The HSE has reported a drop in the number of organ transplants carried out this year as a result of organ donations.
202 organ transplants were performed in Ireland in 2025, compared to 263 last year.
The 2025 statistics match the low number of transplants carried out during the Covid-19 pandemic.
The decrease comes despite the first phase of the Human Tissue Act coming into operation this summer, meaning everybody is considered an organ donor unless they opt out or are included in a so-called excluded group.
Dr Catherine Motherway from the HSE's Organ Donation Transplant Ireland (ODTI) said this year’s decrease is "not due to people not choosing to organ donors".
"None of the potential organ donors this year had their names on the opt-out register," she explained.
Dr Motherway said the Human Tissue Act brings Ireland "in line with international best practice.
"The defining principal of the new law is consent; it is still your choice whether you want to be an organ donor."
The ODTI said the life-changing operations this year were possible because of the "selflessness" of 68 deceased and 29 living organ donors and their families.
Across the three national transplant centres, 140 kidney, nine heart, 15 lung, 33 liver and five pancreas transplants were completed.
This included kidney transplants from 29 living donors.
Some donated organs that do not have a suitable match in Ireland are, where possible, offered to other countries where a suitable recipient can benefit.
This is a reciprocal arrangement, with Irish patients also receiving organs from donors outside this country.
The HSE has urged people to talk to their family members about organ donation and to make intentions known.
Minister for Health Jennifer Carroll MacNeill said 2025 marked a "significant moment for our organ donation and transplantation services with the introduction of a soft opt-out system".
She thanked all donors and their families for "their enormous act of kindness to transplant recipients, as well as to society".
Reacting to the falling numbers of transplants, the Irish Kidney Association called for "immediate attention and coordinated investment across our healthcare system to address the significant increased demand on services."
It said there were 540 people on the waiting lists for kidney transplants, approximately 20% of the total number of patients currently on kidney dialysis in Ireland.
Speaking on RTÉ's Morning Ireland, IKA National Advocacy Manager Colin White said that road traffic accidents were contributing to the decline.
"When it comes to road traffic accidents, it's the success of the intensive care units in recent years that has seen the transformation in that area," he said.
"For a number of years now, road traffic accidents have been taking a declining percentage of the total number of organ donors.
"I think if we look internationally, the traditional brainstem death organ donation is declining, but where other countries are not only standing still, but moving forward, is by investing in death after circulatory death donation, which is another form of organ donation.
"Equally, they're looking at organ donation in people over the age of 60."
Mr White said that the transplant programme in Ireland needed better management.
"I think the framework is there," he said. "Organ donation nurse managers are in situ around the country, but there's not enough of them.
"If we compare ourselves to Northern Ireland, their equivalent, there are specialist nurses for organ donation and they have a significantly higher number per population.
"It’s having the right people in the right place at the right time in the hospitals to speak with the families of potential organ donors. It's equally having protected access to theatre space so the organ retrieval can happen, and then having the recovery beds and the appropriate staff to look after them.
"We need the capacity there for that to be managed."
Mr White said that investment into the transplant programme would be beneficial on a number of levels.
"If we take the average life of a transplanted kidney, let's say, of about 15 years, over that period per patient, you're going to save about €1.6 million," he said.
"Investing upfront in developing the transplant programmes across the country, the programme is going to pay for itself, it truly is."
