renewal;
b. Government Services Insurance System (GSIS);
c.
Social Security System (SSS);
d. Philippine Health Insurance Corporation (PhilHealth);
e.
Commission on Elections (COMELEC); or
f.
Such other department or agency assigned by the PSA.
Such objection shall be registered and recorded real-time in the PODRRS. Upon the receipt 
of the duly-signed written objection, the concerned agency shall thereafter issue a certification 
and an opt-out card to the person which shall serve as a proof that his objection was duly 
registered and recorded.
Provided that, any person who has registered his/her opt-out may cancel his/her registration 
at any time in the prescribed form, as may be determined by the DOH- PhilNOS, in coordination 
with the abovementioned agencies. Such cancellation shall be recorded real-time in the PODRRS.
SEC. 7. Opt-In System. – Upon the effectivity of this Act, any person who desires to donate 
his/her organs and/or tissues, may register, in respect of such organ and/or tissue, with the DOH-
PhilNOS shall be considered.
SEC. 8. Allocation of Organs and Tissues. – In the allocation of any organ and/or tissues retrieved 
pursuant to this Act, matching and other circumstances, as may be determined by DOH and DOH-
PhilNOS shall be considered.
SEC. 9. Organ Donation from Deceased Donors. – The recovery and transplantation of organs 
from deceased donors as provided in the preceding sections shall be prioritized over organs from 
living donors.


SEC. 10.  Organ and Tissue Donation from Living Donors. - Any individual, at least twenty one 
(21) years of age, of sound mind, who underwent screening and counseling procedures and has 
been found suitable as living donor based on the physical and psychological evaluation and 
assessments made by the physicians of the transplant facility who are not in any way directly 
connected  with  the  transplant  recipient,  and  thus  fully  understands  the  risks,  benefit  and 
consequences of transplanting organs and tissues from his/her body, may so donate by way of 
written consent to such removal for purposes of transplanting the same to another living human 
body. Such informed consent shall be in a document witnessed by a relative of the donor and two 
(2) physicians neither of whom shall be a member of the team of medical practitioners who will 
effect the removal of the organ or tissue from the donor's body nor the physician or transplant team 
attending to the recipient of the organ to be removed.
In no instance shall a minor be made a living donor of any organ or tissue to anybody. 
Further, no transplant shall be undertaken if it will result in a physical and/or psychological harm to 
the donor. Furthermore, an individual is allowed to donate only one organ or tissue in his/her 
lifetime. Finally, a foreigner is not allowed to become a recipient of any organ or tissue unless it can 
be shown that he/she is a former Filipino citizen or that the potential donor is related to the said 
former Filipino foreigner by consanguinity within the fourth degree. 
SEC. 11. Choice of Type of Donation. - It shall be the choice of the donor whether to make a non-
directed or directed type of donation, taking into consideration the following:
(a) In making a non-directed type of living donation, a non-indigent donor is to proceed to 
an accredited transplant facility of his/her choice, bringing with his a verified certification from 
two (2) physicians to the effect that he/she is physically and medically fit to donate the organ of 
his/her  choice.  The  said  transplant  facility  shall  then  conduct  the  required  pre-transplant 
psychological screening to determine his/her suitability for donation. The cost of the screening 
shall be free of charge. If found suitable to make the donation, the transplant facility shall then 
register the name of the potential donor in the Philippine Organ Donor and Recipient Registry 
System (PODRRS) maintained by the Department of Health for matching with a recipient. In case 


of an indigent donor intending to make a non-directed living donation, he/she shall proceed to an 
accredited government transplant facility which shall conduct initially a psychological screening, 
determine his mental fitness to make such a donation. If found suitable, the same government 
transplant facility shall subject the potential donor to a test to determine his physical fitness to 
undergo the donation. In both cases of screening and physical testing, the procedure shall be free of 
charge. If the potential donor is finally found psychologically, mentally and physically fit to make 
the donation, his/her name shall then be registered by the same transplant facility in the PODRRS 
for matching with a recipient.
It is understood that a non-directed living donor makes such donation out of mere altruism 
but a grateful recipient who, after the transplant, had knowledge of the identity of his/her donor, is 
not precluded from giving financial assistance to the latter.
(b) In making a directed type of living donation, the potential donor shall undergo 
psychological, mental and physical tests to determine his/her fitness to become a donor, the costs of 
all which shall be borne by the intended recipient, unless the recipient is an indigent in which case 
the said tests shall be conducted free of charge in the government transplant facility in which the 
indigent is to be scheduled for transplant. 
SEC. 12. Requirement of Registration. - All patients in transplant shall also register themselves in 
the Philippine Organ Donor and Recipient Registry System (PODRRS) maintained by the 
Department of Health (DOH). 
SEC. 13. Duty of Non-indigent Recipients. - In all cases of living donation, whether directed or 
undirected, and notwithstanding any agreement to the contrary, it shall be the responsibility of the 
non-indigent  recipient  to shoulder the  cost  of the   transplantation procedure and pre and 
postoperative medical care of the donor, who has been found suitable mentally and physically to 
make the donation. 
Further, the recipient shall cause the name of the donor to be registered in the registry of the 
PODRRS. Furthermore, the recipient is obliged to shoulder the expenses of travel and housing, if 
any, and lost wages, if applicable and other related expenses  in connection with the donation. 


Finally, the recipient shall be made to answer financially, wholly or partly depending on their 
agreement, for any subsequent disease that may be developed by the donor in connection with the 
organ or tissue donated. Nothing in this Act, however, shall proscribe the voluntary act of the 
recipient  in providing additional assistance to the family of the donor either through livelihood 
projects and/or educational support to the family of the donor. 
SEC. 14. Duty of the State. - If the organ or tissue recipient is indigent, as certified to by the local 
branch of the Department of Social Welfare and Development of the area where the recipient is a 
resident, the actual transplant shall be made in any of the accredited government transplant 
facilities and the pre and postoperative medical care of the donor shall be shouldered by the said 
transplant facility while the expenses of travel and housing, if any, and lost wages, if applicable, 
shall be shouldered by the local government of which the recipient is a resident. The local 
government unit concerned as well as the district representative of the place where the donor is a 
resident shall likewise, as far as practicable, provide preferential assistance in terms of educational, 
scholarship or other non-monetary benefits to the family of the donor and/or his next of kin. 
SEC. 15. Duty of Living Donors. - In all cases, it shall be the duty of the living donor, for his own 
protection, to ensure and verify that his name is registered in the national registry of donors 
maintained
 
by
 
the
 
PODRRS. 
SEC. 16. Incentives for Living Donors. - An organ or tissue donor shall be entitled to a leave of 
absence with pay for the period of his confinement for purposes of actual transplantation and post-
transplant recovery for a period not to exceed fifteen (15) working days.
Should  the  donor  develop  a  disability,  as  defined  under  the  Social  Security  and 
Government Service Insurance System charters, resulting from the transplantation procedure, 
he/she shall be entitled to a disability pay, as therein defined and computed. 
Further,  should  the  donor  eventually  develop  a  disease  or  sickness  necessitating  a 
transplant, the said donor shall be given priority in the registry of potential recipients.


Furthermore, airline companies are to provide at least twenty percent (20%) discount on 
airfare of potential donors, on their way to and from the actual transplant operation, who have been 
found suitable, mentally and physically to make the donation. 
Finally, pharmaceutical companies and their distributors ensure that at least a twenty percent 
(20%)  discount  is  likewise  provided  for  post-transplant  and  transplant-  related  medicines 
personally consumable by the donors. 
SEC. 17. Regional Tissue Bank. - There shall be a Tissue Bank in every region, established in a 
DOH-accredited hospital, to be supervised by the Department of Health which shall provide 
effective mechanisms on storage, donation, transportation and transplantation of tissues stored in 
the facility.
SEC. 18.  Persons Authorized to Perform the Retrieval and Transplantation of Organs and 
Tissues. – The retrieval and transplantation of organ and tissues shall only be performed by 
transplant surgeons duly accredited and certified by the Philippine Society of Transplant 
Surgeons. Provided that, the removal of the eye and eye tissues shall be performed only by the Eye 
Bank Technicians who undergo training in the science of eye banking conducted by an 
organization duly-accredited by the DOH. Such trainings shall be in accordance with the accepted 
international standards of eye banking and shall include, but not limited to, retrieval, processing, 
storage, and distribution of eye tissue.
SEC. 19.  Transport of Donated Organs and Tissues. – In order to maintain the quality and 
integrity of organs and tissues for transplantation, to ensure traceability, and to minimize any 
potential risk, it is vital that donor organs and tissues and their accompanying blood and tissue 
samples are packaged, labelled, and transported to the Transplant Facility appropriately, and in a 
speedy and timely manner.
SEC. 20. Philippine Network for Organ Sharing.  - The Department of Health- established 


Philippine Network Organ Sharing (PHILNOS) which promotes organ donation from deceased 
donors is hereby recognized but in addition, it shall also come up with mechanisms and guidelines 
on living organ donors, as provided herein.
The DOH shall report to Congress before June 30 of every year the analysis of information 
derived from the registry. 
SEC. 21. Regulatory Authority. - The Department of Health shall be responsible for the following:
(a) Implementing the provisions of this Act:
(b) Issuing guidelines relative to the process of donor-screening and evaluation as well as 
donor and recipient pre and post-transplant counseling;
(c) Issuing guideline on the accreditation of transplant facilities, whether government or 
private, thereby ensuring that all necessary equipment and facilities are available as well as 
guaranteeing that the transplant team have the necessary expertise and experience in conducting 
the same;
(d) Issuing guidelines relative to the duties of hospitals and their respective physicians 
relative to the conduct of transplant and all its necessary incidents. 
SEC 22. Prohibited Acts. – The following acts shall be prohibited:
a.
Entering  into  a  contract  or  agreement  under  which  a  person  agrees,  for  valuable 
consideration, whether given or to be given to himself/herself or to another person, the sale 
or supply of any organ or tissue, whether before or after his/her death or the death of another 
person, as the case may be;
b. Giving or offering to give valuable consideration for the sale or supply of, or for an offer to 
sell or supply, any organ from the body of another person;
c.
Performing organ and/or tissue removal and/or transplantation of an unauthorized person
d. Advertising  and  promoting  the  buying  and  selling  of  organs  and/or  tissues in  the 
Philippines; and
e.
Destroying, forging, mutilating, and altering the PODRRS or any related documentation 
wilfully.


SEC. 23. Penalties. – The following penalties are hereby provided:
a.
Any person found guilty of committing any of the acts enumerated in Section 22 (a), (b), 
and (c) shall suffer the penalty of imprisonment of twenty (20) years and a fine of not less 
than  One  million  pesos  (P1,000,000.00)  but  not  more  than  Two  million  pesos 
(P2,000,000.00)
b. Any person found guilty of committing any of the acts under Section 22 (d) and (e) shall 
suffer the penalty of imprisonment of two (2) years and a fine not less than One hundred 
thousand  pesos  (P100,000.00)  but  not  more  than  Five  hundred  thousand  pesos 
(P500,000.00)
c.
A non-indigent recipient who fails to perform any of the mandatory duties mentioned in 
Section 13 hereof as well as the local chief executive and responsible officers of the local 
government unit concerned, the officials and employees of hospitals and companies 
directly involved under Sections 14 and 16 respectively hereof shall be held individually 
liable and suffer the following penalties:
d. Fine of not less than One Hundred Thousand Pesos (Pl00,000.00) but not exceeding Five 
Hundred Thousand Pesos (P500,000.00) or imprisonment of not less than one (1) year but 
not more than five (5) years, or both, at the discretion of the court.
e.
For any subsequent violation in case of public and private corporations, a fine of not less 
than Two Hundred  Thousand Pesos  (P200,000.00)  but  not  exceeding  Six  Hundred 
Thousand Pesos (P600,000.00) or imprisonment for not less than two years but not more 
than six (6) years, or both, at the discretion of the court.
Upon filing of an appropriate complaint, and after notice and hearing, the proper authorities 
may also cause the cancellation or revocation of the business permit, permit to operate, franchise 
and other similar privileges granted to any business entity that fails to abide by the provisions of 
this Act.
SEC. 24. Data Management. – The DOH and DOH-PhilNOS, in coordination with the 
National Privacy Commission (NPC) and other concerned agencies, shall ensure that all data 
compiled under this Act shall be strictly confidential through the implementation of appropriate 


organizational, physical, and technical security measures in accordance to existing laws, rules, 
and regulations.
SEC. 25.  Implementing Rules and Regulations.  – The DOH and DOH- PhilNOS, in 
coordination with the concerned departments and agencies, shall within sixty (60) days from the 
effectivity of this Act, promulgate rules and regulations to faithfully implement the provisions of 
this Act.
SEC. 26. Appropriation. – The amount of One Billion Pesos (P1,000,000,000.00) shall be 
appropriated for the management and implementation of this Act which shall be included in the 
General Appropriations Act (GAA).
SEC. 27. Repealing Clause. - All laws, executive orders, presidential decrees, presidential 
proclamations, letters of instructions, issuances, rules and regulations or parts thereof which are 
inconsistent with the provisions of this Act are hereby repealed or modified accordingly.
SEC. 28. Separability Clause. - Any portion or provision of this Act that is declared 
unconstitutional or invalid shall not have the effect of nullifying other portions or provisions hereof 
as long as such remaining portions can still subsist and be given effect in their entirety.
SEC. 29. Effectivity Clause. - This Act shall take effect fifteen (15) days after its 
publication in the Official Gazette or in two (2) newspapers of general circulation.
 
Approved,