Organ donation is one of the greatest expressions of community and compassion. That is why it is known as the gift of life.
There are currently more than 650 people on transplant waiting lists in Ireland, over 500 of them waiting for a kidney. Behind each figure is a person – on dialysis three times a week, waiting for a lung, a liver, a heart, a pancreas – and a family living with uncertainty and hope.
When someone chooses to become an organ donor, they are offering strangers a precious second chance. It’s an act of generosity that ripples outwards. It helps patients, their families, their friends and their wider communities.
You are three times more likely to need an organ transplant than to be in a position to donate your organs after death.
Over 650 people are on the organ transplant waiting list.
THE DONOR CARD
The Organ Donor Card is a visual representation of your decision to give the ‘Gift Of Life’ in the event of your death. By signing the card and carrying it with you, you are documenting your wishes to be an organ donor.
The card plays an important role in initiating the ‘Organ Donation Conversation’ with your loved ones. Discussing your wishes openly ensures that your family understands and honours your decision.
The Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Act 2024 commenced on Tuesday 17th June 2025. The Irish Kidney Association welcomes this legislation as a positive step forward in the advancement of organ donation and transplantation in Ireland, providing a long-awaited legal framework for these life saving practices.
The Human Tissue Act introduces two key elements
Opt-out Register
The introduction of an Opt-out Register that will be managed by the HSE. Individuals who do not wish to donate their organs can register their decision on the Opt-out Register. If a potential organ donor is on this register, their family will not be approached regarding organ donation, and their wishes will be respected.
Deemed Consent
The introduction of Deemed Consent. By not opting out, a person is agreeing to be considered as a potential organ donor. The family remains part of the decision making process.
The legislation introduces an Opt-out Register that is operated by the HSE. If you choose not to be considered a potential organ donor, you can record your details on the Opt-out Register and your wishes are protected as a point of law.
Under the new legislation, if a potential donor is identified, the healthcare professional will first check the Opt-out Register to see if the potential donor has registered their objection.
If the potential donor has registered their decision on the Opt-out Register, the family will not be approached and organ donation will not take place.
If the potential donor has not registered their decision on the Opt-out Register, the family will be approached to be asked if their loved one would have had any objection to organ donation going ahead.
The HSE has put together a Frequently Asked Questions section on their website that address many of the common queries or concerns that have been raised in relation to the legislation.
It has always been the case that in the event that someone is identified as a potential organ donor (they have been declared brain-stem dead when on a life-support machine in an Intensive Care Unit) their family is approached for consent to retrieval of the organs for transplantation. This role remains with the commencement of the Human Tissue Act.
Who Is a Designated Family Member?
A designated family member is someone who had a close relationship with the person before they died and can help communicate their wishes.
The person chosen should have had meaningful contact with the medical team and be able to help communicate the person’s wishes clearly.
The law also sets out an order of priority if more than one person could act as the designated family member.
The Role of the Family
When Someone May Not Be Able to Act As A Designated Family Member
They are legally separated from the deceased.
This includes a husband, wife or civil partner of the person who has died if:
They have a legal separation (a deed of separation or a court-ordered separation, either in Ireland or from another country that Ireland recognises.
They have signed a written agreement to separate.
They have separated and have not lived together for at least 12 months in a row.
They do not feel able to make a decision.
This includes anyone who does not have ability to give informed consent. For example, if the person:
Does not have the mental capacity to give informed consent.
Does not want to think about or discuss whether they agree or object.
Cannot make a clear decision about agreeing or objecting.
Cannot clearly say that they have no objection to organ donation being presumed.
They are under 18 (except in certain situations).
Children under 18 are not counted when deciding who the ‘designated family member’ is.
The only exception is if the child under 18 is the parent of the person who has died. In that case, they can be the designated family member.
They cannot be contacted in time.
This applies where it is not reasonably possible to contact or talk to the person in the time available for a decision about organ donation to be made and acted on. If there is no realistic way to reach them in time, they will not be treated as the designated family member for that decision.
The relationship to the deceased cannot be confirmed.
This applies where doctors cannot be sure what the person’s relationship is to the patient. If the relationship cannot be clearly confirmed, that person will not be treated as the designated family member.
Why the Family Conversation Matters
Under the Human Tissue Act 2024, every adult in Ireland is treated as having agreed to be a potential organ donor when they die, unless they have put their name on the Organ Donation Opt-Out Register, or are in one of the groups that are excluded.
However, this does not mean that families are left out of the process. In fact, families remain a key part of the decision. Even though consent is presumed, the medical team will always speak with the family before any donation goes ahead. No organs will be donated without this careful and respectful conversation.
The wishes of the person who has died should always be at the centre of any decision. The family’s role is to help the healthcare team understand and respect those wishes.
Against the backdrop of the extraordinary thoughtfulness of organ donors and their families, the IKA is deeply concerned about the decline in transplant activity. Figures published by the HSE show that organ donation and transplantation in Ireland fell sharply in 2025, with 202 organ transplants carried out – the lowest total in five years and well below the five-year pre-pandemic average of 282.
