Kidney swap policy

India’s kidney transplant landscape may be on the cusp of meaningful reform. The Centre's push for a unified ‘one nation, one swap transplant’ system aims to streamline kidney exchange procedures across states. This idea is long overdue in a country where nearly two lakh patients require transplants annually, yet only a fraction receive them. The initiative draws strength from recent milestones. Ten patients received kidneys through swap transplants in Ahmedabad earlier this month, marking a remarkable achievement in paired donation. These transplants, where incompatible donor-recipient pairs are matched with others in a similar situation, offer a lifeline when direct donation isn’t possible. Yet, the system remains underutilised, constrained by state-level silos, rigid regulations on donor-recipient relationships and a lack of awareness.

The Centre’s move, backed by the National Organ and Tissue Transplant Organisation’s recent directive to states and union territories, attempts to correct this by enabling broader geographic matches and creating a national registry of incompatible pairs. It's a step that could save countless lives, especially for patients whose only mismatch is bureaucratic, not biological.

But the process of approvals for swap transplants must be expedited. The definition of ‘near relative’ under current rules often acts as a barrier for those willing but disqualified by paperwork. Also, public trust must be rebuilt, especially in light of recurring organ trafficking scandals. India is the world’s third-largest transplant hub, but size alone doesn’t equal equity or access. A centralised swap transplant mechanism could be the game-changer — provided it’s implemented transparently, ethically and with sensitivity to the needs of patients and their families. In the world of organ transplants, time is not a luxury. For thousands awaiting kidneys, a national swap system offers hope; not just for survival, but for a life renewed.