India’s organ transplant paradox: women donate the most and receive the least

Women in India donate nearly twice as many organs as men, yet men are more likely to be recipients. Rupsa Chakraborty asks why The National Organ and Tissue Transplant Organization (Notto), India’s apex government body overseeing organ donations, says that 63.8% of all living organ donors from 2019 to 2023—mostly liver and kidneys—were women. Yet men received the majority of donated organs, accounting for 69.8% of the recipients. A BMJ analysis of the data reveals deep rooted gender inequalities pervading India’s health systems and societal attitudes to women’s health. The underlying causes of this paradox include sociocultural factors, economic dependence, and healthcare attitudes and practices, requiring a holistic approach. In the past five years women made 36 038 of the 56 509 living organ donations in India, yet only 17 041 were transplanted into women, while 39 447 went to men (box 1). This means that men received organs at about 2.3 times the rate of women (fig 1), despite women donating nearly twice as many. Every 100 male donors benefited around 192.71 male recipients, whereas every 100 female donors benefited only around 47 female recipients. Box 1 ### Tracking gender inequalities—a year-by-year data insight The BMJ looked at data procured from India’s National Organ and Tissue Transplant Organization (Notto) over five years, providing a detailed analysis of living organ donation trends from 2019 to 2023. In 2019 there were 6717 female donors (accounting for 63% of all donations) and 3891 male donors. However, only 2891 women (27%) were organ recipients. In 2020, women comprised 65% of the 6461 total donations, but the number of female recipients dropped to 1773 (27%). This trend continued in 2021, as women contributed 7012 (66%) of 10 646 total donations. However, only 2676 women received organs, lowering the percentage of female recipients to 25%. In 2022, female donors made up 8338 (62.45%) of 13 351 donations, and the percentage … RETURN TO TEXT