Revealing the potential of non-transplanted donor organs: a comparative analysis in the Eurotransplant region.

Post-mortem organ donation is essential for modern transplantation medicine, yet a substantial proportion of recovered donor organs are not transplanted. These organs, although clinically declined, hold significant and untapped value for biomedical research and technological innovation. Eurotransplant reports and United States national data were reviewed to quantify transplanted and not used organs and to assess temporal trends. During the study period, 100,260 organs were reported in Eurotransplant, of which 32,242 (32.16%) were not transplanted. Of all reported organs, 16.05% were accepted for transplantation but not used, representing a stable and predictable number of organs suitable for secondary research use. A review of international, European, and national legislation demonstrated that, in many Eurotransplant countries, existing laws focus almost exclusively on transplantation and provide limited guidance on the research use of non-transplanted organs, with the Netherlands, Slovenia, Luxembourg, and partially Belgium as notable exceptions. Emerging technologies highlight the scientific and clinical relevance of these organs. Establishing legal and ethical pathways for their secondary use could reduce organ wastage, support innovation, and improve transplantation outcomes. Engagement with the Austrian Federal Ministry of Health, informed by the findings of this work, contributed to an amendment of the Austrian Organ Transplantation Act.