While advanced nations in organ donation honor donors and their families as national heroes, establishing a "culture of remembrance," South Korea's organ donation system has remained frozen for years—trapped by outdated laws and baseless conspiracy theories. Although the government has belatedly moved to address the issue, the National Assembly's legislative pace fails to match the desperation of patients on waiting lists.
According to medical industry sources on June 13, the Ministry of Health and Welfare finalized the "First Comprehensive Plan for Organ and Tissue Donation and Transplantation (2026-2030)" in October last year, which includes the introduction of Donation after Circulatory Death (DCD). This marks the first comprehensive plan since the June 2023 amendment to the Organ Transplant Act. Beyond DCD legalization, the plan focuses on expanding donation registration institutions from private to public sectors over the next five years and strengthening recognition for donors.
For these solutions to work in practice, amendments to related laws including the Organ Transplant Act and the Life-Sustaining Treatment Act must follow. Current law limits organ procurement to living donors (for certain organs such as liver and kidney), deceased persons, and brain-dead patients—leaving donation after cardiac arrest in a legal gray zone.
DCD is broadly categorized into five types: cases where the patient is already dead upon hospital arrival; cases where cardiac arrest occurs inside or outside the hospital and CPR fails to restore circulation; cases where cardiac arrest occurs after withdrawal of life-sustaining treatment with family consent for patients who are not brain-dead; and cases where cardiac arrest suddenly occurs before organ procurement from a brain-dead patient. In Korea, the third category is considered the most realistic model.
Medical practice has already demonstrated its feasibility. In 2020, a team led by Professor Lee Jae-myung of Korea University Anam Hospital's Critical Care and Trauma Surgery department rapidly secured the liver and both kidneys from a 52-year-old patient who died of cardiac arrest following withdrawal of life-sustaining treatment, saving three precious lives. However, without supporting legislation and institutionalization, not a single additional case has been performed in the six years since.
With the government signaling its commitment to institutionalization, attention has turned to politicians. Rep. Seo Mi-hwa of the Democratic Party of Korea, a member of the National Assembly's Health and Welfare Committee, recently ignited discussion by introducing amendments to both the Organ Transplant Act and the Life-Sustaining Treatment Decision Act centered on DCD implementation. The bills would include patients withdrawing from life-sustaining treatment among eligible organ donors and legally enable essential procedures—such as donation consent, donor testing, and recipient selection—before withdrawal of life-sustaining treatment is carried out. Notably, to prevent institutional confusion, the legislation clearly defines the time of death after cardiac arrest as "five minutes after irreversible cessation of spontaneous circulation and respiration."
However, society's distorted views toward organ donation remain the final obstacle. Previously, Rep. Kim Ye-ji introduced and then voluntarily withdrew a bill that would have prevented bereaved families from overturning a donor's expressed wishes during their lifetime. Her decision came after conspiracy theories spread on online communities suggesting that Rep. Kim, who is visually impaired, was "trying to receive eye transplants for herself"—raising concerns that negative perceptions of donation itself would proliferate. The foundation for a society that honors donors and their families as heroes lies in legislative resolve that ensures donors' noble intentions are not buried by institutional gaps.
Joo Dong-jin, Secretary General of the Korean Society for Transplantation and professor of transplant surgery at Severance Hospital, emphasized: "Increasing brain-dead donors would be the best approach, but the current supply is woefully inadequate. The introduction of DCD is urgently needed for organ donation to expand."