The number of people donating organs has fallen for the first time in more than a decade, leading to a call for more donors.
Fewer people dying in circumstances where they could donate and no increase in the rate of people signing up to give consent for their organs to be used if they die are behind the 5% drop.
Figures from the Organ Donation and Transplantation Activity Report 2014/15 shows there were 4,431 transplants compared with 4,655 in 2013/14.
It means 224 fewer people received an organ transplant.
Of the transplants carried out, 1,092 were made possible by living donors who gave a kidney or part of their liver, while 3,339 patients benefitted from organs donated after death.
NHS Blood and Transplant, which published the report and leads organ donation across the UK, is calling for the public to discuss and consider organ donation.
It said that if there are fewer potential donors then gaining consent or authorisation from everyone is even more important, and the consent/authorisation rate remains "stubbornly" below 60%.
The report said unless there is a revolution in attitudes to organ donation people waiting for a transplant will continue to die needlessly, and families are much more likely to agree to donation if they know it is what their loved one wanted.
Last year, nearly nine out of 10 families said yes when their loved one’s decision to donate was known, for example either through the NHS Organ Donor Register or after a previous discussion with them.
But the report said that even when a decision to donate was known, 120 families felt unable to honour their loved one’s decision to donate, denying them their dying wish to save others after their death.
NHS Blood and Transplant’s director of organ donation and transplantation Sally Johnson said: "We are truly grateful to the families of the 1,282 deceased donors and to each of the 1,092 living donors who made transplants possible last year.
"Their donations allowed over 4,400 people to get the organ transplant they’ve been waiting for to save or vastly improve their lives.
“We have always known that because the opportunities to donate are so small, it is essential to increase the number of people who say yes to organ donation.
"If the pool of potential donors is reduced then this is even more important.
“We understand that families are expected to consider donation in their darkest hour so we would remind everyone to tell those closest to you now if you want to donate your organs - and then record that decision on the NHS Organ Donor Register.
"Should the time come, your family will know you want to donate your organs to help to save others.
“The decreases we can see across all types of organ transplant will lead to more deaths if we do not reverse this trend going forward. We know there is a combination of reasons for the decreases, but we cannot hope to save more lives unless UK citizens talk about organ donation with their families and agree to donate if ever they are asked."
To join the NHS Organ Donor Register visit www.organdonation.nhs.uk or call 0300 123 2323.