Irish Kidney Association chief executive Mark Murphy said the dialysis capacity cannot meet the growing demand. He also warned the number of people on dialysis would double in the next five years.
Of the 1,300 people on dialysis, 450 are awaiting a transplant. However, it can take up to two years just to get on the waiting list.
There were 124 kidney transplants last year, compared to 146 in 2004. However, figures for transplant operations over the last decade have been lower.
Renal services are being reviewed by a national expert committee appointed by the Health Service Executive (HSE).
Its report is expected to be published later this year.
While the Government has given the green light to re-establishing the living donor transplant programme in Ireland and provided money to start it up last December, the HSE has yet to drive it forward.
While Ireland is fifth in Europe for organ donation, the country falls back to 12th position for kidney transplants because it does not have a living donor programme.
Ireland has continued to carry out one or two living donor transplants each year, but the recipients are nearly always children.
Mr Murphy also reckons it will take 10 years before the number of live kidney transplants could be increased to 150 a year.
“Transplantation is far cheaper than dialysis and I wonder why the investment is not there. Economics, let alone the quality of life changes, should be the driver,” he said.
It costs €75,000 a year to keep a patient on dialysis. A transplant costs €20,000 and€ 8,000 a year for follow-up treatment.
Mr Murphy, who is also chair of the Irish Donor Network, also believes more organs would be harvested if intensive care units had paid donor co-ordinators.
Chief executive of the Cystic Fibrosis Association of Ireland, Godfrey Fletcher, said Ireland needed its own independent transplant authority to audit the allocation of donated organs.
Currently, UK Transplant is contracted by the Department of Health to ensure donated organs are matched and allocated in a fair and unbiased way.
Mr Fletcher said 23 lungs were donated between 2003 and 2004 but only 14 over the period 2004 to 2005 and the reasons for this needed to be examined.
Patients with cystic fibrosis are still going to the Freeman Hospital in Newcastle for lung transplants but only six underwent the procedure in the hospital last year.
About 20 Irish people are on the Newcastle waiting list, of which 14 are cystic fibrosis patients.
Meanwhile, the liver transplantation unit in St Vincent’s Hospital in Dublin carried out a record 56 liver transplants last year, beating its record of 45 transplants et in 2004. During the same year, Ireland exported six livers and imported six.