Inside India's Expanding Organ Transplant System: Steps, Costs and Challenges

A patient with advanced organ failure begins the transplant journey at a certified centre, where doctors review medical history, conduct tests and rule out contraindications before deciding eligibility. The compiled information is then submitted to NOTTO, which verifies the case and adds the patient to a national waiting list that prioritises based on medical criteria such as MELD scores for liver or mechanical support for heart.

Once a donor organ is identified—either from a living donor or a brain-stem-death donor—the transplant coordinator secures family consent, confirms blood-type compatibility and initiates a tightly timed transport chain. Surgical teams harvest the organ, preserve it, and deliver it to the recipient hospital, where the patient is re-evaluated and prepared for immediate surgery. Post-transplant care involves costly surgery (Rs 10 lakh-Rs 35 lakh) and ongoing immunosuppressive therapy costing Rs 15,000-Rs 30,000 per month, with long-term risks such as rejection and infections. Although 2025 saw almost 20,000 transplants and over 1,200 families donating after death, the shortage of deceased donors means many registered patients still wait years for an organ.