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There needs to be a "revolution" in societal attitudes towards organ donation so more lives can be saved, the NHS Blood and Transplant (NHS BT) has said.
The proportion of families who agree to organ donation after the death of a family member remains "stubbornly low", NHS BT spokeswoman Sally Johnson said.
Figures show that during 2013/14, more than four in 10 families approached about organ donation said no to donating a loved one's organs.
"Family refusal is our biggest problem and it's sad we lag so far behind some other countries in terms of consent/authorisation rates to donation," she added.
More people are donating their organs in Britain than ever, according to health officials
The last financial year was a "record year" for organ donation and transplantation in the UK, NHS Blood and Transplant (NHS BT) has said.
In 2013/14 there were 4,655 transplants carried out - a 10% rise on the previous year, a spokeswoman said.
New figures, published by the authority to mark National Transplant Week, show that almost one in four of the transplants were organs from "living donors".
The remainder of organ donations came after a death.