Organ Donation: Which Countries Have The Most And Least Organ Donors?

Organ donation is the process of providing an organ or tissue to someone in need of a transplant. Donors can be living or deceased, and their generosity can transform lives. Receiving an organ donation can significantly improve or save the lives of people suffering from organ failure. A single donor can potentially save multiple lives—making it a selfless act with profound impact.

However, only 10% of the global demand for organ donation is currently being met, leaving millions of people waiting for life-saving transplants. Donation rates vary widely across the world, influenced by cultural attitudes, healthcare infrastructure, and national policies. In this article, we explore which countries have the highest organ donation rates, as well as those with the lowest.

In this article

• Which countries have the highest organ donation rates?
• Countries with the lowest organ donation rates
• Which country has the highest percentage of unutilised deceased organ donors?
• The most commonly donated organ
• How to become an organ donor

Organ donation around the world

Our research explores where organ donors are in the highest demand and which countries are stepping up to meet that need. By studying key data, we’ve uncovered the gaps in donations and the countries leading the way with the most registered donors.

We compare donation rates, the number of registered donors by country, and the organs most commonly donated worldwide. Additionally, we examine different donation systems—opt-in vs. opt-out—and how they impact donor registration.

Beyond organ donation, this research also emphasises the importance of international health insurance, which can play a key role in supporting people who need transplants and ensuring healthcare access globally.

Different countries have different types of healthcare systems

Take a look at the major types of healthcare systems around the world

The countries with the highest organ donation rates

1/ Spain

494 deceased donors per one million people

Spain has the highest organ donation rate, with 2,346 deceased registered donors in 2023, equaling 494 donors per one million people.

Spain’s effective government policies, public awareness campaigns, and robust healthcare system have achieved this impressive rate. Spain’s success in organ donation is due to its registration system, which automatically registers people as donors unless they explicitly opt out.

Spain has also focused on training medical professionals to identify potential donors early, ensuring that families are informed and supported. The country’s strong emphasis on transplant networks and national collaboration has also helped simplify the organ donation process and reduce wait times for patients needing transplants.

2/ United States

480 deceased donors per one million people

In 2023, the United States identified 480 deceased organ donors per one million people. The US operates under an opt-in donation, where people must register as donors at the United Network for Organ Sharing. Individuals can also register with the Department of Motor Vehicles by indicating their wishes on their driver’s license or state donor registry should they get into an accident.

Despite the challenges, the US has made significant progress in recent years, thanks to the efforts of the Organ Procurement and Transplantation Network, which works to improve the efficiency of organ donor identification and education. The US has also implemented public awareness campaigns to educate nationals about the importance of organ donation and the growing need for transplantable organs, especially with increasingly long waiting lists.

According to the American Transplant Foundation, over 100,000 Americans are currently waiting for an organ transplant, with the need for kidneys being the most critical.

3/ Portugal

368 deceased donors per one million people

Portugal is another European country experiencing an influx of organ donors, registering 368 deceased donors per one million people in 2023. This is a significant increase over the past decade, largely due to Portugal’s adoption of an opt-out donation system in 2018, automatically registering nationals as organ donors unless they choose to opt-out. 

Since its introduction, the country has seen a notable rise in donor registration and overall rates. Between 2018 and 2023, the number of deceased organ donors per million people rose by approximately 20% in Portugal.

Despite these gains, challenges have remained, particularly in rural areas with limited medical care access. However, Portugal continues to make progress in bridging these gaps, improving the efficiency of its transplant system, and reducing waiting times.

Top 10 countries with the highest organ donation rates

Rank

Country

Region

Total deceased donors

Total deceased donors per 1 million people

1

Spain

Europe

2,346

494

2

United States

Americas

16,336

480

3

Portugal

Europe

375

368

4

Belgium

Europe

383

327

5

Slovenia

Europe

64

305

6

Italy

Europe

1,731

294

7

Croatia

Europe

116

290

8

Czech Republic

Europe

299

285

9

Finland

Europe

155

282

10

France

Europe

1,791

276

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The countries with the lowest organ donation rates

1/ Kazakhstan

4 deceased donors per one million people

Kazakhstan has one of the lowest organ donation rates globally, with just 4 deceased donors per one million people in 2023. This places it at the top of the list of nations lacking in organ donations.

Despite efforts to raise awareness about the importance of donations, Kazakhstan still faces challenges in increasing these numbers, including cultural factors, a lack of public awareness, and limited infrastructure for transplantation.

Organ donation is voluntary in Kazakhstan, and the country’s healthcare system is still developing in this area. The government has recognised the ongoing need for training medical professionals to identify potential organ donors and support families in making decisions.

Kazakhstan’s lack of organ donations is a stark reminder of the global disparities and the ongoing work needed to increase donor registration and medical structure in certain countries.

2/ Oman

4 deceased donors per one million people

Oman is ranked alongside Kazakhstan, with only 4 deceased organ donors per one million people. Despite a relatively well-developed healthcare system, Oman faces several challenges when it comes to increasing organ donation.

One of the primary reasons Oman has a low organ donation rate is the influence of cultural and religious views. In Oman, as in other parts of the Middle East, there may be concerns about the sanctity of the body, and afterlife considerations play a huge role in public opinion.

Public awareness about the importance of organ donation remains limited, and many people are unaware of its benefits. This lack of understanding can create uncertainty and fear around the process and discourage people from registering as donors.

Despite these challenges, Oman is slowly making progress in addressing the organ donation gap, including launching a collaboration with neighbouring countries and international organisations to improve transplant and donation infrastructure.

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3/ Japan

12 deceased donors per one million people

Japan, with 12 deceased donors per one million people, faces unique challenges in improving organ donation rates despite being one of the world’s most advanced healthcare nations. While this figure is higher than that of countries like Kazakhstan and Oman, Japan falls behind countries such as Spain and Portugal.

One of the key barriers to organ donation in Japan is deeply rooted cultural attitudes. In Japan, there is a fear and reluctance surrounding the idea of death and the preservation of the body after death. Organ donation was also historically restricted by strict laws and a deep reluctance to recognise brain death as the official cause of death.

Although Japan passed the Organ Transplant Law in 1997, which legalised organ transplants from brain-dead individuals, the law included provisions that required consent from families for donation. This family-based consent law has significantly slowed the rate of donations.

The Japanese government has slowly increased its efforts to raise awareness and improve the donation process. For example, in 2020, the country introduced a law that lowered the age for registering as a donor from 15 to 13, hoping to encourage more young people to consider organ donation.

Top 10 countries with the lowest organ donation rates

Rank

Country

Region

Total deceased donors

Total deceased donors per 1 million people

1

Kazakhstan

Central Asia

7

4

2

Oman

Middle East

2

4

3

Japan

Southeast & East Asia

145

12

4

Malaysia

Southeast & East Asia

43

13

5

Serbia

Europe

13

18

6

Malta

Europe

1

20

7

Panama

Americas

12

27

8

Türkiye

Europe

305

36

9

Saudi Arabia

Middle East

146

40

10

Mexico

Americas

513

40

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The country with the highest percentage of unutilised deceased organ donors

Türkiye has the highest percentage of unutilised deceased organ donors

Percentage of unutilised deceased donors: 37.7%

Türkiye has the highest percentage of unutilised deceased organ donors, with a staggering 37.7% of potential organ donations not being utilised despite donors being registered.

While Türkiye’s organ donation rates are relatively high (36 per one million people), it still faces challenges in maximising its organ donors.

There is a substantial gap between the demand for organ transplants and the available donors. Türkiye has seen a significant rise in registered donors over the years, but the demand for organs, especially kidneys and livers, far exceeds the supply.

This imbalance means that when organs are available, they may not be suitable for transplantation due to tissue incompatibility, organ condition, or the timing of the donor’s death.

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The organ most commonly donated globally

Kidneys are the most commonly donated organ

Kidney transplants in 2023: 69,468

Kidneys are the most commonly donated organ worldwide, with 69,468 transplants across 53 countries in 2023. This is mainly because kidney disease is prevalent, and transplants are often the most effective treatment for people with end-stage renal failure.

There are also more patients waiting for kidney transplants than any other organ, which has contributed to higher donation rates and the longest waiting list of any other organ.

The liver is also in high demand, mainly due to diseases like cirrhosis (often caused by alcohol abuse or hepatitis), liver cancer, and non-alcoholic fatty liver disease. According to a study by Clinical Medicine, liver transplantation is now a routine procedure with a five-year survival of more than 70%. However, there is a shortage of grafts, and 15% of listed patients die while awaiting a graft.

Heart transplants are also in high demand for patients with end-stage heart failure, which can result from coronary artery disease, congenital heart defects, or heart valve disease. The demand for heart transplants is large but not as significant as for kidneys. Heart transplants still face considerable shortages, especially in younger patients.

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How to become an organ donor in the UK

In May 2020, the law around organ donation in England was changed to allow more people to save more lives.

Now that the law has changed, it will be considered that you agree to donate your organs when you die if you are:

• an adult over 18
• you have not opted out
• you are not in an excluded group

However, the public still has a choice whether or not to become an organ donor and can register or amend their decisions on the NHS website.

In Wales, the legalisation is ‘deemed consent’, which means that if you haven’t organised an organ and tissue donation decision, you are considered to have no objection to becoming a donor. Scotland follows the same procedure called ‘deemed authorisation’.

If you’re interested in becoming an organ donor, the process varies by country. Check your local health authority or organ donation registry to find out how to register and understand the donation practices in your country.

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Wherever you go, go with total peace of mind

At William Russell, we have over 30 years’ experience of helping expatriates finding best places in the world to move abroad and settle into their new lives overseas by providing world-class international health insurance. Plus, we produce lots of expert material to help you and your family adapt to life abroad.

Making the move to another country can be challenging. But no matter where you go, you can take one thing off your mind. William Russell offers international health insurance that covers you for everything from minor injuries to long hospital stays, and we also provide medical evacuations for patients who require emergency life or limb-threatening treatment where it’s not available locally.

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Methodology

The list of countries was taken using OECD-registered countries and the Human Development Index, selecting countries with an HDI score of 0.8 or higher as of 2022.

Organ donation data for each country as of 2023 were collected from the Global Observatory on Donation and Transplantation.