<p>Bengaluru: The living donor pool for kidney and liver transplants in India can be increased by 25% by adopting the swap transplantation method, a recent large-scale study published in medical journal ‘The Lancet’ has shown.</p>.<p>This will increase access to transplants for patients who cannot find matching donors locally, and are thus initially matched with a blood group-incompatible donor.</p>.<p>The study, which analysed nearly 1,839 kidney exchange transplants (2000-2024) across 65 centres and 259 liver exchange transplants (2007-2025) across seven centres in India, provides the largest-to-date multi-centre data for living donor transplantation.</p>.<p>ABO (blood group) incompatibility was the biggest reason for those patients choosing exchange or swap transplantation method. There was a notable gender imbalance, with more men being recipients and more women being donors. </p>.<p>In India, less than 10% of end-stage organ failure patients get successful organ transplants.</p>.<p>Cadaver organ donation rates are also relatively low, while living donor transplantation programmes face challenges due to blood group incompatibility and sensitisation.</p>.<p>“Approximately one-third of healthy, willing living donors are incompatible with their intended recipients due to these factors,” noted the study.</p>.<p><strong>Unified platform</strong></p>.<p>Through the study, they are pushing for a unified swap transplant platform for registration and matching of donors and receivers in India so that the right patients get matching donors. Although logistically complex now, this is medically quite simple, identified the study. </p>.<p><strong>Single national portal</strong></p>.<p>“There is no national- or state-level programme for living donor transplantation. There are only cadaver donation programmes. The legal permission for swap transplant takes one to six months, which affects registration as well. Everything can be made seamless if there is one national portal offering a single window clearance for registration, allocation, and permissions,” said Prof Dr Vivek Kute, lead author of the study.</p>.<p>Through the swap or exchange method, an incompatible donor-receiver pair will be matched with another such pair to find the right blood group match.-</p>.<p>This is also cost-effective, as incompatible transplants cost twice the compatible ones. Scientific evidence shows that compatibility is a better option for transplants, but many are forced to rely on ABO-incompatible transplants due to the lack of a better option.</p>.<p>A letter in this regard was issued by the Centre’s National Organ and Tissue Transplant Organisation (NOTTO) on April 16, 2025, to states to implement this method of swapping near relative donors of biologically incompatible receivers.</p>.<p><strong>Swap software</strong></p>.<p>The national-level chintan shivir organised in August 2024 had recommended the setting up of a ‘one nation one swap transplant’ programme, which can expand the compatible donor pool to donors across India.</p>.<p>The Indian Society of Organ Transplantation (ISOT) has created the swap software for the programme.</p>.<p>ISOT has offered this software to NOTTO, said Dr Manish Balwani, secretary, ISOT, who is also the corresponding senior author of the study. </p>
<p>Bengaluru: The living donor pool for kidney and liver transplants in India can be increased by 25% by adopting the swap transplantation method, a recent large-scale study published in medical journal ‘The Lancet’ has shown.</p>.<p>This will increase access to transplants for patients who cannot find matching donors locally, and are thus initially matched with a blood group-incompatible donor.</p>.<p>The study, which analysed nearly 1,839 kidney exchange transplants (2000-2024) across 65 centres and 259 liver exchange transplants (2007-2025) across seven centres in India, provides the largest-to-date multi-centre data for living donor transplantation.</p>.<p>ABO (blood group) incompatibility was the biggest reason for those patients choosing exchange or swap transplantation method. There was a notable gender imbalance, with more men being recipients and more women being donors. </p>.<p>In India, less than 10% of end-stage organ failure patients get successful organ transplants.</p>.<p>Cadaver organ donation rates are also relatively low, while living donor transplantation programmes face challenges due to blood group incompatibility and sensitisation.</p>.<p>“Approximately one-third of healthy, willing living donors are incompatible with their intended recipients due to these factors,” noted the study.</p>.<p><strong>Unified platform</strong></p>.<p>Through the study, they are pushing for a unified swap transplant platform for registration and matching of donors and receivers in India so that the right patients get matching donors. Although logistically complex now, this is medically quite simple, identified the study. </p>.<p><strong>Single national portal</strong></p>.<p>“There is no national- or state-level programme for living donor transplantation. There are only cadaver donation programmes. The legal permission for swap transplant takes one to six months, which affects registration as well. Everything can be made seamless if there is one national portal offering a single window clearance for registration, allocation, and permissions,” said Prof Dr Vivek Kute, lead author of the study.</p>.<p>Through the swap or exchange method, an incompatible donor-receiver pair will be matched with another such pair to find the right blood group match.-</p>.<p>This is also cost-effective, as incompatible transplants cost twice the compatible ones. Scientific evidence shows that compatibility is a better option for transplants, but many are forced to rely on ABO-incompatible transplants due to the lack of a better option.</p>.<p>A letter in this regard was issued by the Centre’s National Organ and Tissue Transplant Organisation (NOTTO) on April 16, 2025, to states to implement this method of swapping near relative donors of biologically incompatible receivers.</p>.<p><strong>Swap software</strong></p>.<p>The national-level chintan shivir organised in August 2024 had recommended the setting up of a ‘one nation one swap transplant’ programme, which can expand the compatible donor pool to donors across India.</p>.<p>The Indian Society of Organ Transplantation (ISOT) has created the swap software for the programme.</p>.<p>ISOT has offered this software to NOTTO, said Dr Manish Balwani, secretary, ISOT, who is also the corresponding senior author of the study. </p>