Organ donation gives patients a second chance at life, supported by laws, medical protocols, and registration procedures that guide the process. While National Donor Day, celebrated every 12 September in Paraguay honouring pioneers such as Dr. Marco Aurelio Aguayo Rodríguez, highlights the importance of this act of solidarity, the broader picture lies in how donation is organised throughout the year. So how does organ donation in Paraguay works?
Medical criteria and procedures
Transplants from deceased donors are only possible when brain death is confirmed. This irreversible condition results from events such as strokes, or severe head trauma. A strict protocol applies: two physicians – at least one a neurologist, neurosurgeon or intensivist – must certify death, and they cannot be linked to the transplant team.
This process remains anonymous. By law, families cannot know the names of the patients who receive the organs, and no information may be given that links donors with recipients. The National Institute of Ablation and Transplant (INAT), under the Ministry of Health, coordinates distribution, ensuring fairness at national and, in some cases, international levels.
The legal framework
Organ donation in Paraguay is regulated by Law No. 1246/98, later amended by the “Anita Law” (Law No. 6170/18). Now all citizens over 18 are considered presumed donors after death unless they have explicitly registered their opposition. This means that, unlike in many countries, becoming a donor is the rule and refusal must be formally declared.
Living donation is also possible under clinical conditions. Options include the kidney, part of the liver, bone marrow (with compatibility checks) and even placental provision in programmed births, which allows the use of the amniotic membrane for treating burn victims or ocular injuries.
How to register your decision
While presumed consent is in place, authorities strongly recommend that people formalise their decision by completing the form available on the INAT website. This allows residents in Paraguay to confirm their choice to donate partially or totally, or to declare refusal. The form can also be completed when renewing the national identity card, where the decision is officially recorded.
To register, applicants must be over 18 and hold a valid, legible national ID. The process is free and applies equally to Paraguayans and foreigners residing in the country. Expressing your decision is crucial, since in many cases families oppose the procedure after death. A formal record works as proof of what the person decided, ensuring that it is respected over the family’s choice.
The reality in numbers
Despite the legal framework, Paraguay’s donation rate is only 3 per million inhabitants, far below the regional average of 12. Each donor can benefit up to eight recipients through organs and corneas. Yet myths persist: some fear doctors may neglect their care if registered, while others cite religion, even though most faiths support the practice.
This gap between potential and reality means many patients continue to wait. Some suffer terminal heart, lung, or liver conditions, while others undergo dialysis three times a week awaiting a kidney. For them, transplants represent not just treatment but the chance to return to work, study, family life and the simple joys of daily living.
Challenges around organ donation in Paraguay
Authorities emphasise that this gesture is the only way to make transplantation possible, and that society’s involvement is essential. They highlight the need for open conversations within families and communities to reduce stigma and encourage more people to take the step, reminding them that anyone may one day depend on a transplant. Organ donation remains a vital issue in Paraguay, with demand consistently outweighing supply.
National Donor Day 2025 highlighted progress, but also reminded Paraguayans of the challenges ahead. Greater awareness, more registrations and stronger community support are essential to build a culture of solidarity, where organ donation is seen not as a taboo but as a gift of life.
