On 30 September 2025, 46-year-old Kamlesh Verma underwent a kidney transplant at a hospital affiliated with MGM Medical College in Indore after spending nearly three years on dialysis. His donor was his mother, Ganga Verma, who was 72. Doctors had to establish that she was healthy enough to undergo the procedure despite her age. The operation was successful, and both were subsequently discharged. The case was reported by PTI and the Free Press Journal, which described the hospital’s medical assessment and the family’s experience.
Ganga’s decision gave her son access to a transplant. It also brings into focus a marked imbalance in living organ donation in India. Women are far more likely to donate organs, particularly kidneys, while men account for most recipients. According to NOTTO data for 2025, women made up 71% of living kidney donors, while men accounted for 77% of recipients. Those figures do not tell us why any individual family chose a donor. They do show that the medical journey of transplantation is also affected by questions of gender and access to treatment.
Kamlesh had a suitable donor within his family. Many patients do not have that option. They may need to register for a deceased-donor organ and wait for one to become available. For patients with kidney failure, dialysis can sustain life during the wait, but the time before a suitable organ is offered may range from weeks to years.
The transplant system has to connect such patients with hospitals, donor families and allocation authorities. It is also essential to ensure that an organ listed for donation is medically suitable for a particular recipient.
In 2013, India performed 4,990 organ transplants. Eleven years later, in 2024, the number had risen to 18,911. According to the figures released with NOTTO’s 2025 annual report, India performed 20,138 organ transplant operations in 2025, the highest number recorded in a single year. The report also noted that 3,526 transplants took place using organs from deceased donors that year. The ministry had earlier quoted a preliminary 2025 total of 20,019 in March; the later August release gave 20,138.
While these figures are encouraging, the Ministry of Health and Family Welfare reported that 89,839 patients were on the waiting list for major organs as of 3rd March 2026. The figures show that India’s transplant programme has grown substantially over the years, but many more patients are still waiting for a suitable organ.
Every patient listed as a recipient has to undergo a long process that includes diagnosis, referral, assessment, registration, allocation and, if a suitable organ becomes available, transplantation.
A patient needs an organ transplant when the existing organ can no longer perform its essential functions because of severe and irreversible damage. A transplant may be recommended when other treatments cannot provide adequate long-term support or have reached their limits.
The most common transplant operations performed in India are kidney transplants. A patient suffering from advanced kidney disease may need to undergo dialysis, which filters waste and extra fluid from the blood. Dialysis can keep a patient alive during treatment, but it does not restore the kidney’s full function. In such cases, a transplant may offer a longer-term alternative.
However, transplantation is considered only after a medical assessment and is subject to the availability of a suitable organ from a family member or a deceased donor. Notably, living donation is possible in kidney transplantation because humans have two kidneys, and both the donor and recipient may be able to live with one.
Transplants are also performed for advanced liver disease, selected cases of heart failure and certain irreversible lung conditions. In liver transplantation, a living donor option is available because only part of the liver is transplanted. The liver has a distinctive capacity to regenerate after partial donation.
Pancreas transplants are less common and may be considered for selected patients, often alongside a kidney transplant. Intestinal transplantation is a highly specialised procedure for patients with irreversible intestinal failure.
When a patient is diagnosed with organ failure, it does not automatically mean that a transplant is the right treatment. Many factors matter during the assessment, including the patient’s overall health, the severity and cause of the disease, and the risks of surgery. A person who needs a transplant may need to undergo further treatment before being considered fit for surgery. Some patients may not be suitable candidates for a transplant because of their medical history or other factors. The assessment does not end once an organ is transplanted. Most organ recipients need lifelong follow-up and medicines to reduce the risk of rejection. They also need regular tests to monitor the transplanted organ and check for infections or other complications.
The transplant programme in India started on a small scale. Over time, it grew into a network involving public and private hospitals, specialist teams and government coordination bodies.
In 1994, the Government of India passed the Transplantation of Human Organs Act, which created the legal framework for the removal, storage and transplantation of human organs. The Act sets out rules for consent and authorisation, recognises brain-stem death for the purpose of organ donation and prohibits commercial dealings in human organs.
In 2011, the law was amended and supported by rules that set out procedures for hospitals, donors and transplant recipients. The national coordinating structure has developed through the National Organ and Tissue Transplant Organisation (NOTTO) and its regional and state counterparts.
These bodies support organ donation and transplantation across hospitals and jurisdictions. The National Organ Transplant Programme supports infrastructure, training, coordination and public awareness.
Over time, the scale of the programme has changed substantially. According to data provided by the government, the number of transplants in 2025 was four times higher than in 2013. A milestone came on 3rd August 1994, when surgeons at the All India Institute of Medical Sciences (AIIMS), New Delhi, performed India’s first successful heart transplant. Since then, the programme’s expansion has involved medical advances as well as the development of hospital networks and allocation systems.
The organs used in transplantation come from living and deceased donors, depending on the organ being transplanted. Some organs, such as kidneys and the liver, can be transplanted from both living and deceased donors. However, other organs, including the heart, can only be transplanted from deceased donors. Corneas are tissues and are also donated after death.
The factors that play a role in choosing a donor include the organ, the patient’s condition, the donor’s health and compatibility, and the rules governing donation.
A living donor must undergo a medical assessment to determine whether donation is safe for them and whether the organ is suitable for the recipient. The process includes informed consent and checks required under the law. Donations from close relatives and non-relatives are subject to different procedures and safeguards. These protections matter particularly when a potential donor feels an obligation to a spouse, parent or child. A medically compatible donor must also be free to make a voluntary decision, without coercion. The Transplantation of Human Organs and Tissues Rules, 2014, notified by the Union Health Ministry, establish the applicable legal requirements.
In many cases, a willing donor is medically fit but incompatible with the intended recipient. In such cases, paired or swap donation can help. Two donor-recipient pairs may exchange donors if each donor is a better match for the other recipient. Such arrangements still require medical checks and approval under the applicable laws.
In the case of a deceased donor, donation can take place only after the donor has been declared brain-stem dead, following the prescribed process. The family is approached about donation, and the organs are assessed for suitability. If donation is authorised and the organs are suitable, a retrieval team removes them for allocation to recipients.
According to data released by NOTTO, India relies heavily on living-donor transplants. In 2024 alone, there were 15,505 living-donor transplants, 3,403 deceased-donor transplants and three domino transplants, making a total of 18,911. The separately published 2024 state-wise dataset recorded 15,469 living donors and 1,128 deceased donors.
The number of deceased-donor transplants is higher than the number of deceased donors because a single deceased donor may provide organs for more than one recipient. For example, the kidneys may go to two recipients, while the heart may go to another. Furthermore, not every organ from a donor will be suitable for transplantation. Its suitability depends on clinical assessment, infection screening and the time available for retrieval and transplantation.
The 2025 annual report records 3,526 deceased-donor transplants, up from 3,403 in 2024. Living donation remains a major part of the programme, particularly for kidney and liver transplantation. Deceased donation can extend access to patients who do not have a suitable living donor. However, not all organs from a deceased donor can necessarily be transplanted, as this depends on several factors, including the suitability of the organs and hospitals’ ability to coordinate retrieval and transplantation.
The difference between those giving organs and those receiving them is difficult to ignore. Figures released by NOTTO for 2025 show that women made up 11,316 of the country’s 16,614 living organ donors, or 68%. The remaining 5,298 donors were men. Among living-donor recipients, 12,903 were men and 3,707 were women, approximately 78% and 22% respectively. The gap is especially pronounced in kidney transplantation: 71% of living kidney donors were women, while 77% of recipients were men. Among living liver donors, women accounted for 60%, compared with 21% of recipients.
It is a persistent pattern rather than a one-year anomaly. A review of kidney transplantation data found that women made up 66.2% of living kidney donors during 2019–2023, while women received only about 30% of living-donor kidney transplants. Such comparisons describe the gender of donors and recipients as groups. They cannot, on their own, establish how many women donated directly to men or why particular donation decisions were made.
There is, however, research into what happens inside families. A study published in the Indian Journal of Nephrology examined 1,171 living kidney transplants performed at a North Indian teaching hospital between 2013 and 2022. Women accounted for 79% of donors, while men were 81.5% of recipients. Among the women who donated, mothers and wives were particularly prominent. Interviews with 92 female donors found that 51.8% described social expectations about women’s position in the family as an influence on their decision; 33.2% referred to economic dependence, while 15% identified altruism. Those are findings from one hospital’s interview sample which document pressures that transplant statistics alone cannot capture.
Other Indian research has raised questions about women’s access to treatment as recipients. In a 2024 study of 374 haemodialysis patients at two government-run centres in South India, 19% of women were on the kidney-transplant waiting list, compared with 33% of men. Fewer women also reported planning a transplant, although that particular difference was not statistically significant. Researchers discussed financial, social and healthcare-access barriers as possible contributors, while acknowledging that an observational study at two centres cannot establish national rates or causation. The national donor and recipient totals do not reveal how many women needed transplantation but never reached assessment or registration.
The imbalance also explains why a 2018 transplant at Safdarjung Hospital attracted attention. Rakesh Sharma donated a kidney to his wife, Asha, who had chronic kidney disease and was receiving haemodialysis. After the operation, she was able to walk and return to daily activities. In the original India Today report, Dr Anup Kumar, then head of the kidney transplant department, described women patients who could not find male relatives willing to donate. He estimated that women accounted for 80–85% of living kidney donors in India at the time. It was precisely the unusual direction of the donation that made the case newsworthy.
A more common direction of donation has also been documented at the same hospital. In February 2024, a 28-year-old wife donated a kidney to her 43-year-old husband despite their incompatible blood groups. Doctors used additional treatment before surgery to make the transplant possible.
The concern has reached Parliament. In its 177th report, presented on 7 August 2026, the Parliamentary Standing Committee on Health and Family Welfare recommended that the ministry and NOTTO undertake a comprehensive study of why women are disproportionately living donors and men are disproportionately transplant recipients. It also called for stronger counselling, informed-consent safeguards, gender-disaggregated reporting and more equitable access to kidney transplantation.
The gender distribution is not the same for every type of donation. NOTTO’s 2025 figures recorded 5,298 male living donors and 11,316 female living donors. Men therefore also donate organs while alive but the number is less than half of the women donors.
These figures establish an inequality that deserves attention alongside the number of transplants performed. Living donation has to be safe and genuinely voluntary, and the chance of becoming a recipient should depend on clinical need rather than a patient’s position in the family.
According to the Ministry of Health and Family Welfare, patients requiring organs from deceased donors can register through the hospitals where they are undergoing treatment. The hospital-based registration process connects patients to the national transplant network.
To ensure that the patient is fit for a transplant, the hospital team examines their medical history and current condition. Tests may include blood-group typing, organ-specific investigations, infection screening and an assessment of heart and lung function. Doctors also consider other serious conditions that could affect the procedure or recovery. The evaluation may involve several specialists, as well as a transplant coordinator who helps the patient and their family understand the process and complete the required steps.
The team assessing the patient is responsible for deciding whether transplantation is clinically appropriate and whether the patient is fit enough to undergo surgery and the treatment that follows. A patient is listed for a transplant only once the assessment is complete. The assessment may need to be reviewed if the patient’s condition changes while they wait for an organ.
If a suitable living donor is available, both the donor and the patient are evaluated. If the patient needs a deceased-donor organ, the transplant centre submits the application and supporting records through the relevant state or regional system.
In practical terms, the patient’s route can be summarised as follows:
Patients and their families are responsible for finding out how registration works in their state, what documents are required and how often the patient’s medical information must be updated. The national system provides coordination, but state procedures and allocation rules can differ. Transfers between hospitals or jurisdictions also require the patient to follow the applicable process. Even the process between two hospitals may differ, so patients should not assume that the process followed at one hospital can be carried forward to another.
The patient’s status can change while they wait for an organ. If a temporary medical problem makes surgery unsafe, the centre may need to update the patient’s status. If the patient’s condition becomes urgent, the treating team can report this through the relevant process. The transplant coordinator is often the patient’s main point of contact for questions about records, status and next steps.
For women with organ failure, reaching this stage can itself be a barrier. A 2024 study in two South Indian dialysis centres found a smaller share of women than men on the transplant waiting list. A patient’s ability to obtain a referral, travel for assessment and secure financial or family support may therefore affect access before an organ is ever allocated. This study cannot establish that the same differences apply throughout India.
According to the Ministry of Health and Family Welfare, 89,839 patients were on the waiting list for major-organ transplants as of 3rd March 2026. This is the number of patients recorded in the system at that time. It does not represent every person in India who might medically benefit from a transplant.
To appear on a formal waiting list, a patient must reach a transplant centre, complete the required assessment and be registered under the applicable system. Some people may be medically ineligible, may not have been referred, or may not be able to access a transplant hospital. Therefore, the waiting-list figure reflects registered patients, not the entire population living with organ failure.
Nor does the total reveal how long each person has waited or how their medical status compares with another patient’s. Waiting time varies by organ, blood group, compatibility, medical urgency, location and the number of suitable organs becoming available. A patient waiting for a kidney may continue dialysis. A patient with advanced liver or heart disease may face a different pattern of risk and urgency.
The waiting list also changes over time. Patients may receive transplants, become temporarily unsuitable, move to another centre or be removed from the list for other reasons. The national figure is a snapshot, not a fixed group of people. It should not be divided by annual transplant numbers to calculate an average waiting time, because the two figures do not describe the same cohort or account for new registrations and changes in status. Without comprehensive, gender-disaggregated information on the patients assessed, listed and removed from the lists, the national total also cannot show whether women and men face comparable chances of reaching transplantation.
In March 2026, the Ministry also stated that 217 of 804 registered transplant hospitals had not reported data to the national registry during 2025. The national totals must therefore be read with attention to the reporting date and coverage. A missing hospital report does not, by itself, establish why the data were absent. However, it can affect the completeness of the information available to authorities and the public.
Whoever has waited longest does not automatically get the organ. When an organ becomes available, doctors and allocating authorities first work out which patients could safely receive it and which allocation rules apply.
Blood-group compatibility comes first. For kidneys, tissue matching and crossmatching show how the recipient’s immune system is likely to react. Medical urgency, body size, the patient’s current condition and organ-specific needs all count too.
Kidneys and livers show how different allocation rules can be. The donation hospital may have priority for a suitable recipient; otherwise, an organ can be offered through the state, regional and national networks. Some states use medical scoring, while others place greater emphasis on how long a patient has been registered. Medical urgency and organ-specific eligibility also affect which patient can receive an offer. Hearts and lungs have requirements of their own.
Geography matters because organs can remain viable for only a limited period after retrieval, and that period varies by organ. Allocating organs locally where medically appropriate can help limit the time they spend without blood supply, but a suitable offer may move to the state, regional or national network. A match that looks perfect on paper can fall through if the organ cannot reach the hospital in time. State systems differ too: some use points-based medical criteria, while others give greater weight to registration order, according to NOTTO’s director.
Policy sets the order in which patients are offered an organ. The people who carry it out are the allocation authority and the transplant coordinator, working with the receiving hospital’s clinical team, and that team makes the final call on whether to accept the organ. It confirms the organ’s condition and that its patient is still fit for surgery. If it declines, the organ passes to the next eligible patient.
Patients mostly deal with their transplant hospital, not the bodies behind it. Much of the coordination happens between hospitals and government agencies.
At the top is NOTTO, part of the Directorate General of Health Services in the Ministry of Health and Family Welfare and based on the Safdarjung Hospital campus in Delhi. It runs national coordination and the registry, issues guidelines and allocation policy, manages organ sharing, supports training and awareness under the National Organ Transplant Programme, and links regional and state bodies.
Below it are five Regional Organ and Tissue Transplant Organisations (ROTTOs), which help coordinate beyond individual states. They are hosted by PGIMER, Chandigarh (north); Government Medical College, Omandurar Government Estate, Chennai (south); Seth GS Medical College and KEM Hospital, Mumbai (west); the Institute of Post Graduate Medical Education and Research, Kolkata (east); and Gauhati Medical College, Guwahati (north-east).
State and union territory organisations, the SOTTOs, work with hospitals on registration, allocation, data collection and reporting. Arrangements vary. Telangana runs its deceased-donor programme as Jeevandan, with its own guidelines; other states have built different systems, and all are still developing.
Hospitals do different jobs. Some are authorised for particular transplant operations; some retrieve organs or tissue; some run tissue banks. Being part of the network does not mean a hospital can do every transplant, or any.
The network has grown substantially over the years. Earlier figures on the health directorate’s website counted 21 SOTTOs and 865 institutions. In August 2026 the government cited five ROTTOs, 26 SOTTOs and around 1,200 registered hospitals, and the Health Secretary said the network now spans 31 states and union territories. That 1,200 covers facilities with different authorisations; it should not be read as 1,200 transplant hospitals. The March 2026 reply to Parliament referred to 804 hospitals registered for organ transplantation.
For a patient, the layers that the process passes by rarely show on the surface. The transplant centre assesses them and holds their records, state and regional bodies help with allocation where relevant, and NOTTO supports the whole from Delhi.
Coordination depends on current information. Who’s registered, which organs are needed, which facilities can do the procedures. The national transplant registry portal has been running since 2015 and is open to authorised users, including hospitals. It holds hospital-reported transplant activity and waiting-list data, which authorities use for planning and coordination.
That only works if hospitals report. In March 2026 the ministry told Parliament that 217 of 804 registered transplant hospitals had not sent data to the portal for 2025, and that action against such hospitals is for state governments to take under the transplantation law. The reply did not say why they had not reported, and non-reporting is not evidence of illegal transplants or any other offence. It does mean national totals, including registry-based counts, must be interpreted with that reporting gap in mind.
On 3 August 2026, the Minister of State for Health, Anupriya Patel, launched e-Pratyaropan on Indian Organ Donation Day, along with a NOTTO mobile app and a year-long awareness campaign called Jug Jug Jiyo Abhiyaan. The platform is meant to join hospitals, doctors, donors, recipients and transplant authorities in one system for registration, waiting-list management, allocation and monitoring. The government explained the platform’s intended functions during the launch, but did not say how many hospitals were using it at the time. Its value will depend on the rollout and on whether hospitals keep their records accurate. Software cannot supply returns that were never filed or replace the surgeons.
Families start paying long before the operation and the cost may include consultations, tests, continuing treatment and dialysis for kidney patients who are waiting. A living donor has their own assessment. A complication means more visits and more bills. The cost of time away from paid work or unpaid family care may also influence who in a household comes forward to donate, a concern identified in Indian research on gender and living kidney donation.
The surgical bill is only part of it. It can include surgeons’ and anaesthetists’ fees, theatre time, intensive care, medicines, consumables and the hospital stay, plus the donor’s care in a living-donor case. Rates differ by organ, hospital and city. The CGHS rates quoted in a December 2024 Lok Sabha reply run from roughly Rs 2 lakh for a related-donor kidney transplant to Rs 25 lakh for lungs, and the ministry said actual costs vary from hospital to hospital. Published prices from private hospitals are not always directly comparable because the treatment packages and exclusions differ. An advertised package is rarely the final figure, so ask for a written estimate that lists what’s included and what’s billed separately.
Costs carry on after discharge. Immunosuppressants, tests and consultations continue, and the amount spent on lifelong immunosuppression can be substantial, depending on the medicines prescribed and what the patient’s scheme or insurer covers. A rejection episode or an infection can mean readmission.
Government help exists, with conditions. Ayushman Bharat PM-JAY includes kidney transplantation in its health benefit package, subject to the scheme’s rules; families should check that the procedure and the hospital are covered. The Rashtriya Arogya Nidhi can give one-time help of up to Rs 15 lakh to eligible poor patients with specified life-threatening diseases, including certain heart, kidney and liver conditions, if they’re treated at a government hospital or institute with super-speciality facilities. A July 2026 government reply also described assistance of up to Rs 1.25 lakh under the Health Minister’s Discretionary Grant. CGHS and state schemes may cover eligible beneficiaries. None of these is automatic, and none covers every patient or every expense.
The hospital’s social-work or patient-assistance department can say which schemes might apply and what papers they want. It’s worth asking early.
Transplant surgery is limited to hospitals authorised for the specific procedure, with specialist surgeons, intensive care, diagnostics and the capacity to follow patients after discharge. India has both government and private transplant hospitals, and what each offers varies.
Government institutions include AIIMS New Delhi, PGIMER Chandigarh and state teaching hospitals. In August 2026, the ministry said ten AIIMS institutions besides New Delhi were offering kidney transplants, with liver transplants at AIIMS Jodhpur, Bhubaneswar, Patna and Rishikesh, and heart transplants at AIIMS Bhopal.
Private hospitals do a large share of the work. A December 2024 parliamentary reply, covering states and union territories that provided a public-private breakdown for 2023, recorded 10,701 procedures in private hospitals and 2,151 in government hospitals. These are figures for the reporting jurisdictions, not a complete nationwide division. A hospital that does one kind of transplant may not do another, and patients sometimes travel to a different city or state to find the right team.
The choice is not just public versus private. Cost, waiting-list arrangements, available programmes, insurance or scheme eligibility, and whether follow-up is manageable from a smaller town all matter. A private hospital is not automatically better, and a government one is not automatically worse. Before registering, patients should confirm the centre is authorised for the organ they need and ask how it handles allocation and aftercare.
Transplants are spread unevenly, which is not surprising for a system that needs trained teams, intensive care, reliable diagnostics and organised donor identification. States built those at different speeds.
NOTTO’s 2024 state data show the gap. Maharashtra recorded 2,073 transplants, Kerala 1,504, Karnataka 786 and Andhra Pradesh 481. Assam recorded 71 and Bihar 31. Those are raw totals of procedures reported in each state, not rates per head of population, and they do not say where recipients lived. Delhi shows why. NOTTO’s 2023 report counted 4,426 transplants there, with foreign nationals accounting for more than 32%.
Living and deceased donation split differently. Delhi-NCR, Tamil Nadu, Maharashtra, Kerala and West Bengal were the top five states for living-donor transplants in 2024. Deceased donation is far more concentrated: of 1,099 deceased donors in 2023, 902 came from five states: Telangana (252), Tamil Nadu and Karnataka (178 each), Maharashtra (148) and Gujarat (146). Uttar Pradesh recorded three and Odisha three. In 2024, Maharashtra had 172 deceased donors and Kerala 11, yet Kerala did 1,504 transplants, so most of its work is living-donor surgery.
Rates tell a different story from counts. Researchers have noted that India’s deceased-donation rate has stayed below one donor per million people for over a decade. A small state can post a high rate on a modest count: Telangana’s 252 donors in 2023 came from a population roughly half of Tamil Nadu’s, which gives it a much higher rate than Tamil Nadu’s 178.
Patients move, too. They go to Delhi, Chennai, Hyderabad, Mumbai or Chandigarh for specialist teams, and that means rent, fares and time off work, more so when the hospital wants them nearby for weeks after surgery. Since the 2023 change, a patient can register wherever they’re treated. Not everyone from a state with few centres is shut out; many make the journey.
Tamil Nadu is the case worth watching. In August 2026, the government recognised it for the highest number of deceased organ donors. Its count dropped to a low of 60 in 2021 and recovered to 268 in 2024, its best in a decade. Finding potential donors, supporting families through consent and coordinating retrieval take organised effort across many hospitals, which is what the recognition points to.
None of this makes a state’s total a ranking of its healthcare. Population, the types of transplant, available centres, donor patterns and patient movement all have to be weighed, and incomplete reporting muddies comparisons further.
Through the National Organ Transplant Programme, the government pays for infrastructure, training, coordination and awareness. Expansion matters most where patients now travel long distances to reach a centre. Adding services at AIIMS institutions is part of it, though opening a programme is only the start; the hospital also needs specialists, intensive care, diagnostics and the capacity for long-term follow-up.
Public participation matters for deceased donation. By August 2026, more than five lakh Aadhaar-verified donation pledges had been recorded since the national digital pledge portal opened in 2023. A pledge helps make a person’s wishes known to their relatives, but it is not a donation. Medical conditions, legal requirements and the conversation with the family still have to be dealt with when the time comes, and a recorded pledge is not the same as an actual deceased donor. India recorded 1,128 of those in 2024.
The same August event brought e-Pratyaropan, the NOTTO app and the Jug Jug Jiyo campaign, and the government also announced guidelines on brain-stem death certification and swap transplantation. Their value will show in how reliably hospitals and coordinating bodies use them.
The operation is the most visible stage, but recovery and long-term treatment matter as much. Doctors monitor the new organ in hospital, watch for complications and decide when the patient can go home. After discharge come medicines, blood tests and follow-up visits. Immunosuppressants lower the risk of rejection but weaken the body’s defences, so doctors also watch for infections and side effects, and patients are told which symptoms need quick attention. Recovery varies with the organ, the patient’s condition beforehand and any complications. Living donors need follow-up as well, even when their own recovery is smooth. How long a transplanted organ lasts differs from one organ to another, and this article makes no general claim about survival.
Ganga and Kamlesh Verma’s experience shows one route through the transplant system: advanced kidney disease, a suitable living donor within the family and a government hospital able to perform the operation. Her decision also sits within a national pattern in which women give most living-donor organs and men receive most of them, a disparity that requires scrutiny without questioning the voluntariness of any individual donor’s decision. Other patients have no suitable family donor and must rely on assessment, registration and the chance that an appropriate deceased-donor organ becomes available.
India now performs more than 20,000 transplants a year, about four times the 2013 level, through a structure that runs from NOTTO in Delhi through five regional bodies and 26 state ones to the hospitals. Living donation still carries most of the load; deceased donation has grown, but not faster than the whole. Government schemes and public hospitals are widening access, but cost, travel, gender-related barriers and uneven reporting still shape what happens to an individual patient. The waiting list is the plainest sign that the supply of suitable organs has not caught up.
For someone on that list, the system is not a statistic. It’s a centre that can assess and treat them, an accurate place in the registration process, continuing care and, in the end, an organ that suits their condition. For patients without a living donor, all of that depends on someone else’s death and a family’s decision.
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