Kidney and liver transplantation: state funding, living donor rules and treatment abroad

What is an organ transplant and who makes the decision?

An organ transplant, or transplantation, replaces a severely damaged organ with a healthy organ, or part of one, from a donor. A kidney transplant is usually considered in end-stage kidney failure, when the patient is on dialysis or close to it; a liver transplant in end-stage liver disease or certain tumours. The organ may come from a deceased donor or a living donor: in the case of the kidney, one kidney; in the case of the liver, part of it. Organs from deceased donors are allocated only to people registered on the national waiting list; registration on the list is free and it covers citizens of Georgia, stateless persons with status in Georgia, asylum seekers, refugees and persons with additional protection (Articles 3, 11 and 12 of the law).

Whether a transplant is indicated, when it should take place and whether the donor is suitable are assessed by the treating nephrologist or hepatologist, the transplant surgeon and the team; the law also requires that removing the organ must not seriously endanger the donor's physical or mental health. This guide does not replace a medical decision: it describes who funds transplants in 2026, what the law requires of a living donor and which documents the case needs in Georgia or abroad.

An important starting point: both the basic Universal Healthcare package and the package for protected groups expressly exclude organ transplantation. Funding therefore comes through the special programmes described below, not under the rules described in the Universal Healthcare guide.

Kidney: the dialysis and kidney transplantation programme

The 2026 state programme "Dialysis and Kidney Transplantation" (code 27 03 03 04) serves Georgian citizens with end-stage kidney failure and those who have had an organ transplant. It is implemented by the National Health Agency, and you receive the services as state assistance. The programme has four main parts:

• Dialysis. Haemodialysis is funded for up to 157 sessions per beneficiary per year, and if more sessions become necessary under the guideline, the provider carries them out free of charge. Peritoneal dialysis is funded through a monthly voucher. Patients with acute kidney injury count as temporary beneficiaries after hospitalisation, for no more than 90 days.
• The transplant operation. One kidney transplant operation is reimbursed at actual cost, but not more than GEL 20,000. The patient is recognised as a beneficiary through an approval letter, issued after review of Form IV-100/a, a copy of the identity document and the cost estimate.
• Immunosuppression. A transplant patient receives immunosuppressive medicines, including induction therapy and medicines for high immunological risk, free of charge and without co-payment. The medicines are dispensed with a prescription from a medical facility, through the pharmacies of the programme's provider.
• The transplantation information bank. The programme also funds the operation of the bank, which keeps records of potential donors and recipients.

The practical conclusion: if the actual cost of the operation exceeds GEL 20,000, the difference is yours to pay. You can try to cover it through the referral commission or the municipality's general healthcare programme, stating the state programme's share and the remaining amount separately in the application.

Liver: the organ transplantation programme and local programmes

Liver transplantation is covered by the 2026 state programme "Organ Transplantation" (code 27 03 03 03), which also includes bone marrow transplantation. The tariff for liver transplantation is GEL 120,000: the service is funded in full within the tariff through a physical voucher, taking actual costs into account, and each service only once per budget year. The programme is implemented by the National Health Agency.

The beneficiary is a Georgian citizen who needs a liver transplant, except beneficiaries of the corresponding programmes of Tbilisi and the Autonomous Republic of Adjara. To obtain the voucher, you apply to the Agency, attaching:

• a copy of the patient's ID or passport, and for an internally displaced person also the document confirming that status;
• for a minor, a copy of the ID of a parent or legal representative and a copy of the child's birth certificate;
• a document confirming that the patient is registered outside Tbilisi and Adjara;
• Form IV-100/a, with the diagnosis, interventions and tests coded under ICD-10;
• for a living donor, the consent issued to the living donation (the programme text still names the consent of the Transplantation Council or a court, while from 1 September 2026 the law requires the consent of the Living Donation Commission and a court);
• the provider facility's invoice.

Under the general rules of the programmes, the voucher or approval letter must be issued within 10 working days of receipt of the application, or within the same period you must be informed in writing of what is holding it up.

Tbilisi and Adjara

The transplantation sub-programme of Tbilisi Municipality funds liver transplantation in Georgia for citizens registered in Tbilisi, also up to GEL 120,000. The application must include an information card confirming registration in Tbilisi for the past year and, for a living donor, the same consent issued to the living donation. People registered in Adjara are served by the Autonomous Republic's own programme, whose conditions you should check with the Adjara health authority. We explain the general logic of municipal programmes in the municipal assistance guide.

Who can be a living donor under Georgian law?

Law of Georgia No. 3611 of 1 November 2023 "On Human Organ Transplantation", which has been in force since 1 September 2026 and replaces the 2000 law of the same name, allows an organ to be taken from a living donor only to treat the recipient, when a suitable organ from a deceased donor is not available and no alternative treatment with a similar effect exists. The donor must be an adult with legal capacity who has no support arrangement in place: a citizen of Georgia, a stateless person with status in Georgia, an asylum seeker, a refugee or a person with additional protection, or a foreign-citizen genetic relative of a recipient who is a citizen of Georgia (Article 15). In addition, the donor must have one of the ties to the recipient defined in Article 16 of the law:

The table summarises Articles 15 and 16 of the law (No. 3611, as amended by Law No. 871 of 26 June 2025). Every living donation needs the consent of both the Commission and a court, and if the declared kinship or relationship cannot be proved, the donation does not go ahead. If the recipient is a foreign citizen, an appropriate agreement between the competent authorities of Georgia and of that country is also required (Article 15(2)(g)). The law governs the transplantation of organs; check the rules for bone marrow donation with the transplant centre.

The law also provides for an organ cross-donation programme: if a recipient cannot receive an organ from their own related or close donor because of immunological incompatibility, organs are exchanged between such pairs under the rules and conditions set by order of the Minister (Article 16(7)). The Living Donation Commission is set up by the Minister; it is independent of the transplant centre and its members are a psychologist, a psychiatrist, a social worker and a living donation specialist. The Commission gives its consent only if every member agrees, and the application to the court is filed by the donor, the recipient or the Commission, according to the donor's place of residence (Articles 19 and 20).

Informed consent and prohibitions

Before giving written informed consent, the donor receives impartial counselling from a living donation specialist on the risks of donation, the expected consequences, alternative treatments for the recipient and the donor's rights; the medical assessment is carried out by the transplant centre and the psychosocial assessment by the Commission. The donor has the right to withdraw from the donation at any time without any consequences for them. The law prohibits receiving or offering money or any other benefit in exchange for donation, as well as organ trafficking: only compensation for lost income and justified expenses is allowed, and the donor's medical costs are covered by the transplant centre. A doctor is forbidden to take part in removing or transplanting an organ if they know or have good reason to suspect that the donation is based on such a deal. The law also prohibits advertising clinics and doctors that carry out transplants, so this guide does not name any particular clinic or doctor.

How do you prove kinship and prepare the papers for the Commission and the court?

The state and Tbilisi programmes require the consent to living donation directly with a liver transplant application, and from 1 September 2026 this consent consists of two separate decisions: one by the Living Donation Commission and one by a court. Both are based on documents proving kinship or the relationship, and collecting them often takes the most time. The declared relationship is checked under a protocol set by a joint order of the Ministers of Health and Justice.

1. Establish the chain of kinship

   For siblings, both persons' birth certificates are needed; for cousins, the parents' birth certificates too, so that the common ancestor is visible. For a spouse, the marriage certificate with the registration date. If the documents cannot establish the genetic link, the law provides for a DNA test.

2. Obtain the civil status records

   Birth and marriage records and, where needed, change-of-surname records from the civil registry. If a document was issued abroad, it needs legalisation or an apostille and a translation.

3. The medical part

   The clinic prepares the donor's and recipient's test results and the compatibility report. Form 100 must be completed for both with ICD-10 codes.

4. The court route

   Besides the Commission's consent, every living donation also needs the consent of a court: the application is filed by the donor, the recipient or the Commission according to the donor's place of residence, under the Civil Procedure Code. For a donor in a close personal relationship, evidence of the length and stability of the relationship is also needed, so consulting a lawyer in advance is worthwhile.

We describe the translation of civil status certificates on the civil status records translation page, and we prepare the certification of documents for use abroad through our apostille service. Check with the tool which countries require an apostille and which require consular legalisation.

Funding sources in one table

The table is based on the 2026 state programmes and Tbilisi's 2026 rules. Funding is determined in each case by the authority's decision; Solidaroba.ge is neither a fund nor a state body.

A transplant abroad: what should you know in advance?

Families mostly consider a foreign centre when a particular type of transplant, or the complexity of the case, is a limitation for the team in Georgia, or when they want a second opinion. Three things need to be taken into account.

• Funding. The state and Tbilisi liver transplantation programmes are designed for operations carried out in Georgia, and the kidney operation tariff reflects local costs. State co-funding of a transplant abroad is considered by the referral commission, on the basis of a specialist expert's opinion; the procedure is in the guide to funding treatment abroad.
• The host country's rules. For a living-donor transplant, foreign centres usually require documentary proof of kinship between donor and recipient and the approval of a local committee. In India, for example, a foreign patient needs the permission of a special committee and confirmation from the embassy, as described in the India guide. Civil status documents need a translation and an apostille.
• Legality. Buying an organ or giving a donor money or any other benefit in exchange for donation is prohibited under Georgian law, and a centre that offers to "find" a donor for money is a sign of serious legal and medical risk. Turn such offers down.

What a transplant centre asks for a preliminary assessment

Centres usually ask for the recipient's full medical history, recent laboratory test results, imaging studies with reports, the history of dialysis or hepatology treatment and the blood group, and for a living donor also the donor's preliminary tests. The centre itself provides the exact list. Our clinic search service can help you choose a clinic and compare cost estimates.

The document package and translation

If the donor is living, a transplant case concerns two patients, so the package is double. For the recipient: Form IV-100/a with ICD-10 codes, discharge summaries, the history of dialysis or hepatology treatment, laboratory and imaging studies with reports, and a list of current medicines. For the donor: the identity document, test results, documents proving kinship or the relationship, and informed consent. For funding: the clinic's invoice or cost estimate and, for a liver transplant, the consent of the Living Donation Commission and a court.

For a foreign centre, medical documents are translated into English or the centre's language, and civil status documents go with a translation and an apostille; for the referral commission, a foreign cost estimate is translated into Georgian with notarisation. We translate discharge summaries following the procedure on the discharge summary translation page and cost estimates following the procedure on the financial documents translation page, and the Translation price calculator shows you an indicative price. The general checklist is in the documents guide, and how to complete the certificate correctly is in the Form 100 guide.

Frequently asked questions about organ transplantation