There is an increase in the number of families who do not want to donate the organs of a relative when they die.

BarcelonaOnce again, Catalonia has achieved very positive organ transplant figures, positioning the region as a world leader in this field. Last year, 1,356 transplants were performed, 0.8% more than two years ago, representing the second-highest figure on record, according to the annual report by the Catalan Transplant Organization (OCATT). Despite celebrating the continuation of this positive trend, OCATT has detected a worrying pattern in the donation process: family refusals have increased to 27.6%, the highest percentage since data has been available. This means that almost a third of Catalan families are ruling out organ donation from a loved one upon their death.

In a conversation with ARA, the director of OCATT, Jaume Tort, acknowledged that this increase is worrying and that they are working to reverse it. Just ten years ago, the percentage of family refusals was lower, at 14.9%, but in the last decade it has been gradually increasing, and the Catalan Health Department (Salut) points to "different social factors." The trend in refusals in recent years is clearly upward: in 2022 it was 17.4%, in 2023 22.4%, and in 2024 25.8%. The prior refusal of the potential donor or their family, without any other reason, was the reason given by families in 77% of cases, while 6% cited religious reasons and 4%, doubts about bodily integrity or brain death. In addition, 3% expressed problems with healthcare personnel or due to social demands.

In response to this increase in refusals, Tort explained that the Catalan Transplant Coordination Office (OCATT) is studying the phenomenon, and the Department of Health will reinforce its outreach efforts to raise public awareness about the importance of organ, tissue, and cell donation. "The situation is complex, and there are several reasons behind it. Behaviors vary depending on the center; it's not uniform, but we have detected more refusals in urban areas, for example," she specified. The average refusal rate in other parts of Spain, however, is lower, between 4 and 6 percentage points lower compared to Catalonia's data.

The transplant coordinator at the Josep Trueta Hospital in Girona, Núria Masnou, emphasized the importance of advance directives, as they save families who must make this decision at a difficult time from many problems. Masnou acknowledged that sometimes, despite the deceased person's expressed wish to donate organs, they must negotiate with families who refuse. In these cases, he explained that everything has its limits, since, despite losing a donor, it is important not to add another wound to the family.

Second best figure in history

However, the number of transplants in 2025 is the second highest in history (1,356), after the 1,393 recorded in 2023. In fact, Catalonia performs 167 transplants per million inhabitants, making it a leader in this field, ahead of the United States (136) and the Spanish average (132.8). The majority of transplants last year were kidney transplants, totaling 945, a 3.6% increase compared to 2024; followed by liver transplants, with 206 (-8%); heart transplants, with 68 (+4.6%); lung transplants, with 110 (+4.8%); and pancreatic transplants, with 27 (-30.8%). At the end of the year, on December 31, 2025, there were 1,407 people waiting for a transplant. Of these, 112 were waiting for a vital organ, such as a liver, heart, or lung. In contrast, regarding deceased donor donations, Catalonia has a rate of 45.5 donors per million inhabitants, behind Spain (53.9) and the United States (49.7). Pediatric transplants decreased significantly in 2025, from 54 in 2024 to 36 last year. Of the total procedures, 18 were kidney transplants, 13 liver transplants, three heart transplants, and two lung transplants. The reduction is mainly due to the lack of a waiting list and improvements in pre-operative treatments, according to Tort. At the end of the year, there were fourteen children waiting for a transplant.