India performs the world's third-highest number of organ transplants, but meets only a small fraction of the country's actual requirement, according to the first study to assess the country's unmet transplant need, according to a Times Of India by Malathy Iyer.
The study, published in The Lancet Regional Health–Southeast Asia, estimates that India needed close to 3.9 lakh kidney, liver, heart and lung transplants in 2021. This number is projected to rise to 4.63 lakh annually by 2040 as the population ages and chronic diseases become more widespread. At present, only a small proportion of patients who need a transplant actually receive one.
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According to the study, only 7.2% of the kidney transplants required in 2021 were actually performed. The gap was even wider for other organs, with liver transplants meeting just 1.5% of need, lungs 1.2%, and heart transplants only 0.2%, TOI reported citing the study's authors.
Dr Manish R Balwani, secretary of the Indian Society of Organ Transplantation (ISOT) and one of the study's authors, was quoted as saying that India's high transplant numbers do not reflect the true scale of unmet demand, since the size of the waiting list is not captured. He said the study aimed to convert everyday clinical observations into data that policymakers could act on, pointing to how registries in the US and Europe track exact waiting-list numbers.
Using Global Burden of Disease estimates, transplant registry data and demographic projections, researchers found that in 2021, around 1.26 lakh patients in India needed kidney transplants, 1.85 lakh needed liver transplants, 83,841 needed heart transplants, and 11,253 needed lung transplants. By 2040, this demand is projected to grow to 1.44 lakh kidney, 2.11 lakh liver, 95,711 heart and 12,846 lung transplants annually.
Dr Vatsala Trivedi, who performed India's first cadaveric kidney transplant in 1997 after the Transplantation of Human Organs Act came into force, told TOI that there is a clear gap between the demand and supply of organs in the country. Trivedi, who was not part of the study, said there is a need to strengthen solid organ transplant services through policies based on data rather than assumptions.
The study also found that India's need for liver transplants is higher than its need for kidney transplants, a pattern that differs from most Western countries and reflects the country's rising burden of chronic liver disease.
Geographical disparities also emerged as a key finding. Maharashtra, Tamil Nadu, Delhi-NCR, Kerala and Telangana together account for 80-96% of India's transplant activity, even though these states make up only about 29% of the country's population. Dr Vivek B Kute, ISOT treasurer and study co-author, told TOI that this geographic concentration was among the most striking findings, noting that outcomes for organ failure patients vary sharply depending on location.
The study further found that India's transplant programme remains heavily dependent on living donors, with about 82% of transplants involving a living family donor. It also flagged a gender gap in access: women account for a large share of living organ donors but receive proportionately fewer transplants. According to Dr Kute, women make up nearly half of the disease burden but received only 36.8% of kidney, 30.4% of liver and 23.5% of heart transplants performed.
With inputs from TOI
