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Brazil · National Transplant System (SNT) · ABTO
Donate in Brazil
Brazil is the largest regional system by volume: 26,509 transplants in 2024, 4th worldwide in absolute numbers. It operates under a presumed donor model with a mandatory family interview
The main barrier is the 46% family refusal rate (2024), the highest among major regional systems
Key figures for Brazil
Transplants 2024
26,509
total: 6,297 kidney, 2,449 liver, 440 heart, 93 lung, 17,089 cornea
Effective donors
19.2 pmp
national rate 2024 (target 21 pmp, below)
Kidney
29.6 pmp
kidney transplant rate 2024 (+1.4% vs 2023)
Family refusal
46%
main obstacle (vs 15–20% in Spain)
Source: Brazilian Registry of Transplants (RBT) 2024 · ABTO · SciELO Braz J Transplant
The public system
How donation works in Brazil
Governing body and law
The National Transplant System (SNT) of the Ministry of Health coordinates the network, with technical support from the Brazilian Association of Organ Transplantation (ABTO). Law 10.211/2001 formally establishes presumed donation (positive silence).
In practice, the family interview remains mandatory and decisive — the family can object. That is why family refusal is high (46%) and the system's main barrier.
How the network works
- 1
Brazil does not have a national donor registry (unlike Argentina). The model operates through OPOs (Organ Procurement Organizations)
- 2
Each hospital has a CIHDOTT (Intra-Hospital Donation Commission) that identifies potential donors and notifies the system
- 3
The CNNCDO (National Central) coordinates distribution according to objective medical criteria
- 4
The family interview is the key moment: the specialized medical team discusses the deceased's wishes with the family
Living donation
Kidney and liver living donation
SUS (Unified Health System) covers living donation. The South region of Brazil (RS, SC, PR) leads with 33.8 pmp in effective donation and 45.1 pmp in kidney transplantation
Donor requirements
- Over 18 years old (legal majority)
- Kinship up to 4th degree by blood or 2nd by marriage, spouse
- Clinical and psychological compatibility
- Non-related: requires judicial authorization or from CNCDO
Coverage and protection
- Full coverage via SUS (Unified Health System)
- CLT Art. 473.VII: justified absence from work for up to 30 days
- "Setembro Verde" (Green September) is the annual mass awareness campaign
- Any economic compensation is prohibited
Main centers
ABTO reference hospitals. The South region (RS, SC, PR) and São Paulo concentrate the highest productivity
Hospital Israelita Albert Einstein
São Paulo · Accredited program since 2002 · 1,000 kidney transplants for SUS patients in 2024
Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP)
São Paulo · Largest university hospital in Latin America · ABTO reference center
Hospital de Clínicas de Porto Alegre
Rio Grande do Sul · Universidade Federal do Rio Grande do Sul · High productivity in kidney transplants
Santa Casa de Misericórdia de Porto Alegre
Rio Grande do Sul · Historic transplant center
Hospital do Rim e Hipertensão (Fundação Oswaldo Ramos)
São Paulo · Dedicated exclusively to nephrology and kidney transplantation
A cultural call to action
The family interview saves lives
"The high family refusal rate (46%) remains the main obstacle to expanding the number of effective donors" — Brazilian Registry of Transplants (RBT) 2024
Brazil has the most developed presumed-consent system in the region and still faces the highest family refusal. The Setembro Verde Campaign and the specialized family interview teams at state OPOs are the bets to reduce this barrier in 2026
Official material
ABTO publishes the Brazilian Registry of Transplants annually with complete data
Talk to your family
In Brazil, the family interview is the most important moment. Making your wishes clear to those who live with you is the most effective way to ensure they are respected
Verified sources
This page summarizes public information from SNT, ABTO, and the Brazilian Registry of Transplants. Medical and legal decisions are yours and your healthcare team's