The Regional cum State Organ and Tissue Transplant Organisation (ROTTO-SOTTO), West and Maharashtra has been established by the Ministry of Health and Family Welfare, Government of India, at KEM Hospital, Parel, Mumbai since 2017. This networking agency has been mandated and defined in the amended Transplantation of Human Organs and Tissues Act of 1994 [Section 13-C], and the Rules of 2014 [Rule 31 (4) (12)].

ROTTO-SOTTO, Mumbai works under the ages of NOTTO and is responsible for the monitoring and surveillance of organ transplant activities in Maharashtra State and the other states in the Western Region like Chhattisgarh, Goa, Gujarat, Madhya Pradesh and union territory of Diu and Daman. It also maintains transplant registries and conducts promotional activities for spreading awareness about organ donation.