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Organ donation in the UK

Donating your organs or tissue means that they will be given to someone who needs a transplant. It can improve their health or even save their life.

Organ and tissue donation include different things: 

- Organ donation involves donating your kidney, heart, liver, small bowel, pancreas, or lungs.
Tissue donation involves donating your skin, bone, tendons, part of your eyes (corneas), or heart valves.

There are different laws applicable when choosing whether or not to donate your organs and tissues in the different nations of the UK. How you make your decision depends on which country you live in.


Organ donation law in England

On 20th May 2020, the law around organ donation in England changed to an opt-out system.

The opt-out system means that all adults (over the age of 18) agree to become organ donors when they die unless they have made it known that they do not wish to donate.

If you have not recorded an organ donation decision and you are not in one of the excluded groups (this includes people under 18, people who have lived in England for less than 12 months or who are not living here voluntarily, and people who lack the capacity to understand the change), it will be considered that you agree to donate your organs when you die. This means that when you die, the healthcare team will consider if your organs or tissues can be donated to someone else.

The law applies to routine transplants, and not novel or rare transplants.

You may not want to make an organ decision yourself, in which case you can nominate up to two representatives to make the final decision about organ donation on your behalf.

You can register your decision on the NHS Blood and Transplant website.


Organ donation law in Wales

Similar to England, the legislation for Wales is ‘deemed consent’ (which is essentially an opt-out system). This means that if you haven’t registered a decision on organ and tissue donation (you’ve not opted in or opted out), you will be considered to have no objection to becoming a donor when you die. You can still opt in to the register if you want to do so, but it is not a requirement in order to give consent for the donation.

You can also nominate up to two representatives (for example family, friends or other people you trust) to make the decision for you.


Organ donation law in Scotland

At present, there is an opt-in system for organ and tissue donation in place in Scotland. Opt-in means that you can join the organ register to say that you would like your organs to be considered for donation after you die. If you don’t join the organ register, your organs won’t automatically be considered for donation. If you live in Scotland and want to donate your organs or tissue, you will need to join the organ donor register to give legal consent by visiting the Organ Donation Scotland website.

However, from 26 March 2021, the law in Scotland is also changing to an opt-out system. If you die in circumstances where you could become a donor and have not recorded a donation decision, it may be assumed you are willing to donate your organs and tissue for transplantation. In other countries within the UK this is referred to as an ‘opt out’ system and will apply to most adult’s resident in Scotland.


Talk to your loved ones about your decision

Whatever your organ donation decision, the best thing you can do is talk with your loved ones and let them know so that your wishes can be carried out after you die. You can share your wishes using our free template.

Families are always approached before organ donation goes ahead, even within an 'opt-out' system, so they will still be able to provide information on your wishes. Should a family member have information that is more recent than any decision recorded on the NHS Organ Donation Register, for example that their loved one would not have wanted to donate their organs or tissues, organ donation will not go ahead.

When families decide not to allow donation, it’s often because they don’t know what their loved one would have wanted.


Within an opt-out system the decision about whether or not you choose to donate your organs is still yours to make.

If you don’t want to donate, it’s really quick and simple to record your decision on the NHS Organ Donor Register. If you change your mind you can always update your donation preferences, just make sure you let your friends and family know so they can support your wishes.

You can find further information on the NHS Blood and Transplant website.

You may also be able to donate your body to science. Body donation is an invaluable resource for medical schools, used to teach medical professionals of the future and as part of scientific studies to help experts understand the human body and disease. Unfortunately, many people are unaware that there is a requirement to apply, and not everyone that applies can be accepted. Contact your nearest medical school for a consent form for more information.


For more help and guidance on planning ahead, visit our guidance and advice section, alternatively, you can use our free template to share your wishes with your family.


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