WALES today enters a brave new world - one in which people aged 18 and over who have lived here for more than 12 months and who die here, will be regarded as having consented to organ donation unless they have opted out.

That will be the key effect of the 'soft' opt-out system of organ donation, known also as deemed consent.

'Revolutionary' is a word used regularly to describe the change in the system, though implementation is likely to be more of an evolutionary process.

It is almost two-and-a-half years since AMs voted to introduce the new system, and its supporters claim it could lead to a 25 per cent increase in the number of organ donors.

Fourteen people in Wales died while waiting for a transplant in 2014/15, and there are currently 224 people on the Welsh transplant waiting list, including eight children, compared with 209 at the end of March 2014.

Since September 2013, advertising campaigns have sought to inform people of the changes.

The latest poll shows that 69 per cent of people in Wales are aware of the organ donation changes, up from 63 per cent earlier this year.

Understanding of the new law is also considered high, with eight out of 10 of those aware of it, being able to describe the changes.

That potentially leaves a sizeable amount of people who are unaware or only vaguely aware however, and those on the frontline, in hospitals where decisions are made about organ donation, must tread very carefully in implementing the new system.

Discussions about organ donation, already very delicate, will inevitably take on a different emphasis, while continuing to seek to avoid confusion, conflict and upset.

People wanting to be organ donors can register a formal decision to opt in, or can do nothing, which will under the new system indicate they have no objection.

People not wanting to be an organ donor can formally opt out at any time.

Whatever stance an individual decides to take however, the key is to make it known, not least to loved ones. Communication is key.

The bottom line for supporters and those who have driven the change in the organ donation system, is a conviction that it will save more lives.

Health minister Mark Drakeford, who steered the new system through the choppy waters of the Assembly, called it "a ground-breaking step."

"Organ donation saves lives - increasing the rate of organ donation allows us to save more lives. That’s the key motivation for this significant change," he said.

"Over the last 20 years a great deal has been achieved in improving medical practice in the field of organ donation but if we’re going to make further progress we need a leap in consent rates and that is why we have changed the law.

"I hope this change will prompt people to talk with their loved ones about their organ donation wishes."

JANET Cripps is in no doubt that the change to the organ donation system in Wales is a positive one.

Five years on from a double lung transplant without which she is likely to have died within months, the 46-year-old, who lives in Risca, says the new system has been "a long time coming."

Her own lungs wrecked by cystic fibrosis, she had already defied the odds by living into her 30s and by having a child - but by late 2010 the disease had taken such a toll that she was wheelchair-bound and housebound, and on oxygen 24 hours a day.

"I never had any doubts about the prospect of a transplant and that was the only thing that was going to save me - luckily it came just in time," she said.

"There are limits to what I can do, but I can get out and about now, walk the dog, things like that, and I've had five more years with my son Will.

"This is a good day. Hopefully the new system will give people in my situation a better chance.

"It is very important that people talk to their families about their wishes and hopefully people will not choose to opt out."

Twenty-five year-old Poppy Roberts, who lives in Monmouth, was also given a second chance at life by a double lung transplant.

Born with cystic fibrosis, hers has been a life punctuated regularly by hospital visits, but her condition became increasingly debilitating after she finished studying fashion and design at Cardiff University.

Constant intravenous antibiotics and regular bouts of oxygen were required to help her keep going, and the future looked bleak.

She describes the three years prior to her transplant on May 31 this year as "absolute hell" and admits to thinking about her funeral.

Having spent four weeks post-transplant in Harefield Hospital in Middlesex, she has been back only once, in September.

"I've been very lucky, nothing has gone wrong," she said.

"I was told to come back in three months. I've not been away from hospital for that long for 15 years.

"I hate the thought of anyone suffering like I did. This has changed my life and now I want to give other people who need a transplant some hope."

Since her transplant, Ms Roberts has worked with Fixers - www.fixers.org.uk - a charity that supports 16-25 year-olds to launch a campaign on any issue that matters to them, and which helps others.

She is encouraging people to sign up to be an organ donor - and her donor has been very much in her thoughts.

"It is horrible that someone has died to save you. But to donate organs to give life to somebody else - nothing is greater than that.

"I didn't know how hard that would hit me. You want to thank them and you can't - but living your life to the full is thanking them."

Of the law change, Ms Roberts believes information and communication is paramount.

"People need to be informed that it is happening, and they need to talk to their relatives.

"Hopefully, when people see stories like mine it will encourage them to sign up to be a donor."

FOR the charity Kidney Wales, today is the culmination of eight years of campaigning for a new organ donation system.

Chief executive Roy J Thomas called it "a journey of hope for those waiting on the transplant list", and believes the rest of the UK should follow.

“The UK sadly lags far behind the rest of Europe in its approach to organ donation. European countries who have a system of presumed consent have higher donor rates," he said.

"Spain currently has the highest organ donation rate in the world, largely due to their opt-out system and Belgium is another country that saw donor rates increase after its introduction."

More than 6,000 people - 90 per cent of those on the organ transplant waiting list, are waiting for a kidney, but fewer than 3,000 transplants are carried out each year.

Gareth Duke, aged 29, from Cwmbran, has had chronic kidney disease since birth and is currently on dialysis three days a week. He has received two transplants, both of which lasted 16 months each.

Before his condition deteriorated Mr Duke represented Great Britain in the Paralympics in 2004 - bringing home gold - and 2008.

“Being on dialysis feels like struggling with one long hangover all the time. It’s hard on the body but it’s what keeps me alive," he said.

"Every day I hope for a new kidney, however there just aren’t enough new organs around. Hopefully the new presumed consent system will change this and people like me can start to live a normal and fulfilling life.”