Netherlands organ donations increase under new registration system

Research from the Dutch Transplantation Foundation and Maastricht UMC+ indicates that organ donations in the Netherlands have increased since the implementation of an automatic registration system in 2020. Under the previous system, where only active opt-ins were recorded, annual donors fluctuated around 250. Following the shift to a ‘no objection’ system, numbers have steadily risen toward 300 per year, reaching a peak of 360 in 2024.

Despite the increase, researchers note the growth is relatively modest. In more than half of the cases involving automatic registration, relatives still choose to decline donation. The study also highlights an increase in organ donations occurring after euthanasia, rising from 11 instances in 2020 to 34 in 2025.

Beyond policy changes, improved technical capabilities for utilizing organs after death have contributed to the rise. Currently, approximately one-third of Dutch adults have explicitly registered as donors, 31 percent have explicitly opted out, and 25 percent are registered under ‘no objection.’