Editorial: Promote organ donation

The Government of India’s move directing hospitals to form organ and tissue donation teams in ICUs is timely and long overdue, given the country’s dismal donation rate

Despite decades of public awareness drives, organ donation in India has remained at a very low level. Apart from infrastructure challenges and regulatory limitations, cultural practices and social stigmas have been the major hurdles in promoting organ donation to save lives. As a result, the country is unable to bridge the wide gap between the number of patients in need of organs and the availability of donors. India’s organ donation rate is just 0.9 donors per million people, compared to over 30 per million in countries like Spain. This mismatch leads to lakhs of patients dying each year waiting in vain for transplants that never occur, even as many viable organs go unused. India recorded nearly 18,900 organ transplants in 2024, driven mainly by living-donor kidney transplants, while deceased donations remain a small fraction. Against this backdrop, the Centre’s directive asking all hospitals in the States and Union Territories to establish organ and tissue donation teams in their Intensive Care Units is both timely and overdue. The National Organ and Tissue Transplant Organisation (NOTTO), under the Ministry of Health, has now urged every hospital to form a dedicated team comprising brain-stem death committee members and counsellors to assist families through the process. This is a necessary step because many potential donations are lost due to a lack of timely counselling, awareness, and coordination. Often, by the time grief-stricken families are approached, the window for organ or tissue retrieval has closed irreversibly. Of over 1.8 lakh renal failure cases reported annually, only 6,000 transplants occur, with a donation rate under 1 per million against a need for 65 per million.

India requires nearly one lakh corneas annually, yet only about one-third of this demand is being met. Unfortunately, many hospitals, especially in smaller towns, lack transplant coordinators, trained ICU staff, and even the basic infrastructure to preserve and transport organs. Without substantial investment in training, logistics, and incentives, the Centre’s mandate may remain on paper. Equally important is public trust. Myths, fear, and misinformation still surround the idea of organ donation. Awareness campaigns must shift from token observances to sustained, empathetic outreach that normalises donation as an act of compassion, not sacrifice. The new directive is a good beginning, but it must evolve into a coordinated national effort, one that blends policy with empathy, logistics with humanity. A single donor has the potential to save nine lives. Tissues such as corneas, skin, bones, and heart valves can be harvested from brain-stem-death cases, cardiovascular deaths in hospitals, or natural deaths, typically within 10 hours post-mortem. Steps must be taken to promote public awareness about the importance of bone donation in treating trauma patients, congenital abnormalities, and other bone-related disorders. There is a need to standardise organ and tissue donation practices across the country, improve counselling for families, and enhance the overall availability of lifesaving transplants.

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