Organ donation

Organ donation is the process of giving an organ to help someone who needs a transplant.

Organs such as kidneys, the heart, liver, lungs, pancreas, and the small bowel can all be transplanted effectively.  

Organ donation can occur as donation from a living donor (living organ donation) and as a donation from a person who has died (deceased organ donation). 

Transplants are one of the biggest achievements of modern medicine and can work to save or greatly enhance the lives of people who need them. The availability of a transplant depends completely on donors and their families consenting to organ or tissue donation.  

One donor can save the life of several people, restore the sight of 2 people, and improve the quality of life of many more. 

'Opt-out' system of organ donation 

Organ donation in England, Northern Ireland, Scotland, and Wales works by the ‘opt-out’ or ‘deemed consent’ system.

With 'opt out' consent law, any person over the age of 18 who is not in an excluded group who has not opted out of organ donation is assumed to have no objection to becoming an organ donor when they die (NHS Blood and Transplant, October 2025).  

If a person does not want to be an organ donor they can opt out and withdraw their consent at any time.  

Deemed consent or the opt out system does not apply to children (persons under age 18). If someone under the age of 18 is a potential donor their guardian or parents would have the option to provide consent on their child’s behalf.  

People under the age of 18 can also record their decision on the NHS Organ Donor Register to consent or opt out of donation. 

Organ donor register 

While the opt-out system presumes organ donation unless a person is under age 18, has opted out, or is a part of an excluded group, the organ donor register is available to ensure that the choice about being an organ donor is upheld.  

If a potential donor’s family objects to the organs being donated and the donor’s decision is not registered, the organ donation will not proceed. Registering is the best way to ensure that your decision to donate or to opt out of donation is upheld. 

Joining the Organ Donor Register is a way of giving legal consent for donation to take place. Everyone can join the NHS Organ Donation Register regardless of age or health, as long as they are considered legally competent.

People may also appoint a representative who is legally able to uphold the potential donor’s decision. 

When you register to donate your organs, you are also given the opportunity to choose whether you will donate specific organs and/or tissue or to donate all of your organs as well as tissue as part of your consent. 

For more information about the opt out system and consent with organ donation, refer to the NHS organ donation website (see ‘Resources and Information’). 

Eligibility of organ donation  

It is the person’s physical condition rather than their age that is the deciding factor of organ and tissue donation eligibility. Having a medical condition does not necessarily prevent a person from becoming an organ or tissue donor.  

The decision about whether some or all organs or tissue are suitable for transplant is made by a doctor, taking into account a person’s medical, travel, and social history.  

Anyone who has been diagnosed with or is suspected of having the following cannot become a donor: 

• Creutzfeldt-Jakob Disease (CJD) 
• Ebola virus disease 
• Active cancer 

People with HIV cannot normally become an organ or tissue donor, but can still register to donate. Organs of donors with HIV may be used in rare cases to help others who are HIV+ with similar conditions as the donor. 

Every year hundreds of people die while waiting for an organ transplant or before they even get on to the transplant list.

There is a shortage of organs available for those in need of a transplant, and the gap between the number of organs donated and the number of people waiting for a transplant is increasing.  

The shortage of organs has led to an increasing number of organ donations by living people as living donations (see 'Experiences of living donors').

Organ donation in black and minority ethnic communities

People from Black African, Black Caribbean, and South Asian communities living in the UK are more likely to need a kidney transplant than the rest of the population.

This increased likelihood is because people from these communities are more likely to develop diabetes or high blood pressure, both of which are major causes of kidney failure.

As well, kidney donors are matched by blood group and tissue type. As such, there is a better chance of finding a match with and better outcomes for the recipient if the donor is of the same ethnicity. 

Unfortunately, while the need for donor organs is high, the donation rates are relatively low among Black and South Asian communities, reducing the chance of a successful match being found (see 'Life before the transplant').

Therefore, not only are members of these communities at higher risk of kidney failure, it is also harder to find a suitable donor, and waiting lists are growing.

Although living donor kidney transplantation can help some of these people, it is also essential to increase the number of people from these communities who are willing to donate organs after their death (see ‘Views on organ donation’).

Of note, all the major religions of the UK support the principles of organ donation and transplantation.

What is tissue donation?

Tissue donation involves donating tissue such as corneas, skin, bone, tendons, cartilage, and heart valves to help others.

Every year thousands of people with a severe eye disease or injury have their sight restored by donated corneas. Bone, tendons, and cartilage are used for reconstruction after an injury or during joint replacement surgery.

A bone transplant can prevent limb amputation in patients suffering from bone cancer.

Heart valves are used to help children born with heart defects and adults with diseased or damaged valves. Skin grafts are used to treat people with severe burns.

Bone marrow or stem cells can also be donated. Bone marrow is a soft tissue found in the centre of certain bones in your body and stem cells are cells that change into other blood cells.

People donating bone marrow and stem cells must register with a donor organisation registry and meet the organisations eligibility criteria (for more information see ‘Resources and Information’). 

Most people can donate tissue. Unlike organs, it may be possible to donate tissue up to 48 hours after a person has died.

Last reviewed: November 2025.
Last updated: November 2025.