The burden of kidney transplants in India is still growing at a rate far exceeding the availability of donor organs. Nearly 1.75 to 2.5 lakh Indians require a kidney transplant every year, according to estimates. But only 13,000 to 15,000 kidney transplants are done each year. India performed 13,476 kidney transplants in 2024, of which 11,558 were from living donors and only 1,918 from deceased donors.
The problem is further compounded by India's low rate of organ donation, at about 0.77 to 0.81 per million population, still well below one donor per million. While the country ranks third globally in total raw transplant volume, it relies heavily on living rather than deceased donors. Therefore, thousands of patients are left dependent on lifelong dialysis or die awaiting a suitable donor organ. While medical advances have made transplantation highly successful, myths and misconceptions surrounding organ donation continue to discourage many families from consenting to organ donation.
Another mistaken idea is that if you are a registered organ donor, doctors might not try their best to save you. In reality, organ donation is offered only after all life-saving measures have failed and brain death has been declared according to strict medical and legal criteria, hence the name deceased donor. The treating team and the transplant team function independently, and the transplant team is not involved in brain death declaration to ensure transparency and ethical practice.
Brain death is the complete and irreversible loss of all brain function and is legally recognized as death in India. Although the heartbeat may continue temporarily because of ventilator support, patients declared brain dead cannot recover. Improving deceased organ donation rates requires raising public awareness of brain death.
Another common argument against organ donation is religious convictions. However, most major religions encourage acts of charity, compassion, and organ donation in saving human lives.
Some individuals worry that organ donation will cause the body to become deformed or interfere with customary funeral customs. Organ retrieval is a surgical process carried out by qualified specialists with respect and dignity. Following the meticulous reconstruction of the body, families are free to carry out their traditional funeral customs.
Age is another misconception that prevents many individuals from pledging their organs. There is no age limit for organ donation. The suitability depends on the medical condition of the organ. Older people can still donate organs or tissues, which can greatly improve or save lives.
Families are often deterred by worries about organ trafficking and misuse. India's organ transplant program is governed by stringent legal and regulatory structures. In Karnataka, the State Organ and Tissue Transplant Organization (SOTTO) is called Jeevasarthakathe. This government body oversees the implementation of the Transplantation of Human Organs Act and maintains a transparent, state-wide transplant waiting list and manages organ allocation.
Perhaps the greatest barrier remains the lack of conversations within families. Even when individuals support organ donation, their wishes are often unknown to loved ones at the time of brain death when organ donation decisions need to be taken. Open communication about organ donation might make families feel better prepared and self-assured in emotionally taxing circumstances.
With informed conversations, India can bridge its transplant gap and offer hope to the thousands of patients waiting for their second chance at life.
The author is consultant – nephrology, transplant physician at Manipal Hospital Old Airport Road.
