Korea to permit organ donations after heart stops amid deadly shortage

SEOUL – South Korea’s Health Ministry on Thursday said it would permit organs to be taken after a donor’s heart had stopped beating, as it struggles to deal with a shortage of organs for transplant

Currently, South Korea depends almost entirely on “brain-dead” donors for organ transplants — patients who are considered dead because their brains have stopped functioning entirely but whose heart and lungs are still kept going by life support.

However, the number of such donors has declined — from 478 in 2020 to 397 in 2024 — while the number of patients waiting for transplants increased from 43,182 to 54,789 during the same period.

To help address the shortage, the government plans to allow organ donation after circulatory death, when patients’ hearts have stopped.

Health officials said the process is already common in countries such as Spain, where organ donation rates from both brain-dead and circulatory-death donors are comparable — 26.22 and 27.71 per million people, respectively.

The change will require legal revisions to allow patients who consent to both organ donation and the withdrawal of life support to donate after their death.

“When a patient who has agreed to end life-sustaining treatment and organ donation is disconnected from life support, the heart stops, and after a globally recognized five-minute ‘no-touch period,’ the patient is officially declared dead before organ retrieval begins,” explained Lee Sam-yeol, head of the Korea Organ and Tissue Donation Agency.

The move is part of the government’s first comprehensive plan for organ and tissue donation and transplantation, spanning 2026 to 2030.

It lays out detailed measures to expand donations in a country where the average wait stretches to four years. Some patients wait up to eight years for a kidney, while 8.5 people die each day before receiving a needed organ.

Other aspects of the comprehensive plan include efforts to raise donor registration rates from 3.6 percent to 6 percent by 2030, and to increase the number of brain-dead organ donors from 7.8 to 11 per million people during the same period.

The ministry also plans to expand the number of donor registration centers from the current 462 to 904 nationwide, designating additional registration locations such as local government offices and the Korea Road Traffic Authority.

It will also simplify donor reporting systems, enhance compensation for medical staff involved in donor management, and review new organ types eligible for transplantation as medical technology advances.

In addition, the plan strengthens social recognition for donors and their families. The government will consider expanding financial assistance — currently up to 5.4 million won ($3,800) in funeral and medical costs — and build public memorial spaces, such as “walls of remembrance,” in hospitals and government buildings.

Efforts will also focus on domestic tissue donation, as more than 90 percent of human tissues used in Korea are imported. The ministry will improve awareness, support local tissue banks and train specialists for tissue collection.

Finally, the plan calls for stricter oversight of living and child donors, with the government considering limits or gradual abolition of organ donations from minors. It also plans to include stem cell transplant expenses under the national health insurance system to reduce out-of-pocket costs for recipients.

The Health Ministry said the reforms aim to make organ donation “a more accessible, transparent and life-saving process” as South Korea faces an aging population and growing transplant needs.