Blockchain-Based Organ Transplantation: A Decentralized Framework for Secure Donor–Recipient Management Using Ethereum Smart Contracts and IPFS

This paper proposed a blockchain-based organ transplantation management system that combines Ethereum smart contracts, IPFS-based hybrid storage, and a React.js/MetaMask frontend to address the transparency, security, and coordination shortcomings of conventional organ donation platforms. By reviewing seventeen recent studies spanning blockchain-based organ donation platforms, AI- and Random-Forest-assisted matching, CPRA/OPTN-based immunological scoring, broader healthcare-blockchain and EHR applications, blockchain-type risk analysis, Ethereum-versus-Hyperledger platform trade-offs, smart-contract vulnerability detection, and gas-cost optimization, the proposed system's architecture was positioned against a representative slice of the current literature, and a Phase-1 prototype covering donor registration, patient waitlist entry, and hospital oversight was outlined for planned implementation. Several directions are planned for future work: •     Integrating a machine-learning-based matching layer, following approaches such as that of Kumar and Jeysankar, could complement the current rule-based scoring once sufficient de-identified training data becomes available [3]. •  Migrating the deployment target from a local test network to a consortium or permissioned Ethereum-compatible network is recommended in light of the lower perceived regulatory and technical risk of such platforms for patient-record use cases [6]. •  Subjecting the matching and storage contracts to automated, transformer-based vulnerability scanning prior to production deployment would align the project with current best practice in smart-contract security assurance [7]. •      Extending the matching-logic module toward the internationally harmonized, points-based allocation schemes surveyed by Niyigena et al. would move the system closer to supporting cross-institution and potentially cross-border organ exchange [5]. •   Replacing the current boolean blood-group check with a CPRA-weighted immunological score, following Gonuguntla et al.'s OPTN-metric formulation, would let the matching function distinguish "very high" from merely "high" compatibility pairs rather than treating all blood-group matches as equivalent [13]. •  Given the Fabric-based prototype reported by Shrihari et al., a formal cost–benefit comparison between a Solidity/Ethereum deployment and a Hyperledger Fabric migration is warranted before selecting the Phase-2 production platform [16]. • Integrating the gas-waste detectors validated by Raza et al. into the project's CI pipeline would let every future contract revision be automatically screened for the address(this)-caching, division-by-uint, short-string, and redundant-casting patterns shown to affect the large majority of live Ethereum dApps [17].

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