There has been a "huge failure" to boost organ donation rates among black, Asian and other ethnic minority groups, an expert has said.
The UK should now consider a scheme where priority for surgery is given to people already on the organ donor register, according to Dr Adnan Sharif, a kidney consultant at the Queen Elizabeth Hospital in Birmingham.
Figures show that ethnic minorities make up 10.8% of the UK population yet represent 24% of the organ waiting list.
Just 4.2% of organ donors are from minority ethnic backgrounds and there are only around 118,000 people registered from these backgrounds to give an organ after their death, Dr Sharif wrote online in the British Medical Journal (BMJ).
"Relatives of non-white people are also less likely than white people to give consent for organ donation from loved ones who have died in appropriate circumstances for donation," he said. The figure is 30.3% giving consent compared with 68.5% of white people.
"Simply pushing for more registrants on the organ donor register is not the solution because only a third of eventual donors are actually registered at the time of their death," Dr Sharif wrote in his "personal view" article. "A new approach should be to tackle the elephant in the room: the problem of apathy or so called free riders - people who are happy to receive an organ but not to donate."
Dr Sharif noted Israel's approach to the issue, which is to give priority for organ transplants to previous donors or those registered for at least three years to be donors.
"The prioritisation approach raises ethical difficulties, such as coercion, religious constraints, or strategic behaviour, and translating such a policy to the UK would be fraught with challenges," said Dr Sharif.
"However, developing a prioritisation system for organ and stem cell donation has inherent fairness for all - not just for minority ethnic people. Although it would positively affect the general population, it would also likely serve as an impetus for minority ethnic people, who will have an even longer wait under a prioritisation system if they do not commit."
Figures published last week showed the overall number of organ transplants carried out in the UK has reached a record high. There were 4,212 transplants in 2012/13, up 6% on the 3,960 in 2011/12, according to a report from NHS Blood and Transplant (NHSBT). Around a quarter (1,101) of the transplants were as a result of living donors giving a kidney or part of their liver. The rest (3,111) involved organs donated after a person's death.