Organ Donation in Malaysia: How to Pledge, Religious Views, and the Low Donor Rate

Every year, thousands of patients in Malaysia wait for a phone call that may never come — the call telling them that an organ to save their life is finally available. Behind that long waiting list lies a paradox: hundreds of thousands of citizens have pledged to donate their organs, yet only a tiny fraction of those pledges are ever carried out.

How do you pledge to donate your organs?

In Malaysia, the organ donation programme is managed by the National Transplant Resource Centre (NTRC) under the Ministry of Health Malaysia. The system is opt-in — a person must register voluntarily to state their wishes.

There are several ways to pledge:

• Online — fill in the donor pledge form on the official website dermaorgan.gov.my.
• MySejahtera app — digital pledge registration was introduced on 6 September 2022, and has contributed to the surge in pledge numbers since then.
• Telephone hotline — call 1-800-88-9080 to request that a form be sent by post.

The process is free and requires no medical examination. Organs and tissues that can be donated include the kidneys, liver, heart, lungs, corneas, bones, skin, and heart valves.

One important point is often misunderstood: pledging alone does not guarantee that organs will be donated. In Malaysia, family consent is still required at the time of death.

Why is the actual donor rate so low?

The number of people who have pledged is in fact large. According to Ministry of Health data, more than 412,000 citizens have registered as pledgers, with around 15,000 new pledgers in 2025 alone.

Yet the gap between pledges and actual donations is very wide. The NTRC estimates that the conversion rate from potential donors to actual donations is only around 10%. As the NTRC director has noted, having many pledgers does not mean they become an actual supply.

The current figures illustrate the pressure on the system:

Indicator	Figure	Source
Citizens who have pledged	More than 412,000	MOH
Family refusal rate	Nearly 90% of potential donations	MOH/NTRC
Patients on the waiting list	10,736	MOH/NTRC
— of whom awaiting a kidney	10,707	MOH/NTRC
Total transplant surgeries since 1975	3,492	Malaysian Society of Transplantation

The main cause is not a shortage of pledgers, but family refusal. According to the MOH, nearly 90% of potential donations cannot proceed because family members refuse — even when the deceased pledged during their lifetime.

What is the connection between brain death and family refusal?

One of the main reasons families refuse is a misunderstanding of the concept of brain death. Most cadaveric donations (from the deceased) involve donors who have been certified brain dead but whose heart is still beating with the help of a machine.

Many families find it hard to accept that a person has already died while their body still feels warm and their heart is still beating. In moments of deep grief in the intensive care unit, the decision to allow donation becomes extremely difficult. Emotional factors, uncertainty, and a lack of time to discuss often lead families to choose not to proceed.

What is the Islamic view on organ donation?

Because this topic touches on religious beliefs, it needs to be understood accurately and neutrally.

For the Muslim community in Malaysia, the primary reference is the ruling of the National Fatwa Council. At the first conference of the Fatwa Committee of the National Council for Islamic Religious Affairs Malaysia on 23-24 June 1970, the transplantation of eyes and hearts from the deceased to the living was ruled as harus (permissible) in Islam, subject to several conditions:

• it is done in a situation of necessity when the patient’s life is threatened and the transplant is the last option;
• the donor’s death is certified first before the surgery is carried out;
• there is no element of buying, selling, or trading in organs; and
• consent is obtained from the donor during their lifetime, or from their heirs and family.

The 1970 fatwa originally covered only the eyes and heart. It was later expanded. According to the Federal Territory Mufti’s Office (Bayan Linnas Series 176), donation now includes organs such as the heart, kidneys, liver, lungs, and pancreas, as well as tissues such as corneas, bones, skin, and heart valves. However, the transplantation of the testes and womb is considered impermissible because of their connection to lineage (nasab).

It is important to note that there are differing views among religious scholars. The majority of scholars permit donation based on the principles of mutual aid and preventing harm, but a small number — among them the mentioned Sheikh Mutawalli al-Sha’rawi — hold that it is prohibited. Similar fatwa rulings permitting donation on the principle of necessity have also been issued by Islamic councils in other countries, such as Kuwait (1979), Saudi Arabia (1982), and Singapore (1986).

What about the views of other religions?

Central official sources in Malaysia focus primarily on the Islamic view, but in general Malaysia’s other major religions do not prohibit organ donation and often regard it as an act of charity:

• Buddhism — donation is regarded as a matter of individual conscience, in line with the value of compassion.
• Hinduism — there is no prohibition on donating organs; some adherents see it as a charitable act that brings positive effects.
• Christianity — the donation of organs, eyes, and tissues is accepted as an act of love and charity.

Although the official views of most religions permit donation, in practice the final decision often returns to the family, and emotional barriers remain across all religious groups.

What is the relationship between a personal pledge and the family’s final say?

This is the heart of the matter. A person may pledge sincerely during their lifetime, but because Malaysian law and practice require family consent at the time of death, that wish may go unfulfilled if the family does not agree.

That is why health authorities stress a step that is often overlooked: telling your family about your wishes. A pledge kept in the system but not shared with loved ones often ends up unfulfilled, because families who do not know are more likely to refuse in a state of grief.

What’s next

If you want to understand or consider organ donation:

• Visit dermaorgan.gov.my or register via MySejahtera for official information and the pledge form.
• Discuss your wishes with your family first — their consent determines whether the pledge can be carried out.
• For those with religious concerns, consult your religious authorities or spiritual advisor; for the Muslim community, the rulings of the National Fatwa Council and the Mufti’s Office serve as references.
• For the latest statistics, check the official KKMNOW dashboard.

This article is general and neutral information; it is not medical or religious advice. Refer to official sources and the relevant authorities for personal decisions.