More Adults Now Listed as Organ Donors by Default

Dutch organ donor registrations rose again this year, mainly because more people haven’t recorded a preference and are therefore listed as “no objection” under the 2020 opt-out law. About 3.33 million adults (nearly a quarter of the population) have not made a choice, up from 3.29 million a year earlier. In total, around 58% of adults are registered, with 34% giving active consent, 24% listed as “no objection”, about 31% refusing, and ~11% leaving the decision to relatives, new figures from CBS and the Donorregister show.

People aged 18–25 are the least likely to fill in a preference: 41% have not made a choice (36% in 2022), so they are registered as “no objection” by default. Among those young adults who did choose, the share saying “no” has risen to ~45%. Older age groups are more likely to refuse donation, with over half of people 75+ opting out.

Local patterns differ. Several Bible Belt municipalities have the lowest rates of active registration and the highest share of “no objection.” Amsterdam-focused reporting also notes that nearly one in four adults there has not recorded a choice.

Since mid-2020, the Netherlands uses an opt-out system. If you do nothing, you are registered as having “no objection” to organ donation after death. You can change your preference at any time: to consent, refuse, or leave the decision to relatives via the Donorregister. (Earlier CBS analyses show people regularly update their status over time.)

Health services say higher registration clarity helps families and transplant teams. Researchers also note that policy changes alone don’t always raise actual transplants; donor availability and hospital capacity matter too. Still, the opt-out system provides a clear default while keeping personal choice intact.

If you want to check or change your status, log in to the Donorregister and record your preference; it takes a few minutes and can be updated whenever you wish.