A Survey on Blockchain-Driven Allograft Management: A Secure Approach to Data Provenance

Abstract

The demand for organ transplants is growing rapidly, yet the existing systems for organ donation face significant challenges, including lack of transparency, delays, and fraudulent activities. This paper explores a novel approach to address these issues by leveraging blockchain technology. Blockchain offers a decentralized, secure, and tamper-proof environment that can improve the efficiency and reliability of the organ donation process. By incorporating smart contracts and distributed ledger principles, the proposed system ensures that donor and recipient data are securely recorded, access is appropriately regulated, and organ matching and allocation are carried out transparently. The integration of blockchain also enhances trust and minimizes administrative overhead, making the donation process more accountable and streamlined. The study also outlines a conceptual framework for implementing this technology and highlights the potential impact on reducing illegal organ trade and ensuring ethical compliance. The study also explores how blockchain could help in maintaining a nationwide or even global donor registry that is both interoperable and scalable. In doing so, it opens avenues for real-time updates, faster allocation decisions, and the potential to curb illegal organ trafficking. Through a conceptual prototype and system design, the paper illustrates the feasibility of this approach and sets the foundation for future research and real-world implementation.

Introduction

Allograft (donor tissue) transplantation is a life-critical process that demands data integrity, security, and traceability. Traditional centralized systems often fail to ensure these needs, exposing the process to:

• Fraud and manipulation

• Unauthorized access

• Lack of end-to-end traceability

In response, the paper explores a blockchain-based solution, particularly using Ethereum smart contracts, to enhance security, transparency, and automation in organ donation and transplantation workflows.

2. Key Contributions

• Proposes a three-layered blockchain architecture:

  1. Actors layer – authorized users like doctors, surgeons, coordinators.

  2. Front-end layer – user interface for interaction and data entry.

  3. Back-end layer – Ethereum smart contracts for data storage and verification.

• Ensures role-based access control, real-time auditability, and tamper-proof records using cryptographic authentication (e.g., via Metamask).

• Addresses challenges of existing systems such as:

  • Lack of urgency-based matching

  • Centralization risks

  • Manual inefficiencies

3. Literature Insights

The survey compares multiple blockchain systems for healthcare and transplantation:

• Indriya (2023) – Uses Hyperledger Fabric; good performance (~508 TPS) but lacks urgency logic.

• ProvChain (2017) – Provides data provenance with Merkle trees but has API dependencies and limited scalability.

• Other Ethereum-based systems – Offer automation and transparency but often lack clinical detail, urgency handling, or scalability.

Key gaps identified:

• Limited real-world deployments

• High transaction costs

• Privacy challenges in public blockchains

• Lack of urgency and advanced matching logic

4. Proposed Methodology

The system automates and secures the entire allograft workflow:

1. Registration & Verification Phase:

   • Doctors register donors/patients via smart contracts.

   • Organ procurement and transplant teams verify data.

2. Matching Phase:

   • Automated compatibility matching based on clinical data (e.g., blood type, organ type).

   • Matching events are logged immutably.

3. Blockchain Architecture:

   • Actors interact via web interface + Metamask wallet for secure authentication.

   • Smart contracts handle data operations, enforce roles, and provide real-time audit logs.

   • No gas cost for data retrieval, but secure login is still required for access.

4. Security Model:

   • Defends against internal threats (data tampering) and external attacks (unauthorized access).

   • Implements fine-grained access control, digital signatures, and transaction traceability.

5. Findings and Conclusion

• Blockchain enables verifiable data lineage, secure matching, and end-to-end transparency.

• Ethereum smart contracts offer a good balance of automation, security, and auditability.

• Challenges include:

  • Gas fees

  • Scalability

  • User privacy on public blockchains

Conclusion

The transformative potential of blockchain technology in revolutionizing allograft and organ transplant management. Traditional centralized systems suffer from security lapses, inefficiencies, and lack of transparency—challenges that blockchain can effectively mitigate. By leveraging Ethereum-based smart contracts and a layered architecture, the proposed system ensures secure registration, verification, matching, and transplantation of organs, with full traceability and tamper-proof data provenance. The comparative analysis of existing blockchain-based solutions reveals that while several frameworks offer transparency and automation, most fall short in areas such as urgency-based matching, scalability, and privacy. The system proposed by introducing fine- grained access controls, role- based permissions, and cryptographic verification, significantly enhancing trust, auditability, and compliance. Overall, the integration of blockchain into allograft workflows promises to increase trust among stakeholders, reduce fraud, streamline operations, and enable ethical and accountable organ donation practices. This conceptual foundation paves the way for future research, real-world testing, and policy-aligned implementations in healthcare environments.

References

[1] R. U. Haq, R. Khan, F. Alturise, S. Sahrani, S. Alkhalaf, and M. R. Sarker, \"Transchain: Blockchain-Based Management of Allografts for Enhancing Data Provenance\", IEEE Access, vol. 13, pp. 51182–51193, Mar. 2025, doi: 10.1109/ACCESS.2025.3552576. [2] S. Ghosh and M. Dutta, “Indriya: Building a secure and transparent organ donation system with hyperledger fabric”, 2023. [3] X. Liang, S. Shetty, D. Tosh, C. Kamhoua, K. Kwiat, and L. Njilla, ‘‘ProvChain: “A blockchain-based data provenance architecture in cloud environment with enhanced privacy and availability’’ in Proc. 17th IEEE/ACM Int. Symp. Cluster, Cloud Grid Comput. (CCGRID), May 2017, pp. 468–477. N. Kshetri, D [4] Hawashin, R. Jayaraman, K. Salah, I. Yaqoob, M. C. E. Simsekler, and S. Ellahham, “Blockchain-based management for organ donation and transplantation”, IEEE Access, vol. 10, pp. 59013–59025, 2022.F. Saleh. [5] S. Zouarhi, “Kidner-A worldwide decentralised matching system for kidney transplants”, J. Int. Soc. Telemedicine eHealth, vol.5, pp. 62–63, Apr.2017. [Online]. Available: https://github.com/sajz/kidner. [6] P. Ranjan, S. Srivastava, V. Gupta, S. Tapaswi, and N. Kumar, “Decentralised and distributed system for organ/tissue donation and transplantation”, in Proc. IEEE Conf. Inf. Commun. Technol., Dec. 2019, pp.16. [7] N. Kshetri, “Blockchain and Electronic Healthcare Records”, 2018. [8] A. Al-Mamun and D. Zhao, “SciChain: Trustworthy Scientific Data Provenance”, 2023. [9] D. Fernando, S. Kulshrestha, J. D. Herath, N. Mahadik, Y. Ma, C. Bai, P. Yang, G. Yan, and S. Lu, SciBlock: A Blockchain-Based Tamper-Proof Non-Repudiable Storage for Scientific Workflow Provenance, 2023. [10] P. Ruan, G. Chen, T. T. A. Dinh, Q. Lin, B. C. Ooi, and M. Zhang, Fine-Grained, Secure and Efficient Data Provenance on Blockchain Systems, 2019. [11] P. L. Wijayathilaka, P. H. P. Gamage, K. H. B. De Silva, A. P. P. S. Athukorala, K. A. D. C. P. Kahandawaarachchi, and K. N. Pulasinghe, ‘‘Secured, intelligent blood and organ donation management system -‘LifeShare,’’’ in Proc. 2nd Int. Conf. Advancements Comput. (ICAC), Dec. 2020, pp. 374–379. [12] P. Soni, A. Mathur, D. Patel, and R. Manjula, ‘‘Blockchain based organ donation platform: Defeating trafficking and ensuring transparency,’’ Int. Res. J. Adv. Sci. Hub, vol. 5, pp. 353–360, May 2023. [13] D. Hawashin, R. Jayaraman, K. Salah, I. Yaqoob, M. C. E. Simsekler, and S. Ellahham, ‘‘Blockchain based management for organ donation and transplantation,’’ IEEE Access, vol. 10, pp. 59013–59025, 2022. [14] S. V. Siva and S. T. Sukanya, ‘‘Using hashing algorithm for the organ procurement and transplant network,’’ in Proc. Int. Conf. Scientific Innov. Sci., Technol., Manage., Aug. 2023, pp. 483–493. [15] U. Anuradha, R. Mishra, N. Raj, and T. Yeli, ‘‘Application for tracking organ donations in hospitals and minimize the scope of organs trafficking using blockchain,’’ Int. Res. J. Modernization Eng., Technol. Sci., vol. 5, no. 5, pp. 880–886, 2023

Copyright

Copyright © 2025 Hemalatha K, Aishwarya R, Bhoomika B S, Kruthika K M, Madhavi S. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.