Although Catalonia achieved the second-best transplant figure in history last year, with 1,356 procedures (0.8% more than two years ago), the OCATT has detected a worrying pattern. Family refusals for organ donation increased to 27.6% in 2025, a percentage never before seen since records began, meaning almost a third of Catalan families decline donation.
This percentage has grown gradually from 14.9% recorded ten years ago. The Health department points to “different social factors” as the cause. The prior refusal of the potential donor or their family was the reason cited in 77% of cases, while 6% cited religious reasons and 4% doubts about brain death. Given this increase, the OCATT will strengthen outreach actions to raise public awareness.
“"The negotiation has a limit, because, even if we lose a donor, it is important not to add another wound to the family."
The transplant coordinator at Hospital Josep Trueta de Girona, Núria Masnou, highlighted the importance of the advance directives document to save relatives problems. Masnou acknowledged that, even with the expressed will of the deceased, they sometimes have to negotiate with families who refuse. The trend of refusals shows a clear upward dynamic: 17.4% in 2022, 22.4% in 2023, and 25.8% in 2024.
Despite the rise in refusals, Catalonia remains a world leader with 167 transplants per million inhabitants, surpassing the United States (USA) (136) and the Spanish average (132.8). The majority of transplants in 2025 were kidney (945), followed by liver (206) and lung (110). As of December 31, 2025, there were 1,407 people awaiting an organ.
