The Irish Kidney Association has said it is deeply concerned about the decline in transplant activity as organ donation has fallen to its lowest level in five years.
Around 650 people are waiting for a life-saving organ transplant, according to the Irish Kidney Association.
Figures show that there were 198 organ transplants last year, which compares with the five-year average pre-pandemic number of 282 transplants a year.
The number of living kidney transplants is also down, with 29 performed last year.
This compares with the five-year average pre-pandemic number of 40 a year.
In 2017, there were 51 living donor transplants performed here.
The Irish Kidney Association is launching organ donor awareness week, which runs from 16 to 23 May in conjunction with the HSE's Organ Donation Transplant Ireland (ODTI).
It is encouraging people to share their wishes with their families.
Under legislation since June 2025, people are presumed to have consented to organ donation unless they have registered their opt-out decision.
The association said that family agreement remains essential and that organ donation will not proceed without it, so sharing wishes is important.
Donated organs can include the heart, lungs, livers, kidneys and pancreas.
The figures show that organ donation rates in many other European countries are significantly higher than in Ireland.
Ireland is also at the lower end of rates of living kidney donation compared to the other countries.
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'Don't leave your loved ones in doubt', says kidney association
National Advocacy Manager with the Irish Kidney Association has urged people to get their donor card, as only 1% to 2% of deaths annually lead to an organ donation.
Speaking on RTÉ's News At One, Colin White said: "With the pandemic there was going to be a decline in all activity in hospital. In Ireland and internationally we saw a significant decline in organ donation and transplantation.
"But what is of concern is the recovery from that. We have seen other countries recover at a much faster rate than we are recovering here in Ireland."
Mr White said Ireland has not been moving as fast in putting the pieces together to make the bigger picture.
He said today the HSE Chief Clinical Officer Dr Colm Henry "announced the recruitment of a new clinician to specifically drive forward living kidney donation".
"There is huge potential there. Again, if we compare with our European neighbours, we would be a little bit behind again," he added.
Mr White said the change in legislation did bring in an opt-out register.
He said "only 1% to 2% of deaths annually are in the circumstances where organ donation is even a possibility, so the number of opportunities of organ donation are quite limited".
Mr White said the role of the family remains essential in the process.
"It is written into the legislation that organ retrieval can only go ahead after the healthcare professionals have assured themselves that the family has no objection.
"So this is why the Irish Kidney Associations message for Organ Donor Awareness Week is don’t leave your loved ones in doubt," he said.
He urged people to have the organ donation conversation and to go to IKA.ie/donorcard and to get your donor card, which can be downloaded to a digital wallet.
Mr White also said modern lifestyle is leading to an increased number of people requiring kidney dialysis.
He said some of the leading causes of kidney failure are hypertension and diabetes.
He added that we are also living longer and the typical age of people needing a transplant is over the age of 60.
"There are now medications available and lifestyle alterations available that you can successfully manage", adding that these people then do not end up in kidney failure.
