India performed more than 20,000 organ transplants in 2025, marking a four-fold rise in just over a decade. But with tens of thousands still waiting for kidneys, livers, and other organs, experts say the country needs far greater awareness, deceased donation, and public participation to bridge the gap.
India’s organ transplant programme has recorded a significant milestone, with the country performing 20,138 organ transplants in 2025, the highest number ever recorded. Yet, despite the rapid expansion of transplant infrastructure and expertise, the demand for organs continues to far outstrip supply.
More than 63,000 people are estimated to need kidney transplants, while around 22,000 require liver transplants. For many patients, the wait for a suitable organ can stretch for years, with some dying before a transplant becomes possible.
The latest figures represent a substantial increase from the fewer than 5,000 transplants performed annually a little over a decade ago. Doctors say the growth reflects improvements in transplant infrastructure, surgical expertise, regulation, and coordination between hospitals. But they caution that the numbers represent only a fraction of the country's actual need.
“The rise from under 5,000 transplants a decade ago to over 20,000 last year shows what better infrastructure, awareness, and coordination between hospitals can achieve. However, we are still meeting only a fraction of the actual need. For every patient who receives a transplant, several more remain on the waiting list, and many will not survive the wait,” said Dr Saurabh Singhal, Senior Consultant and Director, Centre for Liver-GI Diseases and Transplantation (CLDT), Aakash Healthcare.
Regulation has improved, but the gap remains
Experts say the growth has also been supported by efforts to strengthen and standardise the transplant ecosystem.
Dr Rohit Gupta, Director, Nephrology and Kidney Transplant, Asian Institute of Medical Sciences, said the progress has been accompanied by stronger regulatory mechanisms, including national guidelines for brain-stem death certification and swap transplantation.
“What is encouraging is that this growth has not happened by accident. It has come alongside stronger regulatory frameworks, like the new national guidelines on brain-stem death certification and swap transplantation. Standardising these processes across states was long overdue, and it is already helping more hospitals run credible transplant programmes,” he said.
The National Brain Stem Death Certification Guidelines and National Guidelines on Swap Transplantation, issued by the Ministry of Health and Family Welfare, seek to address some of the systemic challenges.
Brain-stem death certification is particularly important for deceased organ donation, as organs from such donors can potentially save multiple lives. Swap transplantation, meanwhile, provides an option for living donor-recipient pairs who are medically incompatible: two or more incompatible pairs can be matched so that each recipient receives an organ from a compatible donor.
Myths and misconceptions continue to hold donation back
While infrastructure and regulation are important, doctors say one of the biggest obstacles remains the willingness of families to consent to organ donation.
Religious and cultural misconceptions can sometimes influence these decisions, despite the fact that organ donation is broadly compatible with the principles of major faith traditions practiced in India.
“In our experience counseling families, the hesitation comes from a lack of correct information. Every major faith practised in India supports organ donation as an act of compassion. Once families understand that, the conversation changes completely. We need many more of these conversations happening at the community level, not just in hospitals,” said Dr Bipin Vibhute, Consultant and Program Director, Liver Transplant and HPB Surgery, Jupiter Hospital, Pune.
Experts say awareness campaigns therefore need to move beyond simply asking people to pledge their organs. Families also need to understand what donation entails, when donation is medically possible, and how the process is regulated.
Misconceptions are not limited to deceased donation. Doctors say myths surrounding living donation can also discourage medically eligible people from coming forward.
Concerns about physical health, fertility, and sexual function can be particularly strong among potential male donors and recipients.
“Organ transplantation is not just about extending life; it is about restoring quality of life. For many male patients, a successful transplant can improve energy, hormonal health, and overall sexual function. At the same time, misconceptions that organ donation affects masculinity or reproductive health need to be actively dispelled, as they have no scientific basis,” said Dr Vineet Malhotra, Head of Urology, VNA Hospital.
He said fears around fertility among potential kidney donors were another area where better counselling was needed.
“We often see patients and families worry that donating an organ, particularly a kidney, will compromise fertility. This is not supported by evidence. A healthy donor who is properly evaluated and cleared for surgery does not face reduced fertility as a result of donation. Clearing up this specific fear can meaningfully increase the number of willing living donors,” Malhotra said.
Experts also say women who may be medically suitable for living donation should not be overlooked because of assumptions about their health or family responsibilities.
“From a woman's health standpoint, the biggest gap is simply awareness. Many women who could safely be living donors are never even approached because of assumptions about their health or family responsibilities. That needs to change, and organ donation should be discussed as openly with women as it is with men,” said Dr Archana Dhawan Bajaj, Founder and Director, The Nurture IVF Centre.
Doctors stress that living donation is possible only after rigorous medical and psychological evaluation, and that suitability is determined on an individual basis.
orga
India’s transplant story has therefore become a paradox: the country has developed the expertise and infrastructure to perform an increasing number of complex transplants, but the availability of organs remains the critical bottleneck.
The challenge is particularly acute for patients dependent on deceased donation. Increasing the number of hospitals capable of identifying potential donors, ensuring timely brain-stem death certification, improving coordination with transplant networks, and building public trust are all essential to increasing the donor pool.
“We need sustained public messaging that treats organ donation as routine and not extraordinary, and that directly confronts the myths, religious and otherwise, that keep families from saying yes,” said Singhal.
For patients on transplant waiting lists, the record number of procedures is undoubtedly encouraging. But the larger measure of success, experts say, will be whether India can ensure that fewer patients die waiting for an organ that could have given them a second chance at life.
