There is an increase in the number of families who do not want to donate the organs of a loved one when they die.
There is a 27.6% refusal rate among families, a percentage never seen since records began.
Once again, Catalonia has achieved very positive organ transplant figures, positioning it as a world leader in this field. Last year, 1,356 transplants were performed, representing a 0.8% increase compared to two years ago and the second-highest figure ever recorded, 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, as family refusals have risen to 27.6%, the highest percentage since data has been available. This means that almost a third of Catalan families are ruling out donating the organs of a loved one upon their death. Ten years ago, the percentage of family refusals was lower, at 14.9%, but it has been gradually increasing over the last decade, and the Catalan Health Department points to "various social factors." The prior refusal of the potential donor or their family, without any other reason, was the reason given by families in 77% of refusals, while 6% cited religious reasons, 4% doubts about bodily integrity or brain death, and 3% expressed problems with healthcare personnel or social demands. In response to this increase, the Catalan Transplant Coordination Office (OCATT) is studying the phenomenon, and the Catalan Health Department will strengthen its outreach efforts to raise public awareness about the importance of organ, tissue, and cell donation.
The transplant coordinator at the Josep Trueta Hospital in Girona, Núria Masnou, emphasized the importance of advance directives, as they save families a great deal of trouble when they have to make this difficult decision. Masnou acknowledged that, sometimes, despite the deceased person's expressed wish to donate, they have to negotiate with families who refuse. In these cases, he explained that negotiation has its limits, since, despite losing a donor, it's important not to add another wound to the family. The trend of refusals in recent years is clearly on the rise: in 2022 it was 17.4%, in 2023 22.4%, and in 2024 25.8%.
Second best figure in history
Despite the rise in family refusals, the number of transplants is the second highest in history, after the 1,393 performed in 2023. The majority of transplants in 2025 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 pancreas transplants, with 27 (-30.8%). This translates to 167 transplants per million inhabitants, placing Catalonia at the forefront in this field, ahead of the United States (136) and the Spanish average (132.8). As of December 31, 2025, 1,407 people were waiting for a transplant. Of the total, 112 were awaiting a vital organ (liver, heart, or lung). Regarding deceased donations, Catalonia has a rate of 45.5 donors per million inhabitants, behind Spain (53.9) and the United States (49.7). As for pediatric transplants, these have 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 Jaume Tort, director of the OCATT (Catalan Transplant Organization). At the end of the year, fourteen children were awaiting a transplant.
