Closing the gap between supply and demand of organs for transplantation is a major challenge for health care providers in Europe and beyond.
1. to give an overview of the current European situation with regard to:

1.1. Organizational aspects (Organ Exchange Organizations)
1.2. Waiting lists for organ transplantation (yearly entries, cumulative list)
1.3. Donation from living donors
1.4. Donation from deceased donors
1.5. Gap between supply and demand

2. Factors that impact on donation rates, alternative strategies, and their relative weight on donation figures in Europe.
A descriptive, exploratory analysis of data collected by the Donor Action Foundation, the Council of Europe, UNOS and the Eurotransplant International Foundation.
1. Currently, some 15 OEOs are operational in Europe, with a service area between 125 (Eurotransplant) and 7.1 million people (Baltransplant).
2. European countries differ significantly with regard to their number of patients added annually to a waiting list for transplantation, from about 100 p.m.p. in the U.K. to less than 20 p.m.p. in Lithuania.
3. European countries differ significantly with regard to the number of realized transplants per year, from over 80 p.m.p. in Austria, Belgium, Norway and Spain, to less than 20 p.m.p. in Turkey, Lithuania and Romania.
4. Although the total number of patients waiting for a transplant in Europe had accumulated to >52,000 by the end of 2004, UNOS data suggest that this number may double in the coming years.
5. Optimal use of legislative measures (presumed consent) and implementation of non-heart-beating donation protocols may offer alternatives to increase donation from deceased donors.
The study presented has identified the potential for donation, legal environment, health-economic variables, cultural & religious barriers, organizational measures and professional education as key factors that impact on donation rates from deceased donors. Large differences between European OEOs and countries with regard to their annual donation and transplantation rates, and the number of patients added to a waiting list for transplantation show a huge potential for improving countries' transplantation performance.