The highest demand is for O (2,516) and B (2,132) blood groups, underscoring a stark gap between patients awaiting transplants and available organs—even in Tamil Nadu’s acclaimed transplant system
Published Aug 03, 2025 | 3:17 PM ⚊ Updated Aug 03, 2025 | 3:17 PM
Representative image of kidneys.
Synopsis: Tamil Nadu recorded 1,796 kidney transplants in 2024 — the second-highest in India — reflecting its robust transplant ecosystem. However, a kidney trafficking case in Namakkal has exposed regulatory lapses. The Health Department has since suspended two private hospitals’ transplant licenses and launched statewide inspections, raising concerns over donor welfare and post-operative oversight
Tamil Nadu reported 1,796 kidney transplants in 2024, the second-highest in the country, according to data tabled in the Lok Sabha this July. But even as the numbers reflect the state’s longstanding emphasis on transplantation, a recent kidney trafficking case in Namakkal has brought renewed scrutiny to gaps in regulation and oversight.
Following the probe, the Health Department suspended the transplant licenses of two private hospitals in other parts of Tamil Nadu and launched inspections across multiple transplant centres.
The developments come at a time when Tamil Nadu’s transplant model, often cited for its system-led approach and institutional infrastructure. The system now faces questions it has long left unaddressed. Doctors warn that while the focus has been on expanding surgeries, little attention is paid to what happens to donors afterward, especially those from outside the family.
In parallel, data from the state’s Transplant Authority (TRANSTAN), shows that more than 6000 of patients remain on waiting lists for kidney transplants, even as live donor surgeries continue to dominate. The case opens up a larger conversation: who gets to donate, who gets left behind, and what protections exist for either.
The TRANSTAN data reveals the sheer magnitude of the state’s kidney transplant crisis. Currently, 6,164 patients remain on the active waiting list for various organ transplants, that is more than three times the number of transplants performed in the state last year.
The highest demand is among those with O blood group (2,516) and B blood group (2,132). These figures highlight a significant mismatch between the number of patients in need and the availability of organs, even in a state which is celebrated for its transplant success.
Even though the waiting list is far leaner for other organs, it still contributes to the current gap. 416 patients await liver transplants, 29 for hearts, and 31 for lungs. While the requests for combined heart-lung transplants and pancreas remain as single digits, the overwhelming burden is in the renal space, exposing a chronic gap between need and access.
Speaking to South First, Dr. Sundar Sankaran, Program Director at the Aster Institute of Renal Transplantation, said the state’s public acceptance of organ donation is strong, and the cadaver transplant system is “probably the best in the country.”
Yet despite these achievements, a large number of patients continue to wait for a kidney transplant and the circumstances around living donors, especially poor ones, raise urgent questions about fairness and protection.
For those who donate kidneys outside their families, known as altruistic donors, the situation is particularly grim. “There’s no support from the government. Not even for their health needs. Not even a free consultation or checkup. Nothing at all,” Dr. Sankaran said.
Within families, the donation may come with emotional compensation and a sense of mutual benefit, like property exchange or other similar arrangements. But when the recipient is a stranger, there is often no formal recognition, no medical insurance, not even an annual health check-up for the donor.
The absence of even basic aftercare creates a powerful disincentive for potential donors. Many end up being completely abandoned after surgery. “They’re not followed up. They’re not cared for. They’re discarded,” Dr. Sankaran said.
He added that once the transplant is done, the donor “vanishes from the system,” with no access to continued medical support or even routine examinations. “If someone is donating a part of their body, the system must at least guarantee lifelong medical checkups, support, and protection.”
Dr. Sankaran does not endorse commercial transplants, but he insists on confronting the social and economic realities that drive people into selling their organs. “There is a truth behind the motivation,” he said, pointing to poverty, debts, school fees, and wedding expenses that push people, often poor, to make irreversible choices under duress. “These are the realities that push people,” even within families, he noted, some donations are made under pressure or obligation, blurring the lines of consent.
Against criticism on commercialisation of the human body, Dr. Sankaran challenged that notion directly. “Just because we regulate and legalise something doesn’t mean we are commercialising the human body,” he said.
Drawing a powerful analogy, he added, “There was a time when people hesitated to sell food for money, it was considered a sin or immoral. But now it’s one of the biggest industries in the world.” In the same way, he argued, providing regulated frameworks for organ donation is about acknowledging need, not about reducing humanity to a price tag.
In his view, the current legal and medical framework forces these desperate choices into the shadows. “Only two options exist, either find a matching relative or wait endlessly for a deceased donor organ.” This void gives rise to a dangerous third path: illegal organ trading, with no safety net for donors.
Dr. Sankaran is clear: the system needs to stop pretending these cases do not exist. Instead, he suggests policymakers must ask, “How can we make the process more fair, fast and safer for both the recipient and the donor?”
He draws a parallel with surrogacy, which was once entirely banned but later brought under a legal framework that, at least in theory, offers protections. A similar model could be explored for organ donation, not to encourage sales, but to regulate and monitor transplants, ensuring that the donor is never left to suffer in silence. “It’s not about encouraging people to sell, but about protecting the ones who do,” he said.
(Edited by Ananya Rao)
