Patient advocates criticize federal government's retreat on organ donation registry regulations - Germany Scraps Local Access to Organ Donor Registry Amid Criticism

The German government is set to remove the requirement for local councils to offer barrier-free access to the United States organ donor registry. This move follows years of resistance from state authorities. At the same time, a new law will legalise paired organ exchanges for the first time.

The decision has drawn sharp criticism from patient advocates, who argue it undermines efforts to boost donor numbers. Currently, only a handful of municipalities provide secure, accessible terminals for registration—despite a 2020 legal mandate to do so.

In 2020, the Bundestag passed a law creating a centralised organ donor registry. The measure also required councils to set up data-protected terminals where citizens could register their donation decisions. But state governments refused to implement the change, leaving most residents without easy access.

Six years earlier, a separate Bundestag resolution had proposed allowing registration at ID offices. That idea, too, was blocked by the states. Now, the federal government plans to scrap the 2020 obligation entirely, following a request from state health ministers.

The registry launched in March 2024 and has since attracted around half a million sign-ups. Yet patient groups warn that limited access will slow progress. Eugen Brysch, head of the Foundation for Patient Protection, argued that a state promoting organ donation cannot credibly restrict registration options.

Alongside the rollback, the government will amend the Transplantation Act to permit paired organ exchanges. This system allows incompatible donor-recipient pairs to swap organs with another pair, increasing transplant opportunities.

The upcoming legal changes will end the requirement for councils to provide registration terminals. Paired organ exchanges will become lawful, potentially expanding transplant options. Meanwhile, patient advocates continue to push for broader access to the donor registry, now used by 500,000 people since its launch.