Automatic donor registration resulted in more organ donors, but the increase is modest

The number of organ donations has increased since the introduction of the new system in which everyone is automatically registered as a donor, though the increase is relatively modest, according to a study by the Dutch Transplant Foundation and Maastricht UMC+.

Under the old system, where only people who actively chose to do so were registered as donors, the number of donors hovered around 250 per year. Since the summer of 2020, you have to actively register as not a donor; everyone else is registered as “no objection” to donating their organs after death. However, in more than half of these cases, surviving relatives still refuse to consent to organ donations.

After 2020, the number of donors rose steadily toward 300 per year, with a notable spike in 2024. That year, doctors were able to use organs from 360 deceased people to help others. Last year, the total figure came in slightly above 300.

Another striking trend identified by the researchers is an increase in organ donations following euthanasia. These rose from 11 cases in 2020 to 34 in 2025.

According to the study, the new system is not the only factor driving the increase in donors. Technical capabilities for utilizing organs after death have also improved. Organ donation is possible for only a small fraction of people who die. The donor must be in a hospital setting and possess viable organs.

Over a third of Dutch adults have actively registered as a donor, while 31 percent have actively indicated that they do not wish to donate their organs. A quarter registered under the “no objection” category, and the remaining 11 percent leave the decision to their loved ones.

The findings were published in the journal Transplant International. De Volkskrant was the first to report on the study on Thursday morning.