Wales has the lowest organ donation consent rate in the UK, with families agreeing to donation in just 57 per cent of cases, according to new figures from NHS Blood and Transplant.

The rate compares with 63 per cent in Scotland and 59 per cent in both England and Northern Ireland.

Despite Wales introducing a “deemed consent” system in 2015, families are still involved in discussions and have the final say if a loved one dies in circumstances where donation is possible.

Just 44 per cent of people in Wales have formally recorded a decision on the NHS Organ Donor Register, making it the second lowest rate across the UK nations.

Last year, 20 people in Wales died while waiting for an organ transplant. More than 200 have died on the waiting list since 2015. Around 371 people are currently waiting for a transplant.

Health officials say families are more likely to support donation if their loved one has already made their wishes clear.

James Barnett, 41, from Neath, is one of those waiting. He has been on dialysis for seven years and has been waiting five years for a second kidney transplant.

He received his first transplant in 2009, which lasted a decade, but says antibodies and complications have made finding a new match more difficult.

He said: “Waiting for a transplant is hard. I got my first quite quickly within nine months, so I thought it would be the same this time. But the waiting list is at its highest ever level and I have antibodies.

“I live every day with my phone on loud next to me. Every time I get a call, my heart skips a beat – and then there’s the disappointment when you answer and it’s not the call.”

“But if I’m honest, I’ve changed my mindset to tell myself that it’s not going to happen, that I’m not going to get my transplant. If I do, it’s a bonus.”

He said more people needed to register their decision and talk to their families.

“Put simply, the odds of me – and everybody else on the list - finding the match that we need can only be increased through more families making that extremely difficult yet generous decision to donate their loved one’s organs when they die,” he said.

“I know it’s not a nice thing to think about but it’s an important thing to do.”

Anthony Clarkson, Director of Organ and Tissue Donation and Transplantation at NHS Blood and Transplant, said the figures show a continuing shortage of donors.

He said: “While it’s wonderful to hear that James has benefitted from organ donation, it’s extremely difficult to hear he has now been waiting so long for a second transplant.

“The reality is we just don’t have enough donors to get everybody the transplant they need. We can change that if more people confirm their decision on the Organ Donor Register.”

Anyone wishing to register a decision or find out more can call 0300 123 23, or visit organdonation.nhs.uk