27 - 09 - 2026

What 136 Heart and Lung Transplants Say About India’s Evolving Transplant Care

A heart or lung transplant is often measured by what happens inside an operating theatre. Increasingly, however, the more meaningful measure is what happens afterwards: whether a child returns to school, whether an adult resumes work or sport, and whether a patient who had been living with severe organ failure can regain some measure of independence.

This aspect was at the centre of a gathering at Narayana Health City in Bengaluru, where more than 40 heart and lung transplant recipients and their families came together ahead of World Heart Day on September 29. According to the hospital, its Bengaluru centre has performed 136 heart and lung transplants, covering adult and paediatric heart and lung procedures as well as combined heart-lung transplantation.

The milestone offers a window into how transplant medicine in India is changing. The challenge is no longer confined to performing a technically demanding operation. It involves keeping critically ill patients alive while they wait for an organ, determining who can safely undergo transplantation, managing intensive post-operative care and supporting recipients over the long term.

At Narayana Health City, the transplant programme uses technologies such as Extracorporeal Membrane Oxygenation (ECMO) and Ventricular Assist Devices (VADs) for selected patients with severe cardiac or respiratory failure who cannot safely remain unsupported while awaiting a donor organ. These systems can provide a bridge to transplantation, allowing clinicians to stabilise patients whose condition might otherwise deteriorate during the waiting period.

That capability illustrates an important shift in modern transplantation: the transplant itself is only one component of a much larger clinical system. Advanced imaging, critical care, mechanical circulatory support, surgical expertise and coordinated decision-making all have to function together. For hospitals seeking to build complex transplant programmes, the requirement is therefore not simply a specialist surgeon or a transplant unit, but a wider ecosystem capable of managing patients before, during and after the procedure.

Meaningful lives?

The patient stories presented in Bengaluru also underline why those capabilities matter.

V. K., who is now 16 years post-transplant, was identified by the hospital as the longest-surviving heart transplant recipient in the group. S. S., who had faced end-stage heart failure, subsequently won a gold medal at the World Transplant Games. Baby K. received a donor heart at 14 months of age and was identified by Narayana Health as India’s youngest heart transplant recipient. K. S., who underwent a combined heart-lung transplant at 68, is now 75.

The hospital said 95% of its recipients have returned to meaningful lives, with some children returning to school and recipients participating in competitive sport. These figures and outcomes are claims made by Narayana Health; they are presented here as part of the programme’s account of its transplant experience.

The broader significance lies in the gap between the capacity to perform transplantation and the availability of organs to perform it.

India crossed 20,000 organ transplants in a year for the first time in 2025, according to data cited by the National Organ and Tissue Transplant Organisation (NOTTO). Government data put the number of transplants performed that year at 20,019, while the national transplant waiting list stood at 89,839 as of March 3, 2026.

The numbers point to a healthcare system that has expanded its transplant capacity while still facing a substantial imbalance between demand and supply. The problem is particularly consequential for patients requiring organs such as hearts and lungs, where prolonged deterioration can limit the time available to wait for a suitable donor.

NOTTO has previously identified several factors behind India’s relatively low deceased-donation levels, including gaps in awareness, identification and maintenance of potential brain-stem-dead donors, infrastructure and trained manpower.

This makes the donor question inseparable from the clinical advances being showcased by transplant centres. A hospital can develop the surgical expertise and intensive-care infrastructure required to undertake increasingly complex procedures, but those capabilities cannot by themselves create a supply of organs.

Narayana Health’s Bengaluru programme has also become a destination for patients travelling from outside the state. The hospital said nearly half of its 136 recipients came from outside Karnataka, representing 19 Indian states, while overseas patients, including recipients from Sudan, have also undergone transplantation.

That geographical reach reflects another feature of India’s transplant landscape: highly specialised procedures tend to require patients to travel to centres with the necessary combination of expertise and infrastructure. For families dealing with end-stage heart or lung disease, access is therefore shaped not only by whether transplantation exists in the country, but by where the relevant expertise is available and whether patients can reach it in time.

The experience of recipients after surgery provides another measure of the system’s effectiveness. A successful transplant is not simply the replacement of a failing organ. It creates a long-term clinical relationship involving medication, monitoring, rehabilitation and management of complications. The stories shared at Narayana Health City place that longer trajectory alongside the technical achievement of transplantation.

Constraints

Yet the central constraint remains outside the operating room.

India’s transplant system can perform more procedures, hospitals can develop stronger critical-care programmes and mechanical support can help keep some patients alive while they wait. None of those advances removes the underlying dependence on organ donation.

For that reason, the 136-transplant milestone is simultaneously a measure of clinical capability and a reminder of the limits imposed by organ availability. The next stage of progress in transplantation will depend not only on how many complex operations hospitals can perform, but also on whether the country can expand the pool of donated organs and ensure that patients who need them can reach appropriate transplant centres.

The stories of recipients gathered in Bengaluru put a human dimension on that equation. Sixteen years after a transplant, a former patient can become a long-term survivor; a child can return to school; and an adult once limited by end-stage heart failure can compete in sport.

Those outcomes show what transplantation can make possible. The continuing shortage of donor organs shows how many patients may still never get the opportunity.

By Subramanya Joshi

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