Brazil organ donation: high family refusal rates impact transplant waiting lists

Brazil is facing a significant gap between organ demand and supply, with over 49,000 people currently on transplant waiting lists. Approximately 45,000 of these patients are waiting for kidney transplants, while the cornea waiting list has grown by 15% compared to late 2025.

A major obstacle to increasing transplant rates is the high family refusal rate, which averages around 45% nationally. Under Brazilian law, organ donation requires explicit authorization from relatives, even if the individual expressed a desire to donate during their lifetime. Experts emphasize that open communication with family members is essential to ensure these wishes are honored.

To facilitate the process, the Electronic Organ Donation Authorization (Aedo) platform, managed by the Colégio Notarial do Brasil through the e-Notariado system, allows citizens to formally register their intent online and for free. Since its launch in 2024, more than 32,000 Brazilians have used this service, which involves a digital signature and a videoconference with a notary. While this provides a digital record for the National Transplant System, the final decision remains with the family.