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Spatial variations in rates of registered organ donors have not been studied in the UK at detailed spatial scales despite some evidence of national and regional differences. By drawing on the findings from the existing literature, this study examines associations between small-area variations in rates of new registrants to the UK organ donor register (ODR) within Wales and key demographic factors. Using map-based visualisations and statistical regression methods, spatial patterns in new registrants to the ODR are identified within Wales, a country which moved to an opt-out system of consent for organ donation following the Human Transplantation (Wales) Act 2013. By identifying the underlying factors associated with trends in rates of new ODR sign-up, this study aims to highlight the types of approaches that could be used to help to inform future targeted interventions aimed at improving registration rates.Motivations for registering as an organ donor are likely to be multifaceted and complex.National variations in organ donation registration rates within the UK.Few studies to date examine variations in registration rates at detailed spatial scales.Study uses potential explanatory variables to find associations in Wales.Spatial patterns revealed can inform future intervention campaigns.