Australia has dropped two places and is now number 22 in an international ranking for organ donations and transplants.
"If Australia was to perform as poorly in the Olympic medal tally there would be outrage but clearly the same does not apply for our organ donation system," said Brian Myerson, director of reform group ShareLife.
The number of organ donors in Australia in 2014 was 16 per million population (dpmp), according to The Council of Europe Transplant Newsletter figures analysed by ShareLife.
Spain topped the ranking of the 68 countries, with 35.7 dpmp.
If Australia equalled Spain, about 1100 more transplants could be done in a year, while at present there's about 1700 people on the waiting lists.
"Consent rates continue to dominate the debate but the data shows this is just one element relevant to high donation rates," Mr Myerson said.
"Doctors need to be trained in identifying every potential donor and to ensure donor families are given the right information to make informed decision."
Families shouldn't be blamed for the low organ donation rates, he said.
"Change needs to happen within the hospital system."
2014 GLOBAL RANKING OF DECEASED DONORS PER MILLION
1 Spain 35.7
2 Croatia 34.8
3-7 Malta, Belgium, Portugal, France, United States 25-29.9
8-9 Austria, Czech Republic 23-24.9
10-16 Italy, Norway, Finland, Slovenia, UK, Hungary, Uruguay 20-22.9
17-21 Estonia, Belarus, Sweden, Netherlands, Canada 16.5-19.9
22 Australia, 16
