Over 4 million people withhold consent for organ donation

Before 2020, the Donor Register required people to make an active choice regarding donation of organs and tissues after death. Those who did not make a choice were not included in the register. However, the Donor Act of 1 July 2020 stipulates that all inhabitants of the Netherlands aged 18 and over are to be included in the Donor Register as having ‘no objection to organ donation’ if they do not register their preference. They have therefore been regarded as potential organ donors since the time this act was amended. In 2024 - just as in 2022 - 3.3 million people had not registered a preference in the Donor Register, and are therefore registered as having no objection to organ donation.

One and a half times more adults have registered their choice

On 1 January 2020, when the old Donor Act was still in force, 49 percent of the Dutch population aged 18 years and over had registered their preference in the Donor Register. This means that they gave their active consent to organ donation or actively withheld their consent, or that they had named a family member or another person to decide on this on their behalf. By 1 January 2024 that share had risen to 72 percent. Forty-one percent of adults who had registered their preference in the Donor Register did not consent to organ donation, up by 34 percent compared with 2020.

Adults of non-Dutch origin more likely not to be donors

Thirty-four percent of adults of Dutch origin who had registered their choice in the Donor Register did not consent to organ donation in 2024. This was 64 percent among adults of non-Dutch origin<Link 2>. People aged 18 and over who are of Moroccan or Turkish origin were the most likely not to consent to organ donation (96 and 89 percent, respectively), and adults of European or Indonesian origin were the least likely (45 percent) to do so.

The fact that people of non-Dutch origin are less likely to be donors may lead to a shortage of donors for this group. The chances of finding a matching organ that is not rejected by a recipient are highest if the organ is donated by someone from the same ethnic group.

People born abroad or with both parents born abroad are more likely not to consent

Adults from all groups of non-Dutch origin who were born abroad, or with both parents born abroad, were more likely to withhold their consent for organ donation than adults born in the Netherlands or with one parent born in the Netherlands.

For instance, 78 percent of people born in Suriname have opted to withhold their consent for organ donation; among those born in the Netherlands and with both parents born in Suriname, this share was 76 percent. However, among those with one parent born in Suriname and the other born in the Netherlands, the share was significantly lower, at 53 percent.

Twenty thousand people changed their preference from yes to no

Anyone who is included in the Donor Register can amend their choice at any time. Between 1 January 2022 and 1 January 2024, over 20 thousand adults changed their preference from an active consent to no consent, while 6 thousand people changed their preference in the other direction. Nearly 35 thousand people who were registered as having 'no objection to organ donation’ in 2022 opted for ‘no consent’ in 2024, while 16 thousand gave their active consent.

Rotterdam and The Hague have the highest numbers of residents not giving consent

In Rozendaal, the proportion of adults who have registered their choice in the Donor Register was the highest in the country (86 percent), while in Amsterdam and Diemen it was the lowest (60 percent).

The largest group of adults who have chosen not to allow their organs to be donated were residents of Rotterdam (57 percent), while The Hague ranked second at 56 percent. The share was lowest in Hilvarenbeek and Rozendaal, at 25 percent.