Lack of useable donated organs ‘due to soaring obesity rates’

People dying fatter and older is ‘reducing the numbers of useable donated organs’ as NHS reveals one in SIX body parts now get rejected by doctors

  • The proportion of clinically obese donors has increased by five per cent
  • While many are on the register, some organs are deemed to unhealthy  
  • In total, 849 organs – more than one in six of those retrieved – were rejected
  • Health chiefs said medical conditions and ageing population also play a part 

Soaring obesity levels are contributing to a decline in organ transplants because people’s organs are unusable. 

The proportion of clinically obese donors has increased from 24 per cent to 29 per cent in deceased donors in the last 10 years, figures show.

For every 10 donors, there was one fewer transplantable organ last year than the previous year for a variety of reasons. 

In total, 849 organs – more than one in six of those retrieved – were rejected, almost double the 460 from 10 years ago. 

Almost one in three adults in the UK are obese, as well as one in five children aged 10 to 11 years old. 

Even if a person is eligible to donate and their family also approves, the final decision comes down to doctors who assess the health of an organ. 

Soaring obesity levels are contributing to a decline in organ transplants because the organs are unusable, a report said (stock image)

During 2018-2019, 408 patients died while on the transplant waiting list or within one year of being removed from it, according to NHS Blood and Transplant (NHSBT). 

The overall number of transplants fell by two per cent last year, from 5,104 to 4,990, while more people were added to the list.  

Of all transplants, 3,951 were from deceased donors, 87 fewer than 2017/2018 when there were 4,038.

Currently more than 6,000 people are still waiting for a transplant. 

Fewer organs are being approved for use for complex reasons, an NHSBT report said, including donors being more obese, reflecting the worsening obesity levels in Britain, medical problems and an ageing population.  

There was no change in the number of kidney transplants, but pancreas, liver, heart, lung and heart-lung transplants all fell. Every person is able to donate nine organs in theory.

Anthony Clarkson, director of organ donation and transplantation at NHS Blood and Transplant, said: ‘There are multiple factors which could have led to the drop in transplants this year, and we are working hard to fully understand these. 

‘It is true that in recent years, we have seen an increase in older donors and more donors who are overweight or obese. 

‘However we have also seen a reduction in the proportion of donors who have died from traumatic injuries and other changes which could also play a part. 

‘We assess every donor individually, in order to confirm that their organs are healthy and suitable for transplant. The most important thing is for people to register their decision and tell their families what they want, and that way we can ensure that more lives can be saved.’

There have been improvements, however, with the number or people who donate after death slowly rising, hitting a record high of 1,600 people in the year to March 2019. 

The NHBT said this is because hard work to raise awareness has led to more families are agreeing to support their loved ones’ wishes to donate, which they are entitled to overrule. 

This is despite fewer people being eligible to donate, meaning they died in intensive care or similar circumstances. 

Over the last 10 years there has been a 67 per cent increase in deceased organ donors and a 49 per cent increase in deceased donor transplants. 

The number of living donors also dropped by three per cent, to 1,039, a downward trend that has continued over the last six years.  

Authors of the annual Organ Donation and Transplantation Activity Report said the overall story was one of success.


Everyone can join the NHS Organ Donor Register regardless of age, as long as they: are legally capable of making the decision, and live in the UK.

Having an illness or medical condition doesn’t necessarily prevent a person from becoming an organ or tissue donor. 

The decision about whether some or all organs or tissue are suitable for transplant is made by a medical specialist at the time of donation, taking into account your medical, travel and social history.

There are very few conditions where organ donation is ruled out completely.

A person cannot become an organ donor if they have or are suspected of having Ebola, Creutzfeldt-Jakob Disease (CJD), active cancer, HIV or hepatitis C.

But they also warned that it will be ‘increasingly challenging’ to maintain annual increases in donor numbers.  

Health officials are issuing a plea to the public to talk with families about organ donation in order to save lives.   

Regardless of a law change to an opt-out system in 2020, families still have the final say. 

Anthony Clarkson, director of Organ Donation and Transplantation at NHSBT, said: ‘The reduction in the number of people dying in circumstances where they are able to donate, means that we need to continue to explore ways to improve the donation and transplant process. 

‘We are utilising new techniques and technologies to ensure that donated organs are in the very best possible condition for transplant and are working to increase awareness and understanding of organ donation and the law change across society with the aim that no opportunity for donation is missed.’ 

From spring 2020, all adults in England and Scotland will be considered to have agreed to be an organ donor when they die, unless they have recorded a decision to ‘opt out’ to reduce the number of people who die waiting on the donor list. 

Some groups are excluded from the opt-out system. The situation will not change for those under the age of 18, in which case the family are asked to make the decision. 

It follows the example of Wales in December 2015. Wales now has the highest consent rate in the UK – 77 per cent, up from 58 per cent in 2015. 

Experts hope that once the law change comes into force and public awareness increases, similar increases will be seen in England and Scotland. 


What is an opt-out organ donation system? 

Such a system presumes adults consent to donating their organs, unless they explicitly choose not to.

How is it different to the current system?

Max and Keira’s Law, as it is to be named, is the polar opposite of the current system in England. Currently, adults in England have to sign-up to a national register if they wish for their organs to be taken after their death.

Will people be able to defy the law?

Under the new opt-out system, family members are still given a final opportunity to not go ahead with the organ donation. And the rule only applies to those who are deemed mentally capable of giving consent.

Will the whole of the UK move to the opt-out system?

Wales became the first country in the UK to adopt the system in 2015, which was deemed a ‘significant’ and ‘progressive’ change. Scotland is edging ever closer to passing the same opt out organ donation bill and Northern Ireland is expected to follow suit.

Why will an opt-out system help? 

Campaigners have long argued such a system would increase the number of organs available. Figures estimate that around 6,000 patients are on the waiting list for an organ. Such lists can be as long as five years.

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