Strengthening Organ Donation and Transplantation Across the European Union

To: European Commission

Subject: Strengthening Organ Donation and Transplantation Across the European Union

Download PDF file of the “Strengthening Organ Donation and Transplantation Across the European Union” letter

Dear sir/madam

On behalf of the European Kidney Health Alliance (EKHA), the European Society for Organ Transplantation (ESOT), and 44 other leading organisations across Europe committed to advancing transplantation and kidney health, we are writing with reference to the European Commission and Member States’ commitments to advancing organ donation and transplantation in the European Union.

We urge DG SANTE to translate these commitments into action, accelerating the implementation of the 2024 Council Conclusions on Organ Donation and Transplantation and building on recent World Health Assembly resolutions (WHA77 and WHA78), both of which call for equitable, sustainable, and high-quality transplantation systems – particularly for kidney transplantation, representing over 60% of all transplants in Europe. Responding to Member States’ call, a second EU action plan on Organ Donation and Transplantation, grounded in the achievements from the first, is essential to address persistent gaps and challenges across Europe’s transplantation landscape.

This update remains urgent as the burden of non-communicable diseases in Europe continues to rise, affecting 30% of adults and accounting 90% of all deaths, primarily due to end-stage organ failure.

Transplantation remains the only effective life-saving option, with the exception of kidney failure for which dialysis exists – yet dialysis is a vastly poorer outcome, and highly more expensive. Conversely, transplantation restores health and quality of life, reduces healthcare expenditure, supports employment and education, and significantly lessens environmental impacts compared to prolonged dialysis or repeated hospitalizations, often on intensive care.

In Europe, we have shown leadership in transplantation, yet despite it, major disparities persist. More than 50,000 Europeans currently await a life-saving organ, with around 9 individuals dying every day on transplant waiting lists. Donation rates continue to vary tenfold across Member States, and inequities persist by age, gender, ethnicity, and geography, disproportionately affecting vulnerable and rural populations.

It is therefore a moral and economic imperative that we strengthen transplantation infrastructures to ensure equitable, sustainable, and life-saving care for all citizens.

Accordingly, EKHA, ESOT, and the signatories to this letter strongly call for a second EU Action Plan on Organ Donation and Transplantation, supporting the full implementation of the 2024 Council Conclusions, and underscore the following, key priorities:

1. Coordination and Capacity Building

Establishing streamlined national and EU-wide networks to coordinate organ donation and transplantation, supported by structured training for healthcare professionals and peer-to-peer exchange of best practices.

2. Data and Transparency

Creating a transnational, harmonized registry of donations, transplantations, outcomes, and complications to underpin evidence-based policy, research, and quality improvement.

3. Equity and Access

Launching targeted policies to reduce social and regional inequalities and to promote crossborder cooperation and organ sharing among Member States.

4. Awareness and Education

Developing tailored public awareness campaigns respecting cultural and religious contexts, encouraging both living and deceased donation, including donation after cardiac death.

5. Ethical and Legal Framework

Develop a unified EU roadmap providing clinical, ethical, and legal guidance, while addressing issues such as transplant tourism and financial incentives for donation.

6. Research and Innovation

Support research into organ preservation, regenerative medicine, and prevention of organ failure and post-transplant complications, including cancer, infection and cardiovascular damage.

To this end, all our organisations stand ready to collaborate with DG SANTE and Member States by providing expertise, data, and engagement through our extensive trans-European networks. We believe the Commission’s leadership can ensure that every citizen of the European Union has fair access to highquality transplantation services, in line with Europe’s commitment to solidarity and excellence in health.

Yours sincerely,