In Telangana, the Jeevandan organ donation initiative is heavily reliant on private hospitals, which have accounted for nearly 97% of the 1,710 organ donations recorded, compared to just 61 from government institutions. This trend is mirrored in transplant numbers, with private hospitals conducting 4,245 procedures against 722 in government hospitals. Health experts attribute this disparity to critical gaps in public healthcare infrastructure, particularly in intensive care unit (ICU) availability and trained personnel for identifying potential donors. Government hospitals often struggle with emergency and trauma care demands, which limits their ability to engage in organ donation activities effectively. Experts suggest that enhancing ICU facilities, appointing dedicated transplant coordinators, and increasing public awareness about organ donation are essential steps to improve the situation. They recommend establishing specialized transplant departments in major government hospitals to build a robust organ donation network, similar to successful models in institutions like the All India Institute of Medical Sciences (AIIMS). Without these improvements, economically disadvantaged patients may continue to face barriers to accessing affordable transplant care.