The Hellenic Transplant Organization (HTO) a non-profit organization, sector of the Greek Ministry of Health, was officially established in 1999. Since March 2001, HTO has been responsible for donation and transplantation processes in Greece and organ sharing between Greece and other European countries. The organization’s main tasks are: Donor referral, charting, donor assessment, organ evaluation, organ allocation and transplantation. Today, the results prove that the HTO founding was absolutely necessary, as Greece´s increase rates were previously unthinkable. Precisely, the percentage of referred versus used cadaveric donors increased by 468 % and 134% respectively. Cadaveric kidney transplantation has also shown remarkable progress with a 126% increase during the same period. Similarly, liver transplantation had a three-fold rise (89%) during the same time. Unfortunately, heart and lung transplantations remain very low, thus preventing statistical conclusions to be drawn. Although Greece in previous years had the lowest donor and transplantation rates p.m.p, the position is expected to rise significantly this year, compared to other European countries. Undoubtedly, the numbers and percentages compared to previous years are due to the radical changes implemented by HTO, by introducing the transplant coordination principle and procurement management, concepts not previously established in Greece. However there are still major obstacles, such as intensivists’ refusal to disconnect, inaccessible geographical locations, few transplant centers and society’s suspicion of organ donation concept, that still need overcoming. Nevertheless the first step has been taken and other European countries standards will hopefully be attained soon.