Abstract
Background.
Solid organ transplantation has evolved globally as an established and life-saving treatment for patients with end-stage organ failure.
Methods.
Since 2007, the Global Observatory on Donation and Transplantation (GODT), an initiative of the World Health Organization in collaboration with the Organización Nacional de Trasplantes (Spain), collects data and reports on the activity of World Health Organization member states in regard to solid organ donation, transplantation, and waitlisting. This ongoing effort provides insights into transplant activities in countries with different healthcare systems and practices, economic and cultural contexts, and local disease burdens.
Results.
This annual report presents activities for the year 2024 and summarizes the developments from a global, regional, and country-specific perspective. This report includes information from 92 countries that submitted their data to the GODT by October 29, 2025. Descriptive statistics were applied to analyze and present key indicators.
Conclusions.
A record 173 727 solid organ transplants were performed worldwide in 2024, representing the highest number ever reported to the GODT. This corresponds to a 2% global increase compared with 2023, largely driven by a rise in deceased donations, particularly the expansion of donations after the circulatory determination of death, which accounted for 28% of all deceased donation activity in 2024 (total deceased donations: 47 180). Despite these achievements on a global scale, the data also indicate that major challenges persist, including a continued shortage of organs and pronounced geographical disparities in access to transplantation.
INTRODUCTION
Solid organ transplantation (SOT) has evolved over the last 70 y into an established therapy for end-stage organ failure across diverse healthcare systems, prolonging survival, improving quality of life, and reducing healthcare costs.1 Over the past decades, the global transplant activity has steadily increased, except for the years of the COVID-19 pandemic.2 Nevertheless, SOT continues to face global challenges: a considerable gap between the demand and supply of organs for transplant, particularly pronounced in countries and regions where organizational structures or financial resources supporting donation and transplantation remain limited. Cultural, political, and economic specificities further contribute to these disparities and represent additional local and geographic challenges.1,3
Recognizing the growing worldwide importance of SOT and the observed global, regional, and country-specific challenges and inequalities in transplant care and access, the World Health Assembly (WHA) acknowledged nearly 2 decades ago the need for the collection of reliable and comparable data. In 2006, following the adoption of WHA Resolution WHA57.18, the World Health Organization (WHO), in collaboration with the Spanish Organización Nacional de Trasplantes (ONT), established the Global Observatory on Donation and Transplantation (GODT).4,5 The request of collecting and analyzing global data on the practices, safety, quality, efficacy, epidemiology, and ethics of donation and transplantation of human cells, tissues and organs by the WHO was further emphasized in Resolutions WHA63.22 and WHA77.4, adopted in 2010 and 2024, respectively.5,6 Similarly, member states were urged to contribute to this exercise of transparency and international benchmarking.
Since 2007, the GODT has been systematically collecting global transplant and donation data with the aim to provide comprehensive information on volume, practices, and access to solid organ donation and transplantation. While the registry does not yet provide outcome data or within-country disparities, and participation remains incomplete across countries, its systematic approach to data collection, presentation, and analysis constitute a unique platform for identifying global trends, shortcomings, and achievements in transplantation.
The communication and dissemination of these data are essential to inform transplant professionals, policymakers, and the public, to encourage critical questioning, to identify and raise awareness of areas for improvement, to promote shared learning and collaboration, and to build trust, all essential to advancing the field of solid organ donation and transplantation.
The following report presents data collected from 92 WHO member states by the GODT for the year 2024. It includes descriptive statistics about global organ demand, donation, and transplantation while drawing attention to both notable successes and persistent challenges requiring improvement and further refinement.
MATERIALS AND METHODS
Data Collection
WHO member states are asked to designate a national focal point, either a public official within the respective Ministry of Health or a healthcare professional, who annually completes a standardized questionnaire addressing country-specific data on donation and transplantation (https://www.transplant-observatory.org/download/questionnaire-2020/). For Council of Europe member States, annual data are collected as part of the Newsletter Transplant exercise, which uses officially designated national focal points and the same standardized questionnaire as mentioned above; data are then merged with the GODT database to avoid duplication of efforts.7 Participation in the GODT is voluntary and is not associated with any benefits or disadvantages for participating countries.
The questionnaire addresses basic national information on the status of donation and transplantation programs, organizational structures, legislation and regulatory frameworks, as well as annual activity, including donor and transplant numbers, waiting list data, in addition to family consent and refusal rates for deceased donation. Activities are compiled as aggregated data. The questionnaire was first distributed in 2007, with a revised version incorporating several changes and adaptations being in use since 2012, following a WHO Global Consultation. In addition, a new section addressing travel for donation and transplantation, as well as nonresident transplantations has been introduced in 2020.
Responses are submitted to the ONT in both quantitative (eg, transplant, donor numbers) and qualitative forms (eg, explanations of country-specific practices or data), as appropriate. The ONT undertakes subsequent quality control and analysis.
Data from the United Nations Population Fund State of World Population are used to calculate per million population (pmp) rates.
Data Analysis
National data on organ donation, transplantation, and waitlist activity submitted by October 29, 2025, to the GODT for the reporting year 2024 represent the basis for this report. Data submitted after October 29, 2025, were not included in the analysis. Data analysis and visualization were performed using R (Version 4.4.2; R Foundation for Statistical Computing).
Aggregated data are presented by country, WHO region, and globally in absolute or relative terms as rates pmp, and as percentages.
Data completeness was assessed systematically, and missing values were reported. The numbers of included countries in each analysis are indicated where appropriate. For aggregated variables (eg, transplant numbers, waitlist counts, or other summary indicators), the number of contributing countries was specified and defined as those reporting a value >0. Accordingly, totals presented in the text represent the sum across these reporting countries, with countries reporting zero values not being counted. For proportions (eg, distributions by sex or donor type), zero values were only treated as missing when both corresponding categories were zero. For selected indicators, supplementary notes were provided to highlight country-specific reporting particularities (eg, partial data submissions).
Comparisons of global activities between 2024 and 2023 were performed considering countries only that had contributed with the corresponding figure in both years.
RESULTS
Transplant Activity
A total of 173 727 SOTs were reported by 91 countries in 2024. Kidney transplantation (KTx) accounted for 110 467 procedures (63.6%) in 90 countries; liver transplantation (LTx) for 42 497 (24.5%) in 71 countries; heart transplantation (HTx) for 10 287 (5.9%) in 59 countries; and lung transplantation (LuTx) for 8236 (4.7%) in 48 countries. Pancreas transplantation (PTx) was performed in 2066 (1.2%) patients in 39 countries, while small bowel transplantation (SBTx) remained rare with 174 (0.1%) procedures performed in 20 countries (Figure 1). The global transplant activity reported in 2024 increased by 2% compared with the previous year. A list of all participating countries, including population size and number of transplant centers, is provided in Table 1; transplant activity by organ and country is presented in Supplemental Table 1 (SDC, https://links.lww.com/TP/D359).
FIGURE 1.
Transplant activity worldwide by type of transplanted organ in 2024. Highlighted are the countries in which specific transplants were performed in 2024. Ninety countries reported KTx, 71 countries LTx, 59 countries HTx, 48 countries LuTx, 39 countries PTx, and 20 countries SBTx. Of note, Luxembourg was the only country reporting to the Global Observatory on Donation and Transplantation (GODT) that did not perform transplantations in 2024; Luxembourg contributes with deceased donors and patients receive transplants in neighbor countries based on official agreement. HTx, heart transplantation; KTx, kidney transplantation; LTx, liver transplantation; LuTx, lung transplantation; PTx, pancreas transplantation; SBTx, small bowl transplantation.
TABLE 1.
Population and number of people covered by 1 transplant centers per country ordered by WHO region (year 2024)
| WHO region/country | Population, million | KTx centers, n (pop/center) | LTx centers, n (pop/center) | HTx centers, n (pop/center) | LuTx centers, n (pop/center) | PTx centers, n (pop/center) | SBTx centers, n (pop/center) |
|---|---|---|---|---|---|---|---|
| Africa (n = 4) | 476.1 | 36 (13) | 4 (119) | 5 (95) | 3 (159) | – | – |
| Ethiopia | 129.7 | 1 (130) | – | – | – | – | – |
| Kenya | 56.2 | 8 (7) | – | – | – | – | – |
| Nigeria | 229.2 | 12 (19) | – | – | – | – | – |
| South Africa | 61 | 15 (4) | 4 (15) | 5 (12) | 3 (20) | – | – |
| America (n = 23) | 995.3 | 912 (1) | 420 (2) | 350 (3) | 142 (7) | 225 (4) | 43 (23) |
| Argentina | 46.1 | 61 (1) | 31 (1) | 26 (2) | 11 (4) | 17 (3) | 4 (12) |
| Barbados | 0.3 | 1 (0) | – | – | – | – | – |
| Bolivia | 12.6 | 8 (2) | – | – | – | – | – |
| Brazil | 217.6 | 165 (1) | 100 (2) | 57 (4) | 11 (20) | 21 (10) | 5 (44) |
| Canada | 39.1 | 26 (2) | 10 (4) | 12 (3) | 5 (8) | 7 (6) | 3 (13) |
| Chile | 19.7 | 22 (1) | 9 (2) | 8 (2) | 4 (5) | 2 (10) | – |
| Colombia | 52.3 | 29 (2) | 12 (4) | 13 (4) | 6 (9) | 10 (5) | 5 (10) |
| Costa Rica | 5.2 | 7 (1) | 3 (2) | 1 (5) | 1 (5) | 1 (5) | 1 (5) |
| Cuba | 11.2 | 8 (1) | 3 (4) | 1 (11) | – | – | – |
| Dominican Republic | 11.4 | 5 (2) | 1 (11) | – | – | 1 (11) | – |
| Ecuador | 18.4 | 9 (2) | 3 (6) | 2 (9) | – | – | – |
| El Salvador | 6.4 | 4 (2) | – | – | – | – | – |
| Guatemala | 18.4 | 4 (5) | – | – | – | – | – |
| Guyana | 0.8 | 1 (1) | – | – | – | – | – |
| Honduras | 10.8 | 4 (3) | – | – | – | – | – |
| Jamaica | 2.8 | 2 (1) | 1 (3) | – | – | – | – |
| Mexico | 129.4 | 297 (0) | 94 (1) | 69 (2) | 24 (5) | 35 (4) | 8 (16) |
| Panama | 4.5 | 2 (2) | 1 (4) | 1 (4) | – | – | – |
| Paraguay | 6.9 | 6 (1) | 1 (7) | 3 (2) | – | – | – |
| Peru | 34.7 | 14 (2) | 6 (6) | 4 (9) | 3 (12) | 2 (17) | – |
| Trinidad and Tobago | 1.5 | 1 (2) | – | – | – | – | – |
| United States | 341.8 | 232 (1) | 144 (2) | 150 (2) | 76 (4) | 129 (3) | 17 (20) |
| Uruguay | 3.4 | 4 (1) | 1 (3) | 3 (1) | 1 (3) | – | – |
| Eastern Mediterranean (n = 9) | 321.8 | 90 (4) | 20 (16) | 8 (40) | 5 (64) | 3 (107) | – |
| Jordan | 11.4 | 24 (0) | 3 (4) | 1 (11) | 1 (11) | 1 (11) | – |
| Kuwait | 4.3 | 1 (4) | – | 1 (4) | – | – | – |
| Oman | 4.7 | 2 (2) | 1 (5) | – | – | – | – |
| Pakistan | 245.2 | 42 (6) | 7 (35) | – | – | 1 (245) | – |
| Qatar | 2.7 | 1 (3) | 1 (3) | 1 (3) | 1 (3) | – | – |
| State of Libya | 7 | 1 (7) | – | – | – | – | – |
| Syria | 24.3 | 6 (4) | – | – | – | – | – |
| Tunisia | 12.6 | 6 (2) | 4 (3) | 4 (3) | 2 (6) | – | – |
| United Arab Emirates | 9.6 | 7 (1) | 4 (2) | 1 (10) | 1 (10) | 1 (10) | – |
| South-East Asia (n = 4) | 1710.2 | 703 (2) | 250 (7) | 170 (10) | 95 (18) | 72 (24) | 37 (46) |
| Bangladesh | 174.7 | 10 (17) | 3 (58) | – | – | – | – |
| India | 1441.7 | 630 (2) | 232 (6) | 163 (9) | 90 (16) | 68 (21) | 35 (41) |
| Sri Lanka | 21.9 | 14 (2) | 3 (7) | – | – | – | – |
| Thailand | 71.9 | 49 (1) | 12 (6) | 7 (10) | 5 (14) | 4 (18) | 2 (36) |
| Europe (n = 43) | 718.1 | 422 (2) | 227 (3) | 168 (4) | 92 (8) | 116 (6) | 40 (18) |
| Albania | 2.8 | 3 (1) | – | – | – | – | – |
| Armenia | 2.8 | 1 (3) | 2 (1) | – | – | – | – |
| Austria | 9 | 4 (2) | 3 (3) | 3 (3) | 2 (4) | 3 (3) | 1 (9) |
| Belarus | 9.5 | 7 (1) | 1 (10) | 1 (10) | 2 (5) | 1 (10) | 1 (10) |
| Belgium | 11.7 | 8 (1) | 6 (2) | 7 (2) | 4 (3) | 7 (2) | 1 (12) |
| Bosnia and Herzegovina | 3.2 | 2 (2) | 1 (3) | 2 (2) | – | – | – |
| Bulgaria | 6.6 | 3 (2) | 2 (3) | 1 (7) | – | – | – |
| Croatia | 4 | 5 (1) | 3 (1) | 2 (2) | 1 (4) | 1 (4) | 1 (4) |
| Cyprus | 1.3 | 1 (1) | – | – | – | 1 (1) | – |
| Czechia | 10.5 | 7 (2) | 2 (5) | 1 (10) | 1 (10) | 1 (10) | 1 (10) |
| Denmark | 5.9 | 3 (2) | 1 (6) | 2 (3) | 1 (6) | 1 (6) | – |
| Estonia | 1.3 | 1 (1) | 1 (1) | – | 1 (1) | 1 (1) | – |
| Finland | 5.5 | 1 (6) | 1 (6) | 1 (6) | 1 (6) | 1 (6) | 1 (6) |
| France | 64.9 | 45 (1) | 20 (3) | 24 (3) | 11 (6) | 6 (11) | 3 (22) |
| Georgia | 3.7 | 4 (1) | 3 (1) | – | – | – | – |
| Germany | 83.3 | 38 (2) | 21 (4) | 19 (4) | 15 (6) | 26 (3) | 9 (9) |
| Greece | 10.3 | 5 (2) | 2 (5) | 1 (10) | 1 (10) | 2 (5) | – |
| Hungary | 10 | 4 (2) | 1 (10) | 2 (5) | 1 (10) | 2 (5) | – |
| Iceland | 0.4 | 1 (0) | – | – | – | – | – |
| Ireland | 5.1 | 1 (5) | 1 (5) | 1 (5) | 1 (5) | 1 (5) | – |
| Israel | 9.3 | 6 (2) | 3 (3) | 2 (5) | 2 (5) | 2 (5) | 1 (9) |
| Italy | 58.7 | 39 (2) | 22 (3) | 16 (4) | 10 (6) | 9 (7) | 1 (59) |
| Kazakhstan | 19.8 | 7 (3) | 4 (5) | 1 (20) | 1 (20) | – | – |
| Latvia | 1.8 | 1 (2) | 1 (2) | 1 (2) | – | 1 (2) | – |
| Lithuania | 2.7 | 2 (1) | 2 (1) | 2 (1) | 1 (3) | 1 (3) | – |
| Luxembourg | 0.7 | – | – | – | – | – | – |
| Malta | 0.5 | 1 (0) | – | – | – | – | – |
| Moldova | 3.3 | 1 (3) | 1 (3) | 1 (3) | – | – | – |
| Netherlands | 17.7 | 7 (3) | 3 (6) | 3 (6) | 3 (6) | 2 (9) | 1 (18) |
| North Macedonia | 2.1 | 1 (2) | 1 (2) | 1 (2) | – | – | – |
| Norway | 5.5 | 1 (6) | 1 (6) | 1 (6) | 1 (6) | 1 (6) | – |
| Poland | 40.2 | 20 (2) | 9 (4) | 7 (6) | 7 (6) | 4 (10) | 1 (40) |
| Portugal | 10.2 | 9 (1) | 4 (3) | 4 (3) | 1 (10) | 2 (5) | – |
| Romania | 19.6 | 4 (5) | 6 (3) | 3 (7) | 1 (20) | 1 (20) | 1 (20) |
| Serbia | 7.1 | 4 (2) | 1 (7) | 2 (4) | – | – | – |
| Slovakia | 5.7 | 4 (1) | 1 (6) | 1 (6) | – | 1 (6) | – |
| Slovenia | 2.1 | 1 (2) | 1 (2) | 1 (2) | 1 (2) | 1 (2) | 1 (2) |
| Spain | 47.5 | 42 (1) | 26 (2) | 19 (2) | 9 (5) | 13 (4) | 3 (16) |
| Sweden | 10.7 | 4 (3) | 2 (5) | 2 (5) | 2 (5) | 4 (3) | 1 (11) |
| Switzerland | 8.9 | 6 (1) | 3 (3) | 3 (3) | 2 (4) | 2 (4) | 2 (4) |
| Türkiye | 86.3 | 72 (1) | 50 (2) | 14 (6) | 2 (43) | 10 (9) | 6 (14) |
| Ukraine | 37.9 | 22 (2) | 8 (5) | 10 (4) | 1 (38) | – | – |
| United Kingdom | 68 | 24 (3) | 7 (10) | 7 (10) | 6 (11) | 8 (8) | 4 (17) |
| Western Pacific (n = 9) | 1803.1 | 445 (4) | 238 (8) | 132 (14) | 96 (19) | 90 (20) | 60 (30) |
| Australia | 26.7 | 26 (1) | 8 (3) | 5 (5) | 4 (7) | 3 (9) | 1 (27) |
| China | 1433.4 | 149 (10) | 121 (12) | 76 (19) | 60 (24) | 50 (29) | 45 (32) |
| Japan | 122.6 | 124 (1) | 23 (5) | 12 (10) | 11 (11) | 19 (6) | 13 (9) |
| Malaysia | 34.7 | 3 (12) | 3 (12) | 1 (35) | 1 (35) | – | – |
| Mongolia | 3.5 | 1 (4) | 3 (1) | – | – | – | – |
| New Zealand | 5.3 | 4 (1) | 2 (3) | 1 (5) | 1 (5) | 1 (5) | – |
| Philippines | 119.1 | 44 (3) | 3 (40) | – | – | – | – |
| Singapore | 6.1 | 4 (2) | 3 (2) | 1 (6) | 1 (6) | 1 (6) | – |
| South Korea | 51.7 | 90 (1) | 72 (1) | 36 (1) | 18 (3) | 16 (3) | 1 (52) |
A dash indicates that no transplant centers or transplants have been reported for the country in question.
HTx, heart transplantation; KTx, kidney transplantation; LTx, liver transplantation; LuTx, lung transplantation; pop, population; PTx, pancreas transplantation; SBTx, small bowel transplantation; WHO, World Health Organization.
The number of procedures per country varied widely, with the United States leading in absolute and relative terms, with 48 935 performed transplants (143.0 pmp), followed by Spain, with 6463 transplants (136.0 pmp); all other countries reported transplant rates <100 procedures pmp. The median number of transplants performed across the 91 countries reporting SOTs was 260 (interquartile range [IQR], 56–920; range, 1–48 935). When normalized to population size, a median of 23.8 procedures pmp (IQR, 8.21–54.4; range, 0.08–143.0 pmp) were performed. Notably, 40% (n = 69 631) of all SOT worldwide occurred in the WHO Region of the Americas, 26% (n = 45 439) in Europe, 19% (n = 33 634) in the Western Pacific, 12% (n = 20 677) in South-East Asia, and only 2% (n = 3705) and <1% (n = 641) in the Eastern Mediterranean and Africa, respectively. Further country-level data are shown in Figure 2, with organ-specific activities presented in greater detail in specific sections.
FIGURE 2.
SOTs performed in 2024 by country, ranked in descending order of total transplants pmp after LD and DD. The left side of each bar represents transplantations following LD, the right side those following DD, with segments stacked by transplanted organ type. Absolute numbers of SOTs performed are indicated next to the bars. DD, deceased donation; HTx, heart transplantation; KTx, kidney transplantation; LD, living donation; LTx, liver transplantation; LuTx, lung transplantation; pmp, per million population; PTx, pancreas transplantation; SBTx, small bowl transplantation; SOT, Solid organ transplantation.
In 2024, 70.7% (n = 122 835) of SOT were performed using organs from deceased donors and 29.3% (n = 50 578) with organs from living donors. For 14 reported transplantations, donor type was not specified. While most countries (76; 82.6%) performed transplantation from both deceased and living donors, 14 (15.2%) reported only living donor transplants and 2 (2.2%) relied exclusively on deceased donation (Figure 3).
FIGURE 3.
Type of donation that was performed in the reporting countries in 2024. Of the 91 reporting countries, 14 (15.4%) reported LD only (marked in red); 3 (3.3%) reported DD only (marked in yellow); 48 (52.7%) reported both LD and DD, with deceased donation after brain death only (marked in light blue); and 26 (28.6%) reported also DCD (marked in dark blue). DCD, donations after the circulatory determination of death; DD, deceased donation; LD, living donation.
Deceased Donation
In total, 47 180 actual deceased donors (defined as donors from whom at least 1 organ was recovered with the intent to transplant) were reported by 78 countries. Donations after the circulatory determination of death (DCD) accounted for 28% (n = 13 366; aggregated data from 26 countries) of all actual donors in 2024. The remaining 72% (n = 33 814; aggregated data from 78 countries) were donors after the neurological determination of death or donors after brain death (DBD). Notably, Canada did not report the number of actual deceased donors, but only the number of used deceased donors (defined as donors from whom at least 1 organ was ultimately transplanted). These data were therefore included here in place of actual deceased donor counts.
Deceased donation increased by 3% compared with 2023; the expansion of deceased donation was particularly pronounced in DCD, with a 17% increase. DBD activities decreased by 2%.
The highest deceased donation activity in absolute numbers was reported by the United States, with 16 989 (49.7 pmp) donors and the maximum rate by Spain, with 53.9 pmp (n = 2562), with a median of 78.8 (IQR, 15–371; range, 1–16 989) absolute donors and 9.2 donations pmp (IQR, 1.9–19.8; range, 0.004–53.9) across the 78 countries reporting deceased donation. Detailed country-level data are presented in Figure 4.
FIGURE 4.
Actual DD and LD by country, expressed pmp in 2024. Absolute numbers are shown as bar labels (n =). DDs are stacked by donor type, DBD, and DCD. LDs are stacked by organ type. Japan was the only country performing lung transplantations from living donors. DBD, donation after brain death/donors declared dead by neurological criteria; DCD, donations after the circulatory determination of death; DD, deceased donation; LD, living donation; pmp, per million population.
Among countries performing deceased donation, the donor utilization rate (percentage of actual donors who transitioned to used donors) ranged from 62.4% to 100%, with a median of 98.1% (IQR, 93.3%–100.0%) across 77 countries with complete data. When considering the sum of all reported deceased donors rather than the median across the 77 countries, the utilization rate was 92.3%, corresponding to 3580 deceased donors that remained unused in 2024. When stratified by donor type, the median utilization rate for DBD donors was 98.3% (IQR, 94.2%–100.0%; range, 62.4%–100.0%; data available from 77 countries), while for DCD donors the median utilization was 95.1% (IQR, 87.5%–100.0%; range, 78.4%–100.0%; data available from 25 countries). Calculating utilization rate based on the total number of reported donors by countries with complete data (77 for DBD, 25 for DCD), the utilization rate was 95% for DBD donors and 85.2% for DCD donors, leaving 1649 DBD, and 1931 actual DCD donors not used in 2024. Country-level utilization rates by donor type are shown in Figure 5.
FIGURE 5.
Utilization rates of DDs overall and stratified by DD type and country in 2024. Overall DD utilization rates are shown in gray, utilization rates of DBD are shown in blue, those of DCD in red. Of note, Canada is not included, as the country only reported used donor numbers. DBD, donors after brain death/donors declared dead by neurological criteria; DCD, donors after the circulatory determination of death; DD, deceased donor.
Beyond utilization, the questionnaire also captured demographic characteristics. Overall, 36.4% (n = 16 662) of actual deceased donors were female, based on reports from 73 countries with complete data. A comparable sex distribution was observed across donor types: among DBD donors, 37.4% (n = 12 242) were female (73 countries), while among DCD donors, the respective proportion of female donors was 34.0% (n = 4432; 25 countries).
Analyzing age across actual donors, 5.1% (n = 2372) were <18 y, 64.8% (n = 29 939) were 18–59 y, and 30.1% (n = 13 893) were ≥60 y. These data reflect reports from 75 countries providing complete age information. Stratified by donor type, DBD, and DCD age distributions were broadly comparable. For DBD donors, 5.6% (n = 1848) of actual were <18 y, 66.2% (n = 21 934) were 18–59 y, and 28.2% (n = 9327) were ≥60 y (75 countries). Corresponding figures for DCD donors were 4.0% (n = 524), 61.0% (n = 7961), and 35.0% (n = 4566), respectively (25 countries).
Country-level distributions of actual deceased donor characteristics (age and sex) are presented in Supplemental Figure 1A and B (SDC, https://links.lww.com/TP/D359).
Living Donation
In 2024, 40 996 living kidney (88 countries), 9861 living liver (53 countries), and 18 living lung donations were reported, with Japan being the only country performing LuTx from living donors in 2024. Living donation decreased by 1% compared with 2023.
Among the 88 countries performing living donations, the median number of donations was 70 (IQR, 18–256; range, 1–15 504) in absolute terms, with India reporting the highest number of living donors (n = 15 504; 10.8 pmp). The population-normalized median was 6.6 pmp (IQR, 3.1–10.7; range, 0.08–54) across the 88 countries and was highest in Türkiye, with 54 living donations pmp (n = 4660; Figure 4).
Detailed information on living donor characteristics is provided in the organ-specific sections.
Transplantation Demand
One of the major challenges in SOT is the constant imbalance between the demand for and the supply of transplantable organs. During 2024, a total of 668 160 patients were waitlisted for SOT across 75 countries reporting those data (combined waitlisted data for KTx, LTx, HTx, LuTx, PTx, and SBTx). In total, 522 187 (78.2%) patients were waitlisted for KTx in 68 countries, 97 407 (14.6%) for LTx in 62 countries, 26 311 (3.9%) for HTx (53 countries), 15 039 (2.2%) for LuTx in 46 countries, 6708 (1.0%) for PTx in 35 countries, and 508 (<0.1%) for SBTx in 19 countries. Of note, not all countries submitted waitlist data, as some rely exclusively on living donation and therefore do not maintain waiting lists. As a result, more countries perform KTx and LTx than reporting waitlist data. Country-specific waitlist data are presented in Figure 6. Organ-specific comparisons of waitlist and transplant data are described and presented in the organ-specific sections.
FIGURE 6.
Patients ever actively waitlisted patients during 2024 pmp by country stacked by organ. Absolute numbers of waitlisted patients are shown at each end of the bar. Of note, 11 countries did not report any waitlist data for 2024. HTx, heart transplantation; KTx, kidney transplantation; LTx, liver transplantation; LuTx, lung transplantation; pmp, per million population; PTx, pancreas transplantation; SBTx, small bowl transplantation.
Because of this imbalance, 31 853 patients in 70 countries died in 2024 while waiting for a SOT: 19 936 (62.5%) of those were waiting for KTx in 66 reporting countries, 8895 (27.9%) for LTx in 59 countries, 1744 (5.5%) for HTx in 51 countries, 943 (3%) for LuTx in 42 countries, 312 (1%) for PTx in 20 countries, and 23 (<0.1%) for SBTx in 9 countries.
To further assess the discrepancy between demand and availability of SOT at the country level, we calculated the ratio of transplants performed to first-time registration on the waiting list in 2024 for KTx, LTx, HTx, and LuTx by country. A ratio of 1 represents parity, that is, 1 transplant performed for every new patient added to the waiting list, while values >1 indicate a relative reduction of waitlist burden and values <1 indicate that the demand exceeded the supply. Across all organs, most countries reported ratios <1, indicating that more patients were newly registered compared with transplants performed. KTx demonstrated the widest variation, with some countries reporting ratios >2, suggesting the ability to reduce waitlist pressure, while most remained <1. LTx ratios were closer to 1 in several countries, but the majority still reported values <1. For LuTx, we observed a broad variability across countries, with some ratios >1 and many below. HTx ratios were <1 in all reporting countries except Costa Rica, Japan, and Norway (Figure 7).
FIGURE 7.
Ratio between patients added for the first time to the waiting list and patients receiving transplants in 2024 by organ. A ratio of 1 represents parity, that is, 1 transplant performed for every new patient added to the waitlist; values >1 indicate relative reduction of waitlist burden, while values <1 reflect excess demand over supply.
Organ-specific Data
Data on organ-specific transplant activities, donor and recipient characteristics, and transplant needs in 2024 are summarized in the following section. Of note, the questionnaire collected information on recipient sex and the number of pediatric recipients (recipients <18 y old) only; no further recipient data are available at this time. Only living donor characteristics are mentioned specifically. For characteristics (sex and age) of deceased donors, see section deceased donation and Supplemental Figure 1A and B (SDC, https://links.lww.com/TP/D359). Of note, percentages referring to recipient sex are based on total transplant numbers and may not add up to 100%, as sex-disaggregated data were not available from all reporting countries. The number of reporting countries is indicated in each case.
Kidney Transplantation
A total of 110 467 KTx were performed across 90 countries; this activity was 0.7% higher than the one reported in the year 2023. The United States reported the highest absolute number (83.4 pmp; n = 28 493) while Spain had the highest rate pmp (85.2 pmp; n = 4049) of KTx. Overall, 37.1% (n = 40 996; 88 countries) of these transplant procedures were performed with organs obtained from living donors and 62.9% (n = 69 472; 77 countries) from deceased donors. Among KTx from deceased donors, 73.7% (n = 51 224) were from DBD and 26.1% (n = 18 152) from DCD donors (76 countries). Country-specific data are shown in Figure 8A.
FIGURE 8.
Kidney transplantation and liver transplantation data by country, 2024. A, KTx and waitlist data by country, 2024. B, LTx and waitlist data by country, 2024. Mirrored “butterfly” plot showing waitlist burden (left; pmp) and transplants (right; pmp). Left bars are stacked as actively waitlisted patients, patients still waiting at year-end, and waitlist deaths; right bars are stacked by donor type (DBD, DCD, and LD). n at the left bar end indicates the number of actively waitlisted patients in case available; n at the right bar end indicates the absolute KTx count. Countries without waitlist data display transplant bars only and the other way around. Bars are ordered by transplant rate (pmp, descending). DBD, donation after brain death/neurological determination; DCD, donors after the circulatory determination of death; KTx, kidney transplantation; LD, living donation; LTx, liver transplantation; pmp, per million population; WL, waiting list.
The majority of KTx recipients were male (61.6%, n = 25 248 from living donors; 60.5%, n = 42 035 from deceased donors); 31.1% (n = 12 748; 78 countries) of recipients from living donors and 36.7% (n = 25 483; 73 countries) of those from deceased donors were female (Supplemental Figure 2A and B, SDC, https://links.lww.com/TP/D359). In contrast, 57.4% (n = 23 542; 79 countries) of living donor kidneys came from females (Supplemental Figure 3A, SDC, https://links.lww.com/TP/D359). Globally, 3977 pediatric KTx were performed in 73 countries.
Despite being the most frequently transplanted organ worldwide, with 110 467 kidney transplants performed across 90 countries, KTx also shows the largest gap between demand and availability. By the end of 2024, 377 902 patients remained on KTx waiting lists (data from 74 countries), and 19 936 patients died while waiting (66 countries). During 2024, a total of 522 187 patients (68 countries) were reported as waitlisted at any point, and 166 439 patients were newly added to KTx waiting lists for the first time.
The highest absolute number of waitlisted patients for KTx was reported in China, with 104 716 (73.05 pmp) patients waiting for a kidney. Türkiye had the highest pmp rate of patients waitlisted for KTx with 294.7 pmp (n = 35 707; Figure 8A).
Liver Transplantation
Globally, 42 497 LTx were performed across 71 countries. This activity was 5% higher compared with 2023. The United States reported both the highest absolute number and the highest rate pmp (n = 11 458; 33.5 pmp). Of these LTx, 23.2% (n = 9861; 53 countries) were performed after living donation and 76.8% (n = 32 618; 67 countries) after deceased donation. Among recipients of deceased donor grafts, 79.3% (n = 25 869) received organs from DBD donors and 20.7% (n = 6766) from DCD donors (67/70 countries reported deceased donor type). A total of 1282 split LTx were performed across 37 countries. Only a few cases of deceased domino LTx were reported, with 15 cases across 5 countries: United States (n = 4), Türkiye (n = 4), China (n = 3), India (n = 3), and Portugal (n = 1). Country-specific data are shown in Figure 8B.
LTx recipients of deceased donations were predominantly male (64.2%; n = 20 934), with females accounting for 32.4% (n = 10 580) of recipients (data from 61/67 countries). The same was the case for LTx recipients of living donations—most were male (54.1%; n = 5334) was male, while 38.3% (n = 3775) were female (data from 47/53 countries; Supplemental Figure 4A and B, SDC, https://links.lww.com/TP/D359). In comparison, 44% (n = 4334) of living liver donors were male, and 48.6% (n = 4796) were female (data from 48/53 countries; Supplemental Figure 3B [SDC, https://links.lww.com/TP/D359]). A total of 3652 pediatric LTx were performed in 53 countries.
By the end of 2024, 40 612 patients were waitlisted for LTx (66 countries), and 8895 patients had died in 2024 waiting for LTx (59 countries). India reported the highest absolute number of waitlisted patients (n = 12 903; 8.95 pmp), whereas Mongolia had the highest waitlist rate pmp (n = 268; 76.6 pmp; Figure 8B).
Heart Transplantation
Ten thousand two hundred eighty-seven HTx were performed across 59 countries in 2024, with a 2% increase compared with the previous year. The United States reported both the highest absolute number and the highest pmp rate (n = 4636; 13.6 pmp). Of all transplanted hearts, 89.5% (n = 9210) were derived from DBD donors. Only 9 countries, namely Australia, Austria, Belgium, Italy, Spain, Switzerland, the Netherlands, the United Kingdom, and the United States reported HTx from DCD donors, that accounted for 10.4% (n = 1073) of all HTx (Figure 9A).
FIGURE 9.
Kidney transplantation and liver transplantation data by country, 2024. A, Heart transplantation (HTx) and waitlist data by country, 2024. B, Lung transplantation (LuTx) and waitlist data by country, 2024. Mirrored “butterfly” plot showing waitlist burden (left; pmp) and transplants (right; pmp). Left bars are stacked as actively waitlisted patients, patients still waiting at year-end, and waitlist deaths; right bars are stacked by donor type (DBD, DCD, and LD). n at the left bar end indicates the number of actively waitlisted patients in case available; n at the right bar end indicates the absolute KTx count. Countries without waitlist data display transplant bars only and the other way around. Bars are ordered by transplant rate (pmp, descending). DBD, donation after brain death/neurological determination; DCD, donors after the circulatory determination of death; LD, living donation; pmp, per million population; WL, waiting list.
Of all HTx, 27% (n = 2778) went to female, 69.1% (n = 7113) to male recipients (data available for 54/59 countries; Supplemental Figure 5A [SDC, https://links.lww.com/TP/D359]). Across 44 countries, 1069 pediatric HTx were performed.
By the end of 2024, 13 243 patients were waitlisted for HTx (59 countries), and 1744 died while waiting (51 countries). The United States had the highest absolute number (n = 2938; 8.6 pmp), and Uruguay the highest pmp rate of waitlisted patients for HTx (n = 75; 22.6 pmp; Figure 9A).
Lung Transplantation
Eight thousand two hundred thirty-six LuTx were performed across 48 countries. LuTx activities increased by 6% compared with the previous year. The United States reported the highest absolute number (n = 3404; 9,96 pmp) and Spain the highest pmp rate (n = 623; 13.1 pmp). Only Japan performed LuTx from living donors, with a total of 18 living donor lung transplants. Of all LuTx, 99.8% (n = 8218) were performed following deceased donation, with 85.1% (n = 6996) from DBD donors, and 14.9% (n = 1222) from DCD donors (data available for 48 of 48 countries; Figure 9B).
Thirty-four percent (n = 2798) of recipient receiving deceased donor lungs were female, 58% were male (data available for 44/48 countries; Supplemental Figure 5B [SDC, https://links.lww.com/TP/D359]). Of the 18 living donor LuTx, 55.6% (n = 10) went into females. Across 22 countries, 127 pediatric LuTx were performed.
By the end of 2024, 6136 patients were waitlisted for LuTx, and 943 died while waiting (data from 49 and 42 countries, respectively). The highest absolute number of waitlisted patients was reported from India (0.86 pmp; n = 1246), while Israel had the highest rate pmp (22.5 pmp; n = 209; Figure 9B).
Of note, 112 combined heart-lung transplantations were performed across 19 countries in 2024. Each heart-lung transplantation was counted as 1 heart and 1 lung transplant separately and is therefore included in the corresponding organ-specific statistics.
Pancreas and Small Bowel Transplantation
PTx was performed in 2066 patients and SBTx in 174 across 39 and 20 countries, respectively. These figures represent an 1.5% increase for PTx while the rate for SBTx remained stagnant. The United States reported the highest absolute numbers for both organs (PTx n = 847; 2.48 pmp and SBTx n = 97; 0.284 pmp). In relative terms, Finland reported the highest PTx numbers pmp with 22 procedures pmp (n = 4), and Croatia the highest SBTx number pmp with 0.5 (n = 2). Country-specific data are shown in Figure 10A and B. Of PTx, 92.5% (n = 1912) and 97.1% (n = 169) of SBTx were performed after DBD donation, while 7.5% (n = 154) and 0.6% (n = 1), respectively, used grafts from DCD donors (for PTx, 39 countries with data; for SBTx, 20 countries with data; and for 4 SBTx, the deceased donor type was not specified).
FIGURE 10.
Kidney transplantation and liver transplantation data by country, 2024. A, Pancreas and waitlist data by country, 2024. B, Small bowel transplantation and waitlist data by country, 2024. Mirrored “butterfly” plots show waitlist burden (left; pmp) and transplants (right; pmp). Left bars are stacked as actively waitlisted patients, patients still waiting at year-end, and waitlist deaths; right bars are stacked by donor type (DBD, DCD, and LD). n at the left bar end indicates the number of actively waitlisted patients in case available; n at the right bar end indicates the absolute transplant count. Countries without waitlist data display transplant bars only and are ordered by transplant rate (pmp, descending). DBD, donation after brain death/neurological determination; DCD, donors after the circulatory determination of death; LD, living donation; pmp, per million population; WL, waiting list.
Of all PTx recipients, 39.3% (n = 811) were female, 52.7% (n = 1089) were male (35/39 countries with data). Among SBTx recipients, 40.8% (n = 71) were female, 55.2% (n = 96) were male (17/20 countries with data). In total, 58 pediatric PTx were performed in 9 countries and 49 pediatric SBTx in 8 countries.
By year’s end, 4041 patients were waitlisted for PTx (36 countries) and 288 for SBTx (19 countries). Along 2024, 312 patients died while waiting for PTx (20 countries), and 23 patients while waiting for SBTx (9 countries).
Notably, 1770 combined kidney-pancreas transplantations were reported in 34 countries. Each kidney-pancreas transplantation was counted as 1 kidney and 1 pancreas transplant separately and is therefore included in the corresponding organ-specific statistics.
DISCUSSION
In 2024, a total of 173 727 SOTs were reported to the GODT, a 2% increase compared with 2023. This marks the highest number ever recorded since data collection began in 2007.
Transplantation is often perceived as a highly sophisticated and costly therapy. However, the recent WHA Resolution 77.4 recognizes transplantation as an essential component to achieving target 3.4 of the United Nations Sustainable Development Goals, which is the reduction of premature mortality caused by noncommunicable diseases.8 While the resolution emphasizes the need for prevention and treatment of underlying conditions leading to end-stage organ failure, it also underscores that expanding transplantation capacity can contribute substantially to achieving this goal.9 A recent analysis projected that scaling up KTx alone could prevent between 290 000 and 1 000 000 deaths attributable to chronic kidney disease.10
Despite the clear benefits of transplantation and record-high global numbers of SOT, waiting list data (which underestimate the real need) demonstrate that the growth in transplantation remains constrained by the limited availability of donor organs. Current levels of donor activity are insufficient to meet the worldwide demand. In 2024, a total of 668 160 patients were reported as actively waitlisted for transplantation, and 31 853 patients died while waiting, underscoring the persistent and critical gap between need and supply.
A major factor underlying the persistent imbalance between need and availability is the shortage of organ donors in most countries. Nations lacking deceased donation programs, or reporting very low numbers of deceased donors, are particularly challenged. Even countries with well-established deceased donation programs are unable to meet the demand. Notably, countries that have implemented DCD programs such as the United States and Spain achieve higher donor and transplant rates, demonstrating that the development of DCD programs can effectively expand donor availability. Nonetheless, implementation depends on national legislation, ethical frameworks, and organizational readiness, including a globally unified concept of death that ensures consistency and trust.9,11,12
Beyond DCD implementation and a unified definition of death, several strategies have proven effective in increasing deceased donation rates. Engagement of intensive care professionals, the establishment of robust donor coordination systems, and a willingness to consider expanded criteria donors, including those of advanced age, have proven effective in some settings.13 Even among high Human Development Index countries, deceased donor rates vary greatly, suggesting considerable room for improvement through organizational and policy measures.14
Improving donor utilization may further help narrow the gap between demand and supply. Although the reported median utilization rate across countries was 98.1%, this figure is influenced by differences in donor volume between countries. When examining all deceased donors with complete data, 92.3% were donors whose organs ultimately proceeded to transplantation, while 7.7% (3580) did not proceed to transplantation. The gap was wider for DCD donors, with a utilization rate of 85.2%, leaving 1931 donors whose organs did not proceed to transplantation. These findings suggest that optimizing donor management, expanding acceptance criteria and incorporating novel preservation strategies could significantly improve organ availability.
Besides deceased donations, living donation continues to play an important role in addressing the persistent gap between organ demand and supply, with 14 countries reporting to the GODT relying solely on living donation. However, the promotion of living donation must remain grounded on the principles of donor protection, noncommercialization, and voluntary informed consent. Clear frameworks for living donor registration, follow-up care, and donor protection need to be in place to uphold ethical standards and ensure long-term well-being of donors.15
While expanding deceased and living donor numbers and optimizing utilization are critical, global inequality in access to transplantation remains another major challenge. More than half of all transplantations worldwide are performed in only 2 WHO regions (the Americas and Europe), a concentration that does not reflect global needs or population distribution. In 2024, KTx were reported in 90 countries, LTx in 71, HTx in 59, and LuTx in 48 countries, while many others do not offer these procedures. Access disparities are also evident when considering transplant rates pmp and the availability of transplant centers. These disparities are linked to the complexity of certain transplant procedures, but also to the costs of transplantation, which limits accessibility primarily to high-income countries. These disparities are linked to the complexity of certain transplant procedures, but also to the high costs of transplantation, which limits accessibility primarily to high-income countries. In many parts of the world, transplantation has not yet been incorporated into national health systems or noncommunicable disease treatment strategies, and national investments in several low- and middle-income countries continue to be higher for dialysis than for transplantation—even though, the long-term costs of KTx are lower than those of dialysis.16,17
The inequality in transplant access translates into measurable consequences not only in waiting list mortality but also in patient mobility for transplantation. Although not detailed in this report, patient travel for transplantation is a well-documented phenomenon.18 Ethical models of transnational cooperation, for example, through agreements based on reciprocity such as those implemented in some regions of Europe (eg, Luxembourg), where countries of origin provide organs for transplantation in partner countries, can create legitimate and equitable frameworks for cross-border transplants.19
It is important to acknowledge several limitations of the presented data. Not all countries performing transplantation currently report to the GODT, and some submissions remain incomplete, even though countries are encouraged to contribute their data in line with WHA Resolution 77.4.6 Reasons for nonparticipation include the absence of a national focal point, limited data collection resources, or low prioritization of reporting. Moreover, differences in legislation, reporting standards, clinical practices, and cultural factors complicate direct comparisons across countries and regions. The GODT also does not yet include patient-level information such as demographics, comorbidities, or outcomes, which limits the ability to assess graft and patient survival. Strengthening the questionnaire, promoting complete submissions, and improving consistency in reporting will be essential to enhance data comparability and analytical depth in the future.
Despite these limitations, the systematic collection and dissemination of global transplant activity data remain highly valuable, providing a unique opportunity to understand worldwide transplantation practices. GODT data facilitate the identification of emerging trends, highlight disparities, and pinpoint areas requiring improvement, thereby supporting efforts to expand and optimize transplantation globally. Moreover, they promote transparency, an essential foundation for a medical field that depends on public trust and community participation.
The year 2024 marked a record high in global transplantation activity, reflecting the progress achieved and the success of the transplant community. The continued efforts of the GODT to systematically collect and disseminate global data provide an essential tool for monitoring progress and guiding future strategies.
Supplementary Material
Footnotes
Unrelated to the article, S.G.T. received research funding from the National Institutes of Health (5R01AG064165-02, 1U01AG086168-01, 5P01AI175397-02, U54AG075941), Hevolution Foundation (HF-GRO-23-1199238-25), and from the Pablo and Almudena Legorreta Kidney Health Research Fund an unrestricted gift by Kenneth and Melissa Crane.
F.M. has received speaker honoraria from Glaxo Smith Kline unrelated to the content of this article. The other authors declare no conflicts of interest.
F.M. drafted the article and performed the data analysis. M.C. collected and cleaned the data and contributed to the data analysis and article preparation. S.G.T. and B.D.-G. supervised the study, edited the article, and provided critical revisions, contributing equally to this work. B.M., M.A., A.L., E.C., and M.L.-F. contributed to data collection, interpretation, and reviewed the article. All authors approved the final version of the article and agree to be accountable for all aspects of the work.
B.D.-G. and S.G.T. contributed equally to this article.
Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com).
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