Since 1980s many countries have passed legislations prohibiting monetary transactions in organ donation for transplantation (Tx). All organ donations have become altruistic which means no financial incentives or compensation to persons willing to have their organs, or organs of their deceased family to be taken for Tx. Unfortunately this altruistic supply of organs have been far less than adequate and the results of this altruistic system have proved disappointing. Several approaches have been adopted to increase organ supply, but the gap between supply and demand have been worsened over time and the number of patients dying in Tx waiting list have further increased. The organ shortage has remained the most serious problem in Tx today. As the organ shortage has become more severe worldwide, some from Tx community believe that altruism alone is not enough to satisfy the needs of thousands of patients in Tx waiting list and providing some financial incentives or social benefits are necessary to increase the number of cadaveric or living organ donations. Some Tx ethicists also believe that prohibition of all forms of financial incentives to organ donors which has resulted in many patient deaths and suffering worldwide should not be considered an ethical attitude. In this presentation, First: I will show that how in 1984 the offensive proposal of a physician for kidney sales led the National Organ Transplantation Act (NOTA) to become a law in USA Then similar legislations passed in many other countries. An ethical consensus developed around the world that there should be no monetary competition for transplantable organs, either from living or death person. I will also show that the organ shortage is much more severe today than it was in 1984, emphasizing that the efforts to provide sufficient supply of organs through altruism have met with failure. Second: I will argue that in present altruistic system the transplantable organs are already the subject of market activity and human organs are bought and sold every day as a part of regulated Tx services. Third: I will describe how financial incentives for organ donors might be structured and regulated and will emphasize that providing financial incentives together with social benefits will make compensated programs more attractive and ethically more acceptable. Forth: I will review the many controversies between the altruistic and compensated organ donation programs and will talk in favor of providing financial incentives which I believe it is promising for decreasing organ shortage. Finally I will very briefly review the Iran Model of compensated living unrelated donor renal Tx program and will show that how providing financial incentives has successfully eliminated renal Tx waiting list.