Health ministry report bats for liver and heart transplants under PMJAY

This assumes importance given that health insurance schemes in the country cover life and disability, but not organ donation.

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The recommendation comes in a report, titled the National Review Meeting on Organ Transplantation Activities in Government Hospitals, prepared by the National Organ Tissue Transplant Organization (NOTTO), a top body which manages organ transplantation, under the health ministry.

The call for expanding insurance coverage comes in the backdrop of the low number of organ transplants performed in India. Mint has seen a copy of the report, which has been submitted to health ministry.

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AB PM-JAY is the world’s largest health insurance scheme, providing health cover of ₹5 lakh per family per year. Notably, the scheme’s ambit has been expanded to include free treatment benefits of up to ₹5 lakh per year to senior citizens aged 70 years and above.

Earlier this month, a nationwide review meeting was conducted on organ transplants in government hospitals by a group of top government experts to identify bottlenecks in the system and formulate a roadmap for improvement.

The report underlined that government institutions have inadequate capacities and that new centres are required to be established and made functional. It emphasized the need for a multi-pronged strategy involving policy changes, financial investment, and capacity building to bridge the demand-supply gap in organ transplantation.

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The report highlighted a huge gap between demand and supply: while India requires at least 100,000 kidney transplants per year, only 13,476 were performed in 2024 across both government and private centers.

“These recommendations aim to strengthen India's organ transplantation capabilities and make life-saving procedures more accessible to those in need. During the nationwide assessment of the government hospitals, we identified their challenges and suggested measures to improve their capabilities in terms of infrastructure, finance, manpower etc. We have submitted our report to the health ministry and now the ministry will take action on these recommendations," said Dr. Anil Kumar, director, NOTTO. 

One of the key recommendations is to include comprehensive inclusion of liver and heart transplantation in national health schemes like PMJAY, he added.

“Some states like Maharashtra and Delhi have expanded their coverage under the PM-JAY scheme. So, the recommendation of the report to include liver and heart transplantation under PM-JAY may be considered to accelerate organ transplantation in the government institutions," he said.

Dr Anup Kumar, head of kidney transplant and urology department at Safdarjung Hospital, New Delhi, said, “ It is a welcome move. PMJAY offers coverage of up to ₹5 lakh, but these are very expensive procedures require ₹20-25 lakh in the private sector.  However, in government institutions these transplants can be done in ₹10 lakh. So, to cover these two transplants, the government has to also consider increasing the coverage plan of PMJAY from ₹5 lakh to at least ₹10 lakh."

Further, to bridge the critical demand-supply gap, the expert group has put forth several key recommendations, which include financial incentives for transplant teams, enhanced funding for infrastructure development, establishment of dedicated transplant centres and robust training programmes for medical personnel and transplant coordinators. 

“We have tried to understand why government institutions are not able to do the maximum number of organ transplants and what are the solutions. Do we require to build new centres or strengthen the existing capacities. Some government centres like Institute of Kidney Diseases and Research Centre (IKDRC) Ahmedabad conducted a total of 508 organ transplants in the last year, including 195 cadaveric transplants, PGIMER Chandigarh performed 320 organ transplants including 55 cadaveric transplants," Dr. Kumar said.

However, the report revealed that government institutions like GB Pant Hospital, New Delhi, despite having the physical infrastructure and licence, did not perform any organ transplants.