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Organ and tissue transplantation suffers from a large gap in supply and demand, with less than 10 percent of annual demand being met globally. In India, the problem is exacerbated by persistently anaemic organ donation rates, although the numbers have more than doubled—albeit, from a low base—since 2014, when the National Organ and Tissue Transplant Organisation (NOTTO) was set up. Until recently, analysis was hampered by the lack of comprehe
India’s organ transplant shortfall is often attributed to a lack of public willingness; yet the constraints lie within the system itself. To begin with, conflicting definitions of ‘death’ across legislations create uncertainty for certifying brainstem death. The pathways that could widen the donor pool—donation after circulatory death and expanded-criteria donors—remain unused due to the absence of national clinical guidance. Reporting
