Introduction: Organ donation and transplantation is instrumental but intricately affected by prevailing legal, cultural, socio-economic and health factors. Worldwide trends of gender inequity in organ transplantation exist, with there being more male recipients than female and conversely many more women organ donors than men.

Method: The gender gap in organ donation and transplantation with respect to solid organ transplants specially for kidney, liver, lung, heart, pancreas and small bowel over two time periods of 2019 and 2020 across India was examined through the data submitted annually to the Global database on donation and transplantation (GODT). Living donor transplants highlight this disparity.

Results: Due to the ongoing COVID-19 pandemic situation, the number of transplants, especially living donor organ transplants in India has gone down from 10,608 in 2019 to 6,461 in 2020 and kidney donation comprises about 3/4th of total living organ donations. However, the relative share of women accounting for around 65% of total living organ donors remains. Distinctly, women donors account for around 65% of living kidney donors (5633/8613) and 54% of living liver donors (1084/1993) in 2019, the share of which increased fractionally in 2020 [(3352/4970)67.4 and (832/1489) 55.9% respectively]. There were 6,717 women donors out of 10,608 total donors in 2019, the corresponding share of which was 4,184 out of 6,461 in 2020. Amongst the transplant recipients, females account for only 27% in both the years with the share of women recipients from deceased donors being slightly higher (around 29.5% and 28% in 2019 and 2020 respectively). Women account for 28 % of recipients of living donor kidney transplants with the share of deceased donor transplants being slightly higher (34 and 32.6% respectively in 2019 and 2020). Women comprise only one fourth of total liver transplant recipients. The number of heart, lung, pancreas and small bowel transplants in India are quite low with varying shares of female recipients.

Conclusion: There exists prominent gender disparity in the sphere of organ donation with women comprising roughly 75% of the total donor pool and conversely only 27.6% of all organ transplant recipients. The gender gap in living transplants is higher than that for deceased organ transplants. There is a need for action to eliminate gender disparity in organ transplantation for the disparity exists not only among patients but among physicians and surgeons as well.