A comprehensive guide on organ donation and transplantation —
Become valuable links in the chain of life
If you represent any media, public or private body or association or if you are interested in linking the CSR policy of the company you work for, with awareness-raising about Organ Donation and Transplantation, visit www.onassis.org and fill in the relevant form available in the Health section, in order to participate in the Organmeetings awareness-raising program organized by the Hellenic Transplant Organization (HTO) and the Onassis Foundation, in collaboration with Onassis Hospital.
Because organ donation is an issue that concerns us all
Transplantation is the most modern therapeutic practice of the 21st century worldwide and the only therapeutic response to heart, liver and end-stage lung failure, as well as the most effective treatment for kidney failure. It is a major medical achievement. However, in order for this therapeutic option to be available, organ donation must come first. These two concepts are inextricably linked, which is why public dialog, proper information and coordinated awarenessraising efforts are key to develop policies that will lead to more transplantations
However, discussions about organ donation generate uncomfortable associations in some people’s minds or make them feel awkward, as organ donation is almost automatically associated with the concept of death; their own
or their loved ones’. Therefore, there is a substantial number of citizens who step into the shoes of a potential donor and often avoid speaking openly about this issue.
Furthermore, the widespread lack of information, myths and biases on organ donation sometimes make relatives refuse offering generously the organs of their loved ones, who lost their battle for life in an Intensive Care Unit. Today, no country worldwide, no matter how organized its Healthcare System and the relevant Transplantation Program are, can adequately meet their patients’ needs for organs
In 2024, 1,034 patients in Europe, registered on national transplantation lists, died while waiting for the longed-for transplant . In the U.S., every 10 minutes a new person goes
on the transplantation waiting list, and it is estimated that 22 patients die on average every day while waiting
In Greece, despite the very positive steps that have been taken in the field of transplantation in the postCovid era, 1,350 of our fellow citizens are registered in the National Register of Candidate Recipients, while another 12,000 patients undergo dialysis due to kidney failure.
Organ donation is not only a medical but also a social issue, as it fosters the message of solidarity and social cohesion, establishing links of trust and solidarity among citizens. This is why it concerns us all.
Transplantation gives a second chance in life and it is an option where everyone must have access to.
Source: www.edqm.eu/en/eodd www.organdonor.gov
Organ donation in numbers: It’s not about mere statistics; it’s about people.
14 0.000
111 organs donated in Greece in 2024, a record number in the countr y's transplantation histor y.
2021
362
solid organ transplantations performed in 2024 in Greece, giving a second chance in life.
Source: HTO
33 ,5 00 registered donors in the National Register of Organ Donors in Januar y 2025
12 ,000 patients in Greece on dialysis due to kidney failure.
In 2023, Spain, which is the most successful country in terms of Organ and Tissue Donation and Transplantation, had 49.4 organ donors per million population. This number corresponds to 2,346 donors and 5,419 organ transplantations. On the contrary, in 2023, Greece had 8.3 donors per million population, which in 2024 increased to 10.6 donors per million population, corresponding to 111 donors. Even though in recent years the rates in our country have been growing steadily, it is clear that Greece is still lagging behind compared to the other Mediterranean countries.
49.4 donors* in Spain
36.8
donors* in Portugal
29.4 donors* in Italy
* donors per 1,000,000 inhabitants
** All average rates refer to 2023. In 2024, Greece saw a further increase to 10.6 donors per million population
29 donors* in Croatia
13 ,571
patients are waiting for an organ transplant in Europe.
8 .3 donors* in Greece**
10 0,000+
patients are waiting for an organ transplant in the United States.
Myths and truths about organ donation
Myths are fun, except when they influence a decision that can save lives.
Let’s explore what’s actually true about organ donation and transplantation.
MYTH
“If I find myself facing a serious health issue, the ICU physicians will let me die if they know I am a registered organ donor.”
MYTH
“A person who is very wealthy or influential could bypass the organ allocation list.”
TRUTH
To begin with, physicians at the ICUs do not know whether or not the patient is an organ donor. The HTO is the only entity with access to this information. However, even if they did know, saving the patient is the priority of ICU physicians. Only in the event that the patient has been diagnosed as brain dead, the HTO is notified and the question of organ donation is considered. The physicians diagnosing brain death have nothing to do with the HTO or with the Transplantation Units.
TRUTH
No. Whenever a new organ transplant becomes available, recipients are prioritized using specialized software and based on medical criteria. The software is protected and cannot be tampered with, while the allocation process is controlled by the HTO, the Transplantation Units as well as by specialized scientific committees.
MYTH
“He woke up from his coma just before his organs were removed.”
MYTH
“If I register as an organ donor, people will find out and they will take my organs away.”
TRUTH TRUTH
This is a piece of “news”, formulated in more or less the same terms, that we have often read about or come across in various movies and TV series. This is fake news and a completely mistaken phrasing.
Organs are not removed from patients in a vegetative state but from deceased patients who have been pronounced brain dead based on scientific criteria. Never in the history of medicine has a patient, who had been diagnosed as brain dead, come back to life.
Only the HTO has access to the Organ Donor Register. What is more, Greece, just like other EU countries, forbids the trade of human organs. No traded organs have ever been used in any of the transplant procedures performed in our country. Transplant surgeries, whether from a living or a deceased donor, are only held in transplantation units of public hospitals under the strict supervision of the Hellenic Transplant Organization and the Ministry of Health.
MYTH
“Organ donation is against my religion.”
TRUTH
The major and most widely practiced religions in the world, including Christianity (Orthodox, Roman Catholic and Protestant denominations), Buddhism, Islam, Judaism and Hinduism, are in favor of organ donation both in terms of doctrine and based on the positions expressed by their leaders.
15 questions everyone has about organ donation and transplantation
01. Who could need a solid organ ransplant?
Anyone of us could, at a certain point in our life, have a failing organ which would need to be replaced by a transplant so that we can live on. Modern lifestyle, various harmful habits such as smoking, high blood pressure and diabetes are all factors which render it a lot more likely for us to need a transplant during our lifetime than to become an organ donor after we die.
02. How can a patient be included in the National Register of Candidate Organ Recipients in other words “the list”?
It is more likely for someone to find themselves in the shoes of a potential recipient who needs a transplant due to organ failure, rather than becoming a donor.
To begin with, a patient needs to be diagnosed with end stage organ failure. Then they will be referred by their treating physician to the competent Transplantation Unit dealing with that organ. At the Transplantation Unit, the patient’s name is entered into the National Register of Candidate Organ Recipients, which is kept by the HTO.
03.
How are organs allocated to those on the waiting list and how is impartiality ensured?
Each organ is allocated individually to one of the candidate recipients figuring on HTO’s list based on strict international medical criteria, such as blood type, tissue compatibility between donor and candidate recipient, waiting time, age, bodily dimensions and, lastly, the severity of the patient’s medical condition as attested by the physicians. Priority lists are produced by a specialized HTO software that cannot be tampered with. After that, the HTO lets the relevant transplantation centers know who are the best candidates for each organ, based on the criteria listed above. The criteria both for the candidate recipient inclusion in the waiting list and the organ allocation are based on international protocols and set down by the Greek law.
04.
Are organs kept in a national bank?
No. Solid organs can survive for a very short time outside the human body. The interval between organ removal and transplantation is called cold ischemia time (CIT), as during this time organs are preserved in ice and special solutions. The CIT is only 4 hours for the heart and the lungs, 9 hours for the liver and 24 hours for the kidneys. Tissues like cornea and skin are indeed stored in a “bank”, as they can be preserved for longer.
15 questions everyone has about organ donation and transplantation
05.
What exactly is brain death?
The death of either the heart or the brain, is still death. No matter which of the two organs (heart or brain) suffers devastating injury first, the result is inevitably death. Brain death occurs when a person dies following irreversible and devastating damage of the brain stem (brain stem death). The permanent loss of all brain stem functions results in an irreparable loss of consciousness and in the person no longer being able to breathe without support. The deceased person’s organs continue to function solely through mechanical ventilation. An irreversible damage to the brain stem will inevitably lead to the death of the entire brain within a short period of time. Brain death is then followed by “physical” death, whereby all body organs stop to function. If the deceased person suffers brain death while intubated in an ICU, some of their organs may be mechanically preserved so they can then be removed and transplanted to other people.
All adult citizens have the right to register their desire to help other people suffering from medical conditions after their death.
06. Can someone come back to life after brain death and what is the difference between brain death and vegetative state?
Brain death is a condition where the brain stem has stopped functioning due to irreparable and irreversible damage, as a result of which blood also stops flowing to the rest of the brain. No patient has ever recovered from this condition in the history of medicine. On the contrary, in the case of vegetative state, it is the brain cortex that suffers the damage, while the function of the brain stem is preserved. This means that automatic breathing and cardiovascular function are preserved, although the patient is unconscious. There are clear criteria for the differentiation of these two conditions; patients in a vegetative state are not considered dead, nor can they be considered potential organ donors.
07.
What happens when people haven’t expressed their wish regarding organ donation while still alive?
In accordance with the law, if a person hasn’t registered to the HTO their approval or refusal to become an organ donor and they die under conditions qualifying them for organ donation the decision rests with the person’s family.
08. Can anyone become an organ donor?
09.
Is there an age limit to becoming an organ donor?
Any adult citizen can register as a donor at the Organ Donor Register.
10.
Can a person register as an organ donor if they are suffering from a serious medical condition?
No. All adult citizens have the right to register their desire to posthumously help other people suffering from medical conditions. Clinical practice shows that certain organs from very elderly people may continue to function and therefore can be transplanted.
11.
Can one choose which of their organs will be donated or to whom they will be given?
Yes. Physicians are the only ones in a position to judge, when the time comes, which organs can help save lives and which cannot. Even if the deceased was suffering from a serious medical condition, this does not preclude them from becoming an organ donor. With the exception of certain conditions, most diseases, even transmittable ones, are not considered a contraindication for donation.
In the organ donor form it is possible to choose which organs will be donated. In the case of deceased donation, one cannot choose to whom the organs will be given. An organ donation cannot be directed to a specific person but needs to follow the priority order set out in the National Register of Candidate Recipients.
12.
Can I make a public appeal on social media or any other medium in order to find a compatible living donor?
No. The disclosure of the need or even the availability of human organ transplants is forbidden by law both on a national and on a European level.
People often confuse blood donation with organ donation. If a person needs blood, their family can launch a public appeal on social media or elsewhere. But this is not the case for organ donation.
13.
Are there risks involved for living donors?
There is always a certain amount of risk involved when someone undergoes an organ removal procedure. The exact level of risk depends on the organ to be removed (kidney/liver segments). The physicians who are going to perform the operation need to inform, orally and in writing, the candidate donor about the possible health complications the donation could entail. In any event, all necessary steps are taken in order to minimise any possible complications for the donor, which are now extremely rare.
14.
Can the donor’s family get in touch with the recipient’s family?
15.
What is organ trade? How can we be sure that this is not happening in Greece and Europe?
In accordance with Greek and international law, the identity of the donor is not revealed to the recipient’s family, and vice versa. The reason for this is to prevent any possible dependency relationship forming between the two families. Nevertheless, corresponding anonymously through the HTO is both allowed and encouraged.
The term “organ trade” refers to the trade of organs that are willfully removed from a living donor against financial compensation. This practice takes place in countries whose legislation does not expressly state that this is forbidden. Unlike what we see in many series and movies, Greece, just like all other EU countries, forbids the trade of all human organs. No traded organs have ever been used in any of the transplant procedures performed in our country. Transplant surgeries are only performed in transplantation units of public hospitals, under the strict supervision of the Hellenic Transplant Organization and the Ministry of Health.
A difference that can make the difference
Registered donor and actual donor: two terms that are often confused but are very different.
Registered donors are adult citizens who declare, while they are still alive, that they wish to help their fellow citizens suffering from a medical condition by making their organs available for transplantation after their death. A registered donor receives an “Organ Donor Card”.
An organ donor is either a deceased person, having at least one of their organs removed in order to be transplanted, or a living citizen who donates an organ or tissue that is then transplanted to a relative or a person close to the donor, in accordance with the current legislation. In the case of deceased donation, any person declared brain dead, while they are intubated in an ICU and their organ function is mechanically supported, can become a donor.
Which solid organs can be transplanted?
Lungs
Kidney
Pancreas
Liver
Small intestine Heart
Chain of life
People who became links in the big chain of life of organ donation (a decision made either by them or fate) share their stories. Their interviews are available at www.onassis.org. We encourage you to read them.
“I feel like I am a link in a big chain of life. Every organ donation mobilizes an entire hospital.”
Alexia Tagaraki
Transplant Coordinator, “Papanikolaou” General Hospital of Thessaloniki
She is one of the first 7 Transplant Coordinators (TC) participating in the pilot program that was launched in 2022; a program which now yields tangible results: the number of organ donors has more than doubled in the hospitals where a TC was appointed.
“It is meaningful keeping a heart alive for as long as you can, allowing this heart to keep beating, feeling, dreaming. It is meaningful sharing life.”
She thinks that she wouldn’t want to have to make a similar decision again. But when that moment came, the first two words that popped into her mind were “organ donation.”
Fotini Tsilimeki Donor’s sister
“Of course I was afraid of transplantation, but I never lost my hope and faith in medicine. I was also holding on to the stories of people who had made it before me.”
Sandy Lenti Heart transplant recipient
Everything started with the myocarditis diagnosis in 2012, continued with her hospitalization, then came the medication, which was followed by an artificial heart surgery. Redemption came with her transplant surgery in 2022 at the Onassis Hospital.
“Every minute of waiting is absolutely worth it. Just because you expect to regain your quality of life.”
Giorgos Psarras
Registered in the National Register of Candidate Recipients
Before going on holiday even somewhere in Greece, he needs to look for the appropriate accommodation up to 3 months in advance, so that he can deal with his kidney failure at any time. He expects that everything will change when the compatible transplant is found.
A new era for transplantation thanks to the support of the Onassis Foundation
Hospital Scientific personnel
A long-term vision turns into reality through a series of actions for the development of transplantations in Greece.
Guided by a vision to breathe new life in organ transplantation but also to foster an organ donation culture, the Onassis Foundation is transforming, once again, the healthcare landscape in Greece through the implementation of a National Initiative in collaboration with the Hellenic Transplant Organization (HTO) and the Onassis Hospital.
01.
A new, fully digitized hospital
The new Onassis National Transplant Center and the renovated Onassis Cardiac Surgery Center create a comprehensive hospital, the Onassis Hospital, which is the first fully digitized hospital in the country.
02.
Growth and development of scientific personnel
The continuous training of healthcare professionals, delivered in cooperation with the Hellenic Transplant Organization and the Onassis Hospital, lies at the heart of the National Initiative of the Onassis Foundation. Through the Scholarship Program, a team of specialist physicians was trained in Vienna, so that they can start performing lung transplantation surgeries in Greece. At the same time, the Onassis Foundation has been supporting the role of Transplant Coordinators (TC), by covering the salary of 7 Coordinators for 2 years. In addition to this, there are many important initiatives that are organized and implemented, such as Transplant Masterclasses, a truly benchmark event.
03.
Change of the institutional framework
A major landmark in the field of organ donation and transplantation in Greece is the study for the National Plan for Solid Organ Donation and Transplantation, prepared by an international research team led by distinguished Professors Elias Mossialos and Vassilios Papalois, with the support of the Onassis Foundation. This study paved and showed the way for the new, modern legal framework (Law 5034/2023) that now governs HTO’s operation.
Informing and raising awareness among citizens
The Onassis Foundation disseminates information through awareness-raising and information programs addressed to citizens, parents and pupils, such as the “Orgamites” educational program for primary school pupils. It also organizes seminars, conferences and workshops for healthcare professionals and associated entities, holds information sessions (the “Organmeetings” program) for public organizations, media Groups and businesses always under HTO’s supervision and in collaboration with its scientific team.
At the same time, through targeted campaigns, it informs and raises public awareness about organ donation.
The Onassis Foundation decided to finance the payroll of 7 Transplant Coordinators for two years, in order to strengthen the healthcare system and increase the number of organ donations and transplantations in Greece. This goal has been achieved.
On Thursday, May 30, 2024, it hosted the event “Organ Donation. Chain of Life” at the Central Stage of the National Theater. This event was the culmination of the Organmeetings’ first season.
6 July 2021: The President of the Onassis Foundation, Anthony S. Papadimitriou, delivers to Prime Minister Kyriakos Mitsotakis the study for the new National Plan for Solid Organ Donation and Transplantation. This study serves as the basis for the new legal framework for organ transplantation in Greece and was passed by a large majority in the Greek Parliament in March 2023.
“Orgamites”, a unique, innovative and interactive educational program addressed to primary school pupils aged between 7 and 11, is part of the Onassis Foundation National Initiative. This program has been a major success as more than 23,000 pupils and 2,100 teachers in Greece have attended it so far.
A longtime vision of the Management of the Onassis Foundation is coming to life through the Onassis National Transplant Center: a center dedicated to solid organ transplantation. Together with the renovated Onassis Cardiac Surgery Center, they create the new Onassis Hospital, the first fully digitized hospital in Greece.
Transplant Masterclasses:
A benchmark event in the field of organ donation and transplantation. Two annual events, top speakers, international collaborations, unique presentations, educational workshops.
The future in transplantation is here.
Thanks to the Onassis Foundation Scholarship Program, a team of surgeons, intensivists and anesthesiologists was trained in the leading international lung transplantation clinic of the University Clinic of Vienna, MedUni Vienna/ Vienna General Hospital. This initiative allowed to launch the lung transplantation surgeries in Greece after 10 years of inactivity.
How can I become an organ donor
How can someone express their wish to become an organ donor?
By registering as a donor at the National Register of Organ Donors kept by the HTO and receiving the Organ Donor Card
How can someone receive an organ donor card?
Anyone wishing to become an organ donor can visit the website of the HTO (www.eom.gr), log in using their TaxisNet credentials and apply for a card directly at the HTO or visit a Citizen Service Center (KEP).
Why is it important, if I am positively inclined towards organ donation, to get an organ donor card or at least discuss the subject with my family?
In order to alleviate the relatives of the deceased person from the burden of having to make such an important decision at an extremely difficult moment, especially considering that this decision has already been made by the deceased person. In most cases, the decision is accepted and welcomed with relief by the deceased person’s relatives, who see it as a way of fulfilling his or her last wish.
What is the Hellenic Transplant Organization?
Can I change my mind and cancel my organ donor card?
Certainly. If the organ donor has a change of heart, they have the right to cancel the organ donor card at any time by simply applying for a cancellation at the HTO.
The Hellenic Transplant Organization is the body responsible to develop and implement Greece’s national transplant policy, in collaboration with the Ministry of Health. It is supervised by the Ministry of Health and is responsible, among others, for coordinating, monitoring and safeguarding every step of the process leading from the donor to the recipient in all instances of organ, tissue and cell donation and transplantation. It operates 24/7 and works together with all competent authorities on a national and supra-national level to ensure that transplants are carried out safely and successfully and to promote the concept of organ and tissue donation.