We're being urged to share our thoughts on organ donation with our families as approximately 550 people await a transplant.
Labour MSP Anne McTaggart is calling on the Scottish Government to back a 'soft opt-out' system which would see all Scots being added to the register.
They could then 'opt-out' if they chose not to give after death.
Figures show 39% of people in Fife currently carry a donor card.
However, figures show that almost half of people in Scotland haven't discussed their organ donation wishes with their family, and one in ten of those who are on the NHS Organ Donor Register haven't spoken to loved ones about their decision.
Since 2010/11, the family authorisation rate for organ donation, when a family member agrees that donation can proceed, has increased from 57.1% to 61.6%. Medics say if the rate was to further increase to 80%, around 90 more lives could be saved each year.
Dr Gordon Birnie, NHS Fife Associate Medical Director, Acute Service Division said: "It is encouraging that so many people from Fife have joined the organ donor register.
"I would encourage those who want to be an organ donor, not only to register their wishes but to share those wishes with their family and friends too."
Minister for Public Health, Maureen Watt, said: "Scotland has made huge progress in organ donation and transplantation, and it’s fantastic that 41% of Scots have expressed their wish to donate their organs by joining the NHS Organ Donor Register. The message we want to get across is that it’s vital people talk about their organ donation wishes with friends and family, even if they have joined the Register, so these wishes can be honoured.
"Your family are twice as likely to agree to donation if they know it's what you would have wanted and we know that in the last five years, almost two thirds of those who donated their organs weren't on the Register. With many Scots currently waiting on a transplant, making time for a 'wee chat' could ultimately save lives."