Wales is set to become the first country in the UK where people will be considered to have consented for organ donation unless they specifically opt out.
The current system across the UK relies on people signing up to a voluntary scheme and carrying a donor card stating they are willing to donate their organs.
Now ministers in Cardiff Bay who are keen to drive up low transplant rates believe the new scheme will save countless lives.
A Bill for Wales to adopt a system of presumed consent passed its final stage in the Welsh Assembly last night - despite moral objections from religious groups and concerns about it adding greater distress to bereaved family members.
Assembly Members (AMs) voted in favour of the Bill by 43 votes to eight, with two abstentions.
The new consent law would mean that people aged 18 and over will have to choose not to donate their organs when they die if they have lived in Wales for more than 12 months.
Organs made available under the system would be the same as the “opt-in” method - including kidneys, heart, liver, lungs and pancreas - and could be donated anywhere in the UK.
Ministers have stressed the scheme will be implemented sensitively and are planning to launch a major publicity drive to ensure people are fully informed about which choice to make.
The Bill was guaranteed success as the 30-strong Labour group in the Assembly was whipped to vote in favour.
Conservative and Plaid Cymru AMs were given a free vote, and the Lib Dems said all five of their AMs backed the opt-out system.
The new law is set to come into force after the Welsh Government has launched a two-year £8 million publicity campaign in 2015 and has been described as a historic event by the British Medical Association (BMA).
The BMA's secretary in Wales Dr Richard Lewis said: “This is the most important piece of legislation created in Wales since the laws of Hywel Dda. Patients across the country will now benefit directly or indirectly from this Bill.”
The Welsh Government has long said there is a desperate need to drive up transplantation rates as 226 people in Wales continue to wait for a transplant. They now hope it will increase donors by around a quarter.
Despite five years in the making, the issue was still hotly contested for five hours in the Senedd - with AMs from the Assembly's four parties mulling over more than 70 amendments.
Health Minister Mark Drakeford said regulations would need to be drawn up on which organs would not feature on the list. He did confirm that tissues definitely exempt would be limbs as well as face transplants.
Roy J Thomas, chief executive of Kidney Wales Foundation, said: “Deemed consent has a positive and sizeable effect on organ donation rates of some 25% to 35% higher on average in presumed consent countries.
”One person dies every week in Wales waiting for an organ transplant”, he added. “Three people die a day in the UK.”
Simon Gillespie, chief executive at the British Heart Foundation, said: “This is a special and historic moment for a part of the UK that has decided to stand up and make a life-saving change.
“The Welsh have become the standard bearers and now other UK governments must join them and introduce opt-out legislation of their own.
“The system, where everyone is considered a donor unless they say otherwise, will help increase the number of available organs and better reflect the wishes of the majority of the UK.”
However those views were not shared by campaign group Patient Concern.
Spokeswoman Joyce Robbins said: “This legislation will result in human bodies being treated like clapped-out cars. You strip them of parts for re-use, unless the owner prefers to scrap the whole vehicle.
“It's outrageous to pretend that people feel no differently about a human heart from a used car horn. The risks of turning off support for transplantation far outweigh the possibility of increased organ supply.”
Additional reporting by PA
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