More than 400 patients benefited from organ donations last year but 36 people died while on waiting lists for life-saving transplants, figures show.
Public health minister Aileen Campbell has thanked donors, families and NHS staff for their work as the number of organ donations rose, but said more needs to be done to help others.
Government figures showed there were 99 deceased organ donors for 2015/16 and 84 living donors, resulting in 415 patients receiving a transplant.
At the end of March 2016, there were still 542 patients waiting for a transplant in Scotland. The Government said 36 patients died while waiting and a further 66 were removed from waiting lists.
Those waiting for a transplant include 54-year-old Scott Ramsay, who has been on dialysis for a year after his kidney function rapidly deteriorated.
The father-of-two from Edinburgh said: “I lived most of my life without any problems until my kidney function fell off a cliff last year.
“I’m not doing particularly well on dialysis - doctors have indicated the quality is low for the amount of time I’m dialysing.
“Because I’ve lived most of my life free from illness, there’s been an enormous change.
“I knew a transplant would be the end goal and when I was going through the tests it did cross my mind that I might not be listed.
“I was so delighted to hear that I was being given that chance. The shot at a transplant really is like a golden ticket.”
He added: “I’ve always been on the Register. I more than understand the standpoint of those who don’t want to donate their organs and you have to respect people’s opinions.
“When I tell others my story, many remark on how terrible it is and ask what they can do. My answer is always to think about joining the Register.”
The Scottish Government is considering a “soft opt-out” system for organ donation which will go out to consultation later this year.
Ms Campbell said “significant progress” is being made to help those on waiting lists.
“Since we started our plan of improvement in 2008 we have seen an 83% increase in deceased donor numbers, a 57% increase in the number of transplants undertaken and the active transplant waiting list has also reduced by 21%,” she said.
“I am very aware that organ donation can only occur as a result of tragic circumstances and I’d like to thank every donor and their family who made the selfless decision to donate their organs and enabled others to live.
“I am also very grateful to staff across the NHS in Scotland for ensuring that, when appropriate, patients and their families are offered the opportunity to have donation wishes honoured.
“Today’s figures are encouraging but for as long as people are dying waiting for transplants, more needs to be done. As our campaign says, we need everybody.
“The Scottish Government will, in the near future, be launching a consultation on increasing organ donation. It will include proposals for a potential soft opt-out system for Scotland. Subject to the outcomes of that consultation, we will bring forward legislation.”