An objection to organ removal is declared in the register. Where that entry applies is harder to answer than the term suggests: what matters is which bodies may access the register in an emergency and at which point they may do so. This guide explains the rules of the German Transplantation Act (TPG, Transplantationsgesetz).
Short answer: From the age of 14 you can declare an objection to removal in the register yourself. Only named doctors and certain bodies may query the entry, and only at the points in time set out in section 2a TPG. Since 1 March 2022 the decision model (Entscheidungslösung) is the applicable law. Last updated: November 2026.
Key points
- From the age of 14 you can declare an objection to removal in the register yourself.
- Under section 2a TPG the data serve to establish whether removal under section 3 or section 4 TPG is permissible.
- Only the persons and bodies named in the law receive information. Relatives are not among them.
- Queries are tied to fixed points in time, for example once death has been established or loss of brain function is imminent.
- The organ donor card is covered by a separate guide (in German).
When may the entry be queried in a hospital?
The query is tied to a point in time. Under section 2a(5) TPG a hospital may query the register once death has been established under section 3(1) sentence 1 no. 2 TPG, or when the loss of function of the whole of the cerebrum, cerebellum and brainstem is imminent or presumed. Other bodies are subject to stricter rules, as the table shows.
| Body | Permitted point in time for a query under section 2a(5) TPG |
|---|---|
| Hospital (named doctors or transplant officers) | Death established, or loss of whole-brain function imminent or presumed |
| Coordinating body (section 11 TPG) | Only after death is established, and only if a query by the hospital was not possible |
| Tissue establishments and manufacturers | After death is established, provided no medical reasons for tissue removal stand in the way |
These rules are meant to stop the register from being used before the decision matters. For you this means an entry does not operate through open queries in everyday life, but only within the procedures the law defines.
For practical purposes it matters to distinguish a declaration from an objection. Both sit in the same register but serve different functions: a declaration on organ and tissue donation concerns your decision from age 16, while an objection to removal is possible from age 14. If you choose to object, check which document would be needed in an emergency and word the entry so that it reflects your own view.
Who may receive information from the register?
Under section 2a(4) TPG the declaring person, named doctors or transplant officers of a hospital, named doctors of certain tissue establishments or manufacturers, and named doctors of the coordinating body receive information. Doctors in the hospital and at the coordinating body may not be involved in the removal or transfer, nor be subject to instructions from someone who is. Relatives are not among the authorised persons under the law. The article Organ donation register: how to register online (in German) explains the registration itself.
Who checks the queries?
The BfArM checks the admissibility of requests and information on a sample basis and, where there is cause, in each case. It records requests and information together with the reason and purpose (section 2a(6) TPG). Onward disclosure is also regulated: the named doctor or transplant officer may pass information on only to the persons the law names (section 2a(7) TPG).
What applies at present without a clear declaration?
Under current law the decision model applies. It rests on the law strengthening willingness to decide, in force since 1 March 2022. Removal then requires that the deceased person has consented. How the register fits into this system is discussed in Bundestag document 21/8050 (see sources).
What would change under an opt-out model?
Three proposals on organ donation are before the Bundestag. The group motion with document number 21/7570 comes from 254 members of parliament from the CDU/CSU, SPD, Bündnis 90/Die Grünen and Die Linke. A bill from the Bundesrat carries document number 21/2738. Both provide for an opt-out regulation. Motion 21/8050 instead aims to secure voluntary donation and to strengthen information and registration. The first reading took place on 24 September 2026, after which all proposals were referred to the Health Committee. There has been no vote so far, and no date of entry into force is given.
Under the basic idea of an opt-out model, a missing objection would count as consent. How the bill formulates this in detail is set out in the respective printed paper. A comparison of the models is in the article Organ donation: pros and cons of the opt-out model for young adults (in German).
Frequently asked questions
Can I object if I am not yet 16?
Yes. Under section 2a TPG you can declare an objection to removal yourself from the age of 14. A declaration on organ and tissue donation is possible only from the age of 16.
Can I withdraw my objection later?
Under section 2a(1) TPG a declaration can be changed or withdrawn at any time. You need the access credentials you received when registering.
Who sees my entry if I am in hospital?
A hospital may query the register only through named doctors or transplant officers, and only under the conditions of section 2a(5) TPG. Other staff have no independent right of access under the law.
Why is the register relevant if the decision model applies?
The register is meant to record whether a declaration exists. Motion 21/8050 targets exactly this point by seeking to raise information and registration potential. More entries are a political aim, but they do not guarantee any particular decision.
Is there a public evaluation?
Yes. Under section 2a(1) TPG the BfArM prepares an annual report. It evaluates the data anonymously and must be published by 30 June each year.
What to do next
- Decide whether you want to make an objection or a declaration in the register.
- Check whether you have reached the minimum age for the declaration you want.
- Follow the progress of proposals 21/7570, 21/2738 and 21/8050 before you commit.
- Keep your access credentials so that you can change or withdraw a declaration later.
Related articles
- Health system reform: overview of ePA, e-prescription, doctor visits and sick notes
- Organ donation register: how to register online
- Organ donation: pros and cons of the opt-out model
- Opt-out model for organ donation: what would change
- Filling in the organ donor card
Sources: Section 2a Transplantation Act, organ donation register (gesetze-im-internet.de, retrieved November 2026, German text); German Bundestag, plenary agenda 2026: documents 21/7570, 21/2738 and 21/8050 (24 September 2026, German text).
Last updated: November 2026. This guide is general information, not individual advice.
