Evolution of deceased-donor transplantation in India with decline of commercial transplantation: a lesson for developing countries

The positive impact of a structured deceased-donor program has resulted in a reduction in the number of commercial transplantation operations taking place in India. The engagement of private and government stakeholders has revealed the positive impact of deceased organ donation in India. The best example is the Tamil Nadu state model, where deceased donations have increased to 1.2 per million population compared to the national average of 0.08 per million population. In the last 30 months 994 organs were transplanted. The donation and transplantation in the Government-run hospitals have provided organs to the poor sections of the society free of cost. Immunological surveillance of the prospective recipients remains a challenge, as there is a paucity of immunological laboratories in transplant centers. Generic immunosuppressive drugs manufactured by the local pharmaceutical industry have been shown to be noninferior, and have greatly reduced the cost of achieving immunosuppression.