Organ Transplantation in India

23.06.2025

Organ Transplantation in India

Context

A report released by the Union Health & Family Welfare Ministry highlighted pressing challenges in India’s organ transplantation system, urging urgent reforms for accessibility and transparency.

About the News

• Report by the Union Health Ministry flagged issues in organ transplant infrastructure.
• Shortage of organs despite rising demand across states.
• Financial burden remains a barrier for patients post-transplant.
• National body NOTTO manages the transplant system in India.

Types of Organ Donation

Organ donation in India is broadly classified into two major categories: Living Organ Donation and Deceased Organ Donation. Each follows distinct medical and legal protocols, as outlined under the Transplantation of Human Organs and Tissues Act, 1994.

1. Living Organ Donation

• In this form, a healthy individual voluntarily donates an organ while alive.
• Typically done for organs where survival with one part is medically possible — most commonly:
  • Kidney (as humans can live with one kidney)
  • Liver (as it can regenerate after partial removal)
• Donors are usually classified into:
  • Near relatives – including parents, siblings, spouse, children, etc.
  • Other than near relatives – such as friends, in-laws, or altruistic donors (with appropriate approvals).
     
• Requires rigorous medical, psychological, and legal screening to rule out coercion or financial transactions.
   

2. Deceased Organ Donation

• This occurs when organs are donated after death, specifically following a declaration of brain stem death.
• Brain stem death is diagnosed when:
  • There is irreversible loss of consciousness,
  • Absence of brain stem reflexes,
  • Permanent cessation of independent breathing.
• A panel of authorized doctors must certify brain death as per legal guidelines.
• Vital organs such as the heart, lungs, liver, kidneys, pancreas, and intestines can be retrieved for transplantation.
• In India, donation is legally permitted only after brain stem death, not cardiac death.
   

Legal Framework in India

• Governed by the Transplantation of Human Organs and Tissues Act, 1994, amended in 2011.
• Consent from family or next of kin is essential for deceased donation.
• Brain death declaration must be carried out by a medical board, typically involving:
  • A neurologist/neurosurgeon,
  • Treating doctor,
  • Independent medical administrator.

Ethical Safeguards

• Commercial dealings in organs are strictly prohibited.
• Every donor and recipient must be registered through official channels, such as:
  • NOTTO – National Organ and Tissue Transplant Organization,
  • ROTTO – Regional-level counterpart.
     

Challenges in India

• Low awareness among people limits deceased donations.
   Example: Urban hospitals report reluctance in family consent after brain death.
• ICU shortages delay organ retrieval and preservation.
   Example: Rural hospitals lack ventilator support for brain-dead donors.
• Post-transplant care is unaffordable for poor patients.
   Example: Immunosuppressants cost over ₹10,000/month.
• Illegal organ trade persists despite the legal framework.
   Example: Recent media reports expose black market rackets

Way Forward

• Mass campaigns to boost public awareness and family consent.
   Example: Tamil Nadu’s ‘Be a Donor’ drive increased cadaver donations.
• Include immunosuppressants under health insurance schemes.
   Example: AB-PMJAY can cover post-transplant medication cost.
• Expand ICU infrastructure in district hospitals.
   Example: CSR funds can help equip ICU beds in public hospitals.
• Digital tracking systems for real-time donor-recipient match.
   Example: NOTTO’s portal can be integrated with state e-hospital networks.

Conclusion

Organ transplantation in India stands at a crossroads. While legal and institutional mechanisms are in place, challenges of affordability, awareness, and infrastructure need urgent attention to make the system equitable and life-saving for all.