The population with end-stage renal disease (ESRD) is increasing worldwide over the last decade. For patients with ESRD, renal transplantation is better than dialysis for various reasons. In countries such as India about 80,000 patients are added annually to the pool of ESRD, however, only 2.4% undergo transplant. In recent years, the number of live donor transplants has surpassed cadaveric donations worldwide. However, the number of patients on waiting lists for kidney transplantation is increasing by 10% annually while the annual increase in the number of renal transplants is only 4%. The average waiting period for cadaveric graft is more than five years in the US. Efforts are being made to increase the availability of organs for donation and usage of ‘expanded-criteria donors’ or ‘sub-optimal donors’ is one of them and to overcome many obstacles against transplantation.

There are many factors affecting organ donations worldwide. They include religious factors, legislations, economic factors, presence of organ procurement organizations, cultural issues and the presence of commercial transplantation apart from other unknown factors. The important factors to increase organ donations are: National Organization /OPO, Approved Legislations, Sufficient Government Funding, Support from Religious Authority, Direct Approach and Training for the Medical Community

Conclusion

National accountability and responsibilities of each country towards providing opportunities for care and achieving self-sufficiency (WHO Guidelines).

Each country should customize its organ donation and transplantation program according to its culture. Deceased donation and transplantation is being utilized in our region but remain suboptimal compared to Western countries.

The most important factors affecting organ donation and transplantation are the Organ Procurement Organizations (OPO), the medical community and culture.

Organization around the process of deceased donation - the key for success.