Maharashtra is currently leading the way in organ donation pledges in India, while Delhi lags behind in utilizing the digital registry for organ donation. Since the launch of India's digital organ donation registry on September 17, 2023, over 4.54 lakh pledges have been registered. The data reveals a significant disparity among states, with a few leading the charge and others falling behind.
Maharashtra tops the list with 111,815 digital pledges, followed by Rajasthan (91,043) and Karnataka (52,304). This trend is attributed to a combination of factors, including awareness, cultural attitudes, and local engagement. In contrast, Delhi, despite being a major medical hub, ranks 15th with only 5,506 pledges.
According to officials, the reason for Delhi's lower numbers is that pledges are linked to Aadhaar, and the pledges are counted in the donor's home state. Many Delhi residents originate from Uttar Pradesh, Haryana, and other states, so their pledges are added to those states' tallies. Other states with notable numbers of pledges include Gujarat (41,400), Madhya Pradesh (24,215), Telangana (16,132), Tamil Nadu (14,522), Uttar Pradesh (14,020), Andhra Pradesh (9,919), and Kerala (9,792).
Maharashtra's success in organ donation pledges is partly attributed to its strong culture of voluntary blood donation, reflecting a more open and compassionate attitude toward donation. Age trends indicate that the 30-35 age group leads in registrations with 195,556 pledges, likely due to a combination of maturity, awareness, and a better understanding of the issue. However, younger adults (18-30) are also significantly involved, with 135,728 pledges. Officials believe that the youth are career-focused but highly motivated to donate when engaged effectively. The gender gap is also narrowing, with 244,236 male pledgers and 207,749 female pledgers, a difference smaller than expected.
The Government of India is actively working to promote organ donation through the National Organ Transplant Program (NOTP). The program aims to enhance access to transplants, improve awareness, and augment infrastructure, especially in government institutions. As part of this initiative, the National Human Organs and Tissues Removal and Storage Network has been established, comprising the National Organ and Tissue Transplant Organisation (NOTTO) at the national level, five Regional Organ and Tissue Transplant Organisations (ROTTO), and 25 State Organ and Tissue Transplant Organisations (SOTTO).
Despite the progress, India's organ donation rate remains low, at less than one per million population. This contrasts sharply with Spain, which has the highest rate in the world at around 48 per million. To address this, the government is implementing various strategies, including awareness campaigns and streamlining the donation process.
While Maharashtra has shown significant progress in deceased organ donation, the waiting list for organs continues to grow, with 8,600 people waiting for an organ in 2024, compared to 7,736 in 2023. The majority of those on the waiting list require a kidney (6,840) or a liver (1,533).
Experts emphasize the importance of increasing deceased donations to address the long waiting lists. They also suggest that accepting donations after cardiac arrest, in addition to brain death, could significantly expand the donor pool.
