A Decade of Progress in Organ Transplantation in India: National Trends and Growth Patterns (2015–2024)

Introduction: Organ transplantation in India has shown notable progress over the past decade, supported by evolving policy frameworks and strengthened national coordination. Earlier studies have highlighted the important role of living donation alongside the gradual development of deceased donation systems under the Transplantation of Human Organs and Tissues Act (THOTA) and the National Organ and Tissue Transplant Organisation (NOTTO). Evaluating national trends over time is essential to understand system growth, emerging patterns, and opportunities for further strengthening. This study examines trends in organ donation and transplantation in India from 2015 to 2024.
Methods: A retrospective analysis was conducted using national transplant registry data. Data sources included the Global Observatory on Donation and Transplantation (GODT) and NOTTO annual reports. Key outcome measures included total transplant volume, trends in living and deceased donation, organ-wise distribution, Annual Percent Change (APC), and contributions to overall system expansion.
Results: Total organ transplants increased from 8,348 in 2015 to 18,911 in 2024, representing an overall increase of 126.5%. Year-on-year analysis demonstrated variable growth, with moderate increases between 2015 and 2018 (APC range: +5.7% to +8.4%), followed by a rise in 2019 (+22.5%).
A substantial decline was observed in 2020 during the COVID-19 pandemic (−41.2%), followed by a strong rebound in 2021 (+64.7%) and continued growth in subsequent years (2023: +14.6%; 2024: +2.9%) [Figure 1 depicts the trend in total organ transplants in India with APC].

Deceased donor transplantation increased from 1,659 in 2015 to 3,403 in 2024, reflecting an overall increase of 105% [Figure 2 depicts the deceased donors and deceased donor transplants per million population].

Kidney and liver transplants constituted the predominant procedures, accounting for approximately 75% and 23%, respectively, across the study period — with liver's proportional share rising progressively to 26% by 2024.
A temporary decline in transplant activity was observed in 2020 during the COVID-19 pandemic, followed by strong recovery and continued upward trends. Policy advancements, reforms and national coordination mechanisms have supported steady improvements in system performance.
Conclusion: India has achieved substantial expansion in organ transplantation through coordinated policy efforts and institutional strengthening. Both living and deceased donation pathways have contributed to this progress, with encouraging growth in deceased donation systems. Continued focus on enhancing intensive care-based identification, strengthening governance frameworks, and expanding public engagement can further accelerate progress toward a sustainable, accessible, and equitable transplantation ecosystem.