Football Regulation

Football Regulation


CERVIA (Italy) 2024

Football is the most played and most popular sport in the world. Embracing football under the WTGF banner is a natural step. The mission of the WTGF’s World Transplant Football Commission is to foster the development of the sport of football for transplant recipients at all levels.

The WTGF follows FIFA Rules for the World Transplant Football Cup except as modified herein–if we are to work with FIFA to promote and develop the sport amongst transplant recipients then we will embrace their protocols.

Entry is open to all recipients of life supporting allografts (heart, intestine, kidney, liver, lung, pancreas) and hematopoietic cell (bone marrow) transplants from other individuals or species which require or have required the use of immunosuppressive drug therapies. Players must have been transplanted for at least 1 year, with stable graft function, be medically fit, training regularly and succeed both fitness tests. If a recipient is at least 6 months post-procedure, with stable graft function, has been training and has permission from his own doctor, his entry may be considered by the WTGF medical committee and be allowed. All competitors must be medically approved by their physician to compete.

Each nation should select its best players and ensure that they are medically fit, without significant complications of chronic organ failure or immunosuppressive therapy. Before competing, each competitor must complete a waiver form with the registration which states that he has knowledge of the Rules of the Transplant Football World Cup and of the medical requirements of the WTG.
In addition, all forms, including a WTGF medical certificate and a statement by participant form for each competitor, must be submitted at least one month before the start of the Tournament. The medical certificates will be reviewed by a representative of the WTGF and, if deemed unsatisfactory, that player may be not be allowed to participate. The medical certificate must be fully filled out and signed by a member of the transplant health team.

Gender mixed teams are allowed. International teams (teams with players from more than one country) are not allowed.

Competitors of one nationality who live permanently in another country may compete for their country of permanent residence if they wish. Competitors who have been transplanted in a country other than their country of permanent residence may compete for the country where they were transplanted if that team agrees to accept them. Competitors may not switch once a decision is made except if one of the two conditions above changes.

Football players, trainers and coaches are expected to understand and be familiar with the WTGF Rules of the Transplant Football World Cup. At all times, participants and coaches must respect the etiquette and traditions of the sport. This includes being properly dressed and equipped and conducting themselves in a sportsmanlike manner.

The medical approval of all participants must be reviewed by the trainer or team manager prior to submission.

1.Fitness tests for health and safety

The World Transplant Games Federation has established the following requirements for participants in National and International football events.
The WTGF Football commission recognizes the importance of training sessions first before participating in matches, the number of injuries will decrease!
Participants must have participated in training session/matches at the National level and must successfully complete both tests before being permitted to participate in a WTGF sanctioned international tournament.

Information on the required tests—the Bleep and the Agility test (Illinois test)—can be found in the WTGF General National Football program. All players must be capable of successfully performing both tests.

2. Medical staff

The Host must appoint a Games Chief Medical Officer (GCMO), a half year before the opening match, and develop a Medical Plan that complies with the Minimum Medical Standards. The medical plan should include the communication protocol, medical facilities and emergency management, medical supplies and equipment, to be submitted to WTGF Medical Committee at least 120 days before the tournament. The GCMO must organise medical standards and emergency cover at all football fields whilst competition and training is in progress. It is the responsibility of the Games Chief Medical Officer to continuously monitor the safety of all football fields, weather conditions, volunteers, community members, transportation, and social events during the Tournament and to promote avoidance of risk taking behaviour such as excess alcohol, recreational drugs and extreme fatigue. The Games Chief Medical Officer should ensure that all medical forms are checked and endorsed to ensure safety of the participating athletes.

3. The Games Chief Medical Officer will prepare

  • A list of the location of the nearest hospitals and medical centres to the football fields
  • A list of participating medical experts
  • Confirmation of compliance with Minimum Medical Standards
  • Information concerning Tournament safety and security plans
  • A doctor (with AED) and physiotherapist are required on the football location during training sessions and matches

4. Medical approval forms

Medical forms (MF-1, MF-2 and MF-3) must be completed and signed within six months, and no later than one month before the opening match of the Tournament. These must be returned by the trainer/coach to the LOC Office.

5. The International tournament

The National teams will consist of 7 players, a maximum of 9 reserve players is strongly recommended. Matches will be played in two 20 minute halves, with a break of 10 minutes between halves. In addition, there will be a drink at the midpoint of each half.

If the score is tied at the end of the regulation 40 minutes, there will be two additional 5 minute periods. If the score is still tied, then penalty shots will determine the winner (ABBA system).

Players who are substituted may re-enter the game as often as desired by the team manager/coach.

The teams should have 2 shirts of different (country) colours with numbers by player.

The goalkeeper should wear a shirt that distinguishes him/her from all other players.

Before the start of the match all players of both teams will line up, with the referees in the middle and the country flags before them. National Anthems will be played
Teams play in pools initially followed by semis and final
All teams will only play one match a day during the tournament


The host organisation will organise an Opening ceremony and a closing dinner and for all players and supporters.

7. Official Rules

FIFA, except if modified in the Rules of the Transplant Football World Cup. Matches will be officiated by referees who are certified by a national or international authority. The organizers, and referees must sign the “Agreement of Understanding” indicating that they understand and accept and agree to follow the Rules of the Transplant Football World Cup. A WTGF representative will check that the Agreement of Understanding is signed by the organizers, all referees.

8. Seeding

Seeding should be used in the TFWC to ensure the fairest competition possible.

To ensure the fairest competition possible, the entries should be formatted using standard procedures. The following factors should be considered (in this order):

  • medallists from the previous Transplant Football World Cup Tournaments
  • other pertinent information.

Time permitting, preliminary round competition will be in small “round robin” pools with the top finishers advancing to the knockout round.

9. Protests

Eligibility protests must be submitted in writing by the coach/trainer with payment of $50 US/€50 within 30 minutes after the conclusion of a match. Protests will be passed to the WTGF representatives and the head of the tournament. A decision will be made as soon as possible. The fee will be returned if the protest is upheld. If a member of the Judiciary or the head of the tournament is from a country involved in the protest, that member must recuse himself from the discussion and resolution of the protest.

10. Judiciary Committee and Disputes

The WTGF will appoint a Judiciary existing of one or more WTGF representative and the head of the tournament to resolve any dispute arising in conjunction with the football tournament.

The WTGF Judiciary must meet with the football organisers at least one day before the tournament and as required during the Games. The WTGF Judiciary will liaise with the head of the tournament on an on-going basis and clarify the rules of tournament.

The head of the tournament and WTGF representatives will each be present at all events and be introduced to the referees and officials so that their identity is clearly established.

In the event of a serious breach of discipline, the Judiciary has executive powers to suspend an athlete immediately and refer the matter for further review to the WTGF Board. The Judiciary has the power to suspend the athlete for the rest of the Tournament.

For more information visit the WTGF website or email us at .


To encourage transplant recipients to participate in football, the Federation has developed the following resources to assist members in developing the sport within their countries:

A set of rules for football adapted for transplant recipients.

Guidelines and recommendations for developing a transplant football program locally and within a country.

An Agreement of understanding for Organizers, Trainers and Referees.

Key message points to use to promote a transplant football program.

This medical review form must be used to ensure that transplant recipients are medically fit to participate.

For assistance in building a football program, contact the WTGF at

  • Valeria Gherardini Head of AiCS International Office  +39 3400640993
  • Filippo Tiberia Sport Coordinator of the AiCS-WTGF Football Cup +39 3929781913
  • E-Mail :