80.1% of the Spanish population is in favour of donating their organs after death, but more than half (57.4%) are unaware that the number of donations is insufficient to meet transplant needs. This is the conclusion of the Study on public attitudes towards organ donation and transplantation in Spain, which was presented in Madrid on National Organ, Tissue and Cell Donor Day.
The study was launched by the Mutua Madrileña Foundation (FMM) and the National Transplant Organisation (ONT), and the fieldwork was carried out by researchers from the Public University of Navarra (Jorge S. López and María Soria-Oliver) and the Autonomous University of Madrid (Rubén García-Sánchez, María Jesús Martín and José Manuel Martínez).
This survey updates a study that was last carried out in 2006, also led by the Mutua Foundation and the ONT, so this new analysis allows a comparison of Spanish society's attitude and knowledge of organ donation and transplantation two decades apart. Leaders in donations, but not enough.
Spain has been the country with the highest number of donors per million inhabitants in the world for 34 consecutive years.. In 2025, according to ONT data, 6,334 transplants were performed, very close to the figure for 2024 (6,464), when the all-time record was broken. In the last decade, donation has grown by more than 50%. Even so, the waiting lists for people in need of a transplant continue to grow, something that, according to this study, is an unknown reality.
More than half of the population (57.4%) is unaware that there are not enough donations to meet transplant needs. The ONT insists that "every day, more than 5,000 people wait for an organ transplant. The waiting list is not shrinking, because as transplant activity increases, the indications are expanding and more patients are eligible for this therapy," says Beatriz Domínguez-Gil, director of the ONT.
Furthermore, despite the majority support for donation, seven out of ten people (68%) state that they are "little" or "not at all" informed about how the organ donation and transplantation system works.
No more talk at home about donations
Although support for donation of one's own organs is very high, the study identifies a key factor that continues to limit the number of effective donations: lack of communication within the family environment.
The data are conclusive: if the family is aware of the deceased person's favourable wishes, 90.1% authorise organ donation. However, when this wish is unknown, only 54.9% authorise donation; and when the wish not to donate is known, 14.5% of families still authorise donation. In other words, talking to the family almost doubles the chances of donation.
In this sense, researchers stress that talking about donations at home is one of the most effective gestures to save lives, as it dispels doubts, facilitates family consent and, above all, allows the will of the deceased to be respected. However, only 48% of respondents claim that their family is aware of their wishes regarding donation.
The work also highlights an important gap between intention and action. Almost seven out of ten Spaniards would be willing to officially register their willingness to donate, but only 7.2% have actually done so through the Registry of Last Wills and 12.6% by means of a symbolic donor card. This difference shows that, despite the favourable attitude, many people postpone or avoid formalising their decision, either due to lack of knowledge, bureaucratic barriers or lack of prior reflection.
The study therefore advocates family communication as a more accessible and effective way than administrative registration to ensure that the donor's wishes are respected when the time comes.
The director general of the Mutua Madrileña Foundation, Lorenzo Cooklin, stresses "the importance of continuing to promote communication in this regard within families, as a key tool to transform society's positive attitude into more opportunities for those awaiting a transplant". Faced with this situation, the Mutua Madrileña Foundation and the ONT are calling for action with the hashtag #DiloEnCasa to promote conversation with the family about the desire to be a donor.
Broad commitment to donation
The report confirms that Spanish society not only maintains but also strengthens its commitment to donation over time. Over the last twenty years, willingness to donate has steadily increased (from 67.4% in 2006 to 80.1% today) and refusal has fallen dramatically (from 14.5% to 4.1%), making it a distinctly minority phenomenon.
Motivations for becoming a donor have also evolved. At present, donation is increasingly supported by altruistic reasons, such as saving lives (which strongly influences 81% of the population), improving the quality of life of other people (74.8%) or showing solidarity (68.0%). "It is an achievement to which professionals, the media and the public have contributed, showing that when the right conditions are in place, the population is in favour of solidarity actions", stresses Jorge S. López, research professor at the Public University of Navarre (UPNA) and coordinator of the team that carried out the study.
However, 15.8% of people still say they are not clear. Among the undecided, one third (32.9%) would donate conditionally: to their close circle, when the use of the organs is clearly specified, if they have had a close experience with transplantation or if it would be used to save a child. "It is important that these undecided people turn to professionals to clarify their doubts, either through the ONT or through healthcare professionals closer to them, such as those in primary care," says López.
The study also confirms that giving has become a value shared by all generations. Unlike in 2006, there are no longer significant differences by age group: all age groups now exceed 76% willingness to donate, including those over 65, who two decades ago were more reluctant to donate.
The researchers conclude that Spain has a strong, resilient and mature donation culture, but that the challenge now is not to convince, but to better inform, reduce emotional hesitation, activate the undecided and encourage family conversation.
"Organ donation is today one of the greatest social consensuses in Spain, a collective project that transcends ideological, generational or cultural differences. In a context of crisis and polarisation, solidarity around donation is not only maintained, but strengthened," concludes the director of the ONT.
Non official translation
Operation in which a transplant is performed