Pledges Rise, But Organ Donors Remain Scarce

For someone who has received a donated organ, life after transplantation is a second chance. For thousands still waiting, however, that chance remains uncertain.

This gap was brought into focus as Vice-President C. P. Radhakrishnan inaugurated the National Organ Transplant Games 2026 at Talkatora Stadium in Delhi on Monday, calling organ donation a “Mahadaan” and urging people to overcome myths and misconceptions surrounding the life-saving act.

Describing the Games as a celebration of courage, determination and compassion, he said organ donation could keep hope alive even in the face of personal loss.

In a symbolic display of the strength and resilience of transplant recipients, 570 recipients and donors performed Tadasana together, setting a record for the largest congregation of transplant recipients and donors performing the yoga posture.

But beyond the celebrations, the challenge facing India remains formidable: how to ensure that more people who need transplants actually receive organs.

According to the National Organ and Tissue Transplant Organization (NOTTO), India performed 20,138 organ transplants in 2025, the highest annual number recorded in the country. The number has risen nearly fourfold from 4,990 in 2013. India ranks third globally in the total number of transplants and leads in living-donor transplantation.

However, only 3,526 of the transplants performed in 2025 used organs from deceased donors. The rest largely depended on living donors. Deceased-donor transplants account for around 18% of the country's total, highlighting how heavily India's transplant programme continues to rely on living donation.

The shortage is reflected in the waiting list. According to a Union Health Ministry reply in the Rajya Sabha recently, 89,839 people were waiting for major organ transplants as of March 3, 2026. The government has also reported that more than five lakh citizens have registered pledges to donate organs and tissues after death through the Aadhaar-verified system.

While the rise in pledges is encouraging, registration alone does not translate into an organ donation. In the case of deceased donation, identifying a medically suitable donor, certifying brain-stem death, counselling the family, obtaining consent and coordinating retrieval and transport all have to happen within a limited period.

A recent study published online on September 30, 2026, in the Indian Journal of Medical Research has examined precisely these challenges. Titled ‘Trends and determinants of organ and tissue donation at a level I trauma centre in north India (2022-2025)’, it was conducted by researchers from the Jai Prakash Narayan Apex Trauma Centre at AIIMS, New Delhi.

The team, including Dr Venencia Albert, Dr Vineeta Sharma, Dr Sunaina Rawat, Dr Jengmailiu Gengmei, Dr Navid Iqbal and Dr Deepak Agrawal, analysed the organ donation pathway at the trauma centre over four years.

Of 1,575 deaths recorded in the intensive care units and emergency department, 805 cases were identified as potential organ donors. However, only 148 progressed to a formal brain-stem death declaration. Families consented to donation in 47 cases, and 43 patients eventually became donors.

The overall donor conversion rate was 29%. More concerning, it declined from 39.5% in 2022 to 16.1% in 2025, despite efforts to identify more potential donors.

The study identified medical instability as the leading reason why potential donors could not proceed to donation. Family refusal was the major reason for non-conversion after the brain-stem death declaration. The researchers also noted that social and cultural factors, family disagreements and emotional distress influenced decisions.

The findings underline that public awareness campaigns, though important, cannot address the entire problem. Hospitals need stronger systems to identify potential donors early, maintain their medical stability, ensure timely brain-death certification and provide sensitive counselling to families.

The study also found that 187 organs and tissues were retrieved from 43 donors, with an average yield of 4.35 organs and tissues per donor. It is a single-centre audit and cannot be treated as a national estimate, but it provides a close look at where the donation process can break down.

Another Indian study, published in the Journal of Family Medicine and Primary Care last November, examined the experiences of families approached for deceased organ donation at a public hospital in North India.

Titled ‘The gift of life: Understanding the experiences of organ donor families’, the study by Dr Parul Gupta, Dr Vijay Kumar Tadia and Dr Vipin Koushal of PGIMER, Chandigarh, found that 78% of the decision-makers interviewed felt they did not have sufficient knowledge about organ donation to make an informed decision.

After being informed of brain death, 15% were confused about the concept, while only 32% had accepted brain death as death. The researchers highlighted the importance of building trust and explaining brain death and the donation process clearly to families.

This is particularly relevant in India, where organ donation decisions are often taken collectively, with several family members involved. A family may be confronted with the sudden loss of a loved one and, at the same time, asked to consider donating organs. Without clear communication and adequate time to understand the medical situation, the decision can become even more difficult.

The findings point to the need for trained transplant coordinators and sensitive counselling in public hospitals, where many potential donors are identified.

The National Organ Transplant Games was organised by the Renal Care Foundation, Sir Ganga Ram Hospital, Delhi and NOTTO under the Union Health Ministry, aimed to take this message beyond hospitals and medical institutions through sporting events.

Union Minister of State for Health and Family Welfare Prataprao Jadhav, Lok Sabha MP Bansuri Swaraj, Sir Ganga Ram Trust Society chairman Dr D S Rana, organising chairman of the Games Dr A K Bhalla and NOTTO director Dr Anil Kumar were among those present.