Max and Kiera’s Law, also known as, the Organ Donation Bill 2019 came into effect on the 20th of May 2020. All adults are now considered potential organ donors when they die unless they have ‘opted-out’ or are in one of the excluded groups. A combination of short and long term challenges affect the supply of corneal tissue.

There is a debate as to whether opt-out or opt-in schemes have an effect on the number of organ donations. According to the NHS Transplant activity report 2018–2019, 80% of people in England support organ donation but only 38% have opted in [1]. Belgium had an increase in donation rates after the opt-out system was introduced however Sweden, Bulgaria, and Luxemburg have very low rates of donation despite it. In 2016, a study looking at deceased donation rates showed 21.2 in the UK, 30.7 in Belgium but 43.6 per million population in Spain [2]. Spain’s success is attributed to investment in education and infrastructure rather than its scheme, which is not completely opt-out.

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