Living versus deceased donor transplantation

A living donor gives an organ or part of one while alive — in India this is overwhelmingly a kidney or part of a liver, and almost always within a family. Deceased donation uses organs retrieved after brain stem death or circulatory death, subject to medical and legal certification. The distinction explains an apparent paradox in India's figures: the country ranks first in the world in living donor transplants but has a low deceased donation rate. Living donation depends on a willing relative; deceased donation depends on an entire chain working under time pressure — brain death being certified, the family consenting, an organ retrieval team reaching the hospital, and a matched recipient being found and reached before the organ becomes unusable. Only a national system can make that chain work, which is why deceased donation is the true measure of a country's transplant infrastructure. Tamil Nadu's lead in deceased donation, rather than its transplant total, is the significant statistic in this report.