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5MONDAY When the DR was not decisive or not consulted, relatives had to decide for donation. Relatives were not requested in 10% of these cases. Most reported reasons for not requesting were absence of the relatives or strong emotions among relatives. The relatives' refusal rate was 66% in 2005 and increased to 71% in 2006, but decreased signifi cantly to 59% in 2007. Of the medical potential 68-69% was fi nally not referred for organ donation in the years 2005 and 2006, but in 2007 this total loss was 59%. Thereby, refusal by relatives accounted for about 60% of this lost group of potential donors during these years. Conclusion: The potential of organ donors is 2-3 times higher than the number of donors reported for donation. Most issues in the donation process from donor identifi cation till donor referral, including consent in the DR improved in recent years. The increase in donation in 2007 can be explained by a decrease in refusal by relatives. Thus far relatives still turned out to be the most restrictive factor in the organ donation process. Therefore the request process among relatives still need special attention to increase the number of organ donors in the Netherlands.