The Irish Kidney Association (IKA) has raised concerns about the decline in transplant activity.

The concerns were raised in advance of Organ Donor Awareness Week 2026 (16-23 May), which was officially launched at the Mansion House in Dublin today.

The IKA highlighted the extraordinary generosity of organ donors and their families, and the dedication of healthcare staff. However, it said it was “deeply concerned” about the decline in transplant activity.

HSE figures show that organ donation and transplantation in Ireland fell sharply in 2025, with 202 organ transplants carried out — the lowest total in five years and well below the five-year pre-pandemic average of 282.

Currently, there are more than 650 people on transplant waiting lists in Ireland, over 500 of them waiting for a kidney.

The IKA is calling on the HSE and the Department of Health to take urgent and concrete action in three areas:

1. Greater transparency through data. The IKA said the introduction of an annual Potential Donor Audit under the National Office of Clinical Audit is a welcome development. However, its current remit is limited to the six largest hospitals in the country. This must be extended to all hospitals where potential donors may present. Furthermore, the IKA is calling for the full publication of the HSE Internal Review into transplant services.*

2. Investment in transplant infrastructure. When donation rates are compared with other European countries, it is evident that Ireland is falling behind. Many countries have already surpassed their pre-pandemic levels of activity, and some are achieving record numbers. One specific area of opportunity is the age profile of deceased organ donors: the average donor age in Ireland is significantly younger than in many European countries, suggesting that potential donors at older ages are not being identified or referred at the rate seen elsewhere.

3. Growing living donation. The Human Tissue Act 2024 opens new pathways for altruistic living donation for the first time in Ireland – allowing a person to donate a kidney to a stranger. The IKA is calling on the HSE to resource and promote these new pathways actively, reinstating a previous target of at least 50 living kidney transplants per year – a goal last achieved in 2017.

This Organ Donor Awareness Week, the IKA’s message to the public is unchanged and as urgent as ever:  Don’t leave your loved ones in doubt – Share your wishes about organ donation.

While last June’s Human Tissue Act introduced a soft opt-out system, families remain central in the process – their assent is still required before donation can proceed where an individual has not formally opted out.

The IKA urges everyone to:

•            Talk to your family about organ donation today, let them know your wishes

•            Visit www.ika.ie/donorcard and request an Organ Donor Card or download an Organ Donor Card to the Digital Wallet on your phone

•            If you do not wish to donate, record your decision on the HSE Opt-Out Register

“We are deeply grateful to the 68 donor families of 2025 whose courage and compassion in the most painful of circumstances gave the gift of life to others,” said IKA CEO Ms Carol Moore. “But we owe it to the over 650 people currently on transplant waiting lists to be honest: we are losing ground, and the status quo is not good enough. The Human Tissue Act provides the legal framework, but it must be matched by investment in data capture, infrastructure, and capacity. Organ donation is one of the greatest expressions of community and compassion in Irish life – and Ireland can and must do better.”

Speakers at today’s launch shared personal stories to highlight the importance of sharing one’s wishes with family and the positive impact and enduring legacy of organ donation.

The event was also addressed by Minister for Health, Jennifer Carroll MacNeill, HSE Chief Clinical Officer Dr Colm Henry and incoming Clinical Lead at HSE Organ Donation and Transplant Ireland, Prof Peter Conlon.

* As referenced in the Medical Independent in December 2023, and for the development of the formal strategy recommended in that report to quantify the requirements for transplantation services and to increase critical care capacity accordingly. https://www.medicalindependent.ie/in-the-news/paucity-of-transplant-infrastructure-leaves-services-vulnerable-to-failure/

The National Office of Clinical Audit (NOCA), in conjunction with HSE Organ Donation Transplant Ireland, has announced plans for the national expansion of the Irish Potential Donor Audit (IPDA) to every intensive care unit (ICU) and emergency department across the country on a phased basis. The announcement coincides with Organ Donor Awareness Week (20-27 April).

According to NOCA, the rollout marks a pivotal extension of the audit, which was piloted successfully in six hospitals where organ donation nurse managers and clinical leads in organ donation pioneered the project.

“The first phase sees an ambitious scale-up to an additional seven ICUs, totalling thirteen institutions committed to improving organ donation practices. Phase two aims to include all remaining ICUs and phase three will seek to include emergency departments following extensive engagement with emergency medicine personnel,” stated NOCA.

Key developments include:

• The appointment of a dedicated Audit Manager.
• The launch of innovative NOCA dashboards that provide hospitals with access to vital organ donation data to drive improvement.
• The publication of a report on 2024 data, scheduled for 2025, featuring quality improvement stories and actionable recommendations.

Dr Alan Gaffney, Consultant Anaesthesiologist and Intensivist at Beaumont Hospital, Dublin, and Clinical Lead for the Irish Potential Donor Audit, stated: “The national rollout of the Irish Potential Donor Audit is a very welcome development for all those involved in caring for organ donors and their families. Our aim is to offer the possibility of organ donation to everyone who dies in circumstances where organ donation is a possibility and where it was that person’s wish. Auditing organ donation practices and processes by local organ donation nurses has been shown to increase organ donation opportunities.”

This expansive rollout follows comprehensive development and feasibility studies, including the 2023 Potential Donor Audit Development Project Report and the 2022 Feasibility Project Report. Additionally, a supplementary data report updating the 2023 development project report findings for the full calendar year will be available in Q2 2024 on the NOCA website. This will provide valuable information to the healthcare system to drive improvement in organ donation.

Ms Martina Goggin, Patient and Public Interest Representative for the IPDA governance committee, commented: “Organ Donor Awareness Week is a very important week in the calendar of the organ donation community. This week serves as a crucial reminder of the transformative impact organ donation can have—not just for recipients, but for donor families as well. As the parent of an organ donor, I feel it is most important that potential donors are always identified, and their families are given the opportunity of considering organ donation, by being spoken to by an appropriately trained organ donation specialist.

“Rolling out the Irish Potential Donor Audit at this time is, I feel, very appropriate, as the audit aims to help identify every potential donor at end of life and focus on best practice in approaching and speaking with donor families at a most difficult time of overwhelming anguish. If we had not been approached and asked about donating our son’s organs, quite possibly we would not have thought of it. How disappointing and devastating that would be knowing the comfort organ donation gives, and the ongoing benefit, to a donor family.”

Further information about the Irish Potential Donor Audit is available here: https://www.noca.ie/audits/irish-potential-donor-audit/