Organ donation | Organ donation: “A child saved me”

In the transplant center at the University Hospital Leipzig, a kidney is transplanted into the recipient. Photo: dpa/Waltraud Grubitzsch The clock is ticking. Behind Ebru Yildiz while she talks about how many people in Germany are waiting for a donor organ. For too many of them, the hope of a saving call is not fulfilled. Every eight hours, says Yildiz, a person dies in Germany because there was no donor organ for them. This is particularly bitter because there are therapies that could save these people. “But they don’t reach people,” explains the head of the West German Center for Organ Transplantation. Yildiz founded the “Germany Decides” initiative. The seconds tick by while she gives a presentation on the topic at a conference in Erfurt.

For Alexander Brick, the clock ran out early in his life. He had a liver disease but wanted to suppress it for a long time. In his mid-twenties, Brick says, he wasn't prepared to "believe them" that he was already suffering from an illness that could kill him. It wasn't until a few years later when he looked in the mirror in the morning and saw a man with deep yellow skin looking back at him that Brick realized what he was doing. After further examinations, it quickly became clear: he needed a new liver if he wanted to live longer.

On his 31st birthday, Brick is examined intensively. Everything to clarify whether he is a candidate for a transplant. The result is positive. “From then on it was a case of waiting.” In March 2014, he was put on the list of candidates for a donor liver. More than twelve years have passed since that fateful day for Brick. Since then, little has fundamentally changed when it comes to organ donation. People still die too early because there are no donor organs available for them.

In Germany only around 300 hearts are donated by deceased people every year. According to the German Organ Transplantation Foundation, the number has been stagnating since 2018 - despite all appeals. It is similar with kidneys: Statistics have shown around 1,400 to 1,600 postmortem kidney donations per year for many years. For livers, the numbers range between around 700 and 800.

According to the Federal Institute for Public Health, there were around 8,200 people on the waiting list for a donor organ at the beginning of 2026. In 2025, 4,792 new patients were placed on a waiting list. At the same time, 633 people died before they could receive a suitable organ.

The Germans are by no means fundamentally opposed to organ donation. At least not if they don't buy into the numerous myths and false claims that surround the topic. Yildiz can also tell you about it.

One of her colleagues, for example, initially did not want to donate her organs because she was convinced that her body would have to be burned after organ donation. “I don’t know where she got that from,” says the doctor. It is simply wrong. After Yildiz dispelled the misconception, her colleague was willing to donate her organs after her death - potentially saving someone else's life.

Surveys also show a general willingness to donate organs. A representative survey from 2024 showed that 85 percent of German citizens between the ages of 14 and 75 generally have a positive attitude towards organ donation. Three quarters of them would be willing to donate organs themselves. Only about one in five people excludes a donation. The high level of approval has been stable for years.

The problem in Germany, however, is that many people do not document their attitude towards organ donation. Neither their consent nor their rejection - neither in an organ donor card, nor in the organ donation register, nor elsewhere. Under the current legal situation, the next of kin of a deceased person usually have to decide whether their organs will be donated or not. And often they decide against it.

This doesn't surprise Brick. When a close relative dies, it is always bad. “Having to make such a decision in an emotional and traumatic situation is an unreasonable burden for both the transplant officers in the hospitals and for the families,” he says.

The only thing that can help with this discrepancy, says Brick, is a fundamental change in the legal situation: the introduction of the objection solution. There has been debate for years about whether all people should be considered organ donors in the future unless they expressly objected during their lifetime. Brick, who works for the Thuringia Self-Representation League and is on the board of the German Liver Transplant Association, believes this regulation is the only effective one. All other suggestions are “just scratching the surface.”

Brick is not alone in this assessment. There are also voices within the Thuringian state government who want major reform after all the years of maneuvering in Germany. One of them is Thuringia's Health State Secretary Tina Rudolph (SPD). At the conference organized by the Association of Substitute Insurance Funds, she clearly spoke out in favor of introducing an objection regulation.

“Our goal is not to persuade people to make a specific decision, but we would like to encourage people to think about this question,” says Rudolph. As many people as possible should decide either for or against organ donation and document their decision so that it can be found if the worst comes to the worst. This is also in the interest of their relatives, who then have to make one less difficult decision in the hour of great pain.

Currently, in Germany, organs can only be donated if the deceased gave their consent during their lifetime or – unless they have made their own decision – the next of kin agree to organ donation.

In Spain, on the other hand, an objection regulation has been in effect for a long time. There were around 46 postmortem organ donors per million inhabitants in 2022, compared to just ten in Germany. Spain is by no means the only country that has had good experiences with an objection regulation. It also applies in Austria. There were around 25 postmortem organ donors per million inhabitants in 2022.

Brick is upset that in Germany organs that come from countries with opt-out regulations are also transplanted. Not because it will save people in Germany. But because for him it shows how contradictory the German debate is. “Nobody questions this practice,” says Brick – not even those in politics who have so far prevented an objection regulation. From his point of view, it is ethically highly questionable to transplant organs in Germany that should not have been removed in this country under the current legal situation.

Brick himself was almost unbelievably lucky: just about three months after he was put on the waiting list, on June 25, 2014, he got the call: There was a new liver for him. He will have surgery on June 26th. “Of course I don’t know 100 percent, but I’m sure today: a child saved me,” says Brick. At that time, there was a high priority child on the waiting list for whom an organ had been found. However, in liver transplants, children often only receive part of the donor liver. The larger part of the organ can then be transplanted into an adult. In this case: Brick.

What Brick didn't know at the time of the transplant was that doctors estimated that he would only have about two months to live if a new liver couldn't be found for him. “The kid saved me, definitely,” says Brick. The clock was almost up for him back then. Today he is 43 years old.

The Bundestag will deal with two opposing motions on the topic next week. Supporters and opponents of the contradiction solution can be found in all parties. A group of MPs has just submitted a motion in which they propose more information and calls for decisions - and are strictly against an objection regulation. The dpa news agency reported this on Friday. This would “represent a serious and legally controversial interference with the right to self-determination,” says the motion, which is supported by 58 parliamentarians from the CDU/CSU, SPD, Greens and Left. 

Even before the parliamentary summer break, another cross-party group of more than 200 MPs had called for the introduction of an objection regulation. Adults should then automatically be considered donors after death, provided they have not actively objected to the removal of organs during their lifetime. Currently, express consent is required for this.

The new application that has now been submitted states: “Silence must not be viewed as consent.” The right to self-determination also includes the right not to make a decision without having to fear personal disadvantages and consequences. A contradictory solution also poses risks for trust in the healthcare system.

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