Deceased Organ Procurement has been the main driving force for organ transplantation around the world.

In Egypt, the first live kidney transplantation was performed in 1976 with more than 7500 cases performed so far. We performed the first living donor liver transplantation (LDLT) in our Centre, in 2001. Now, more than 4300 cases have been performed so far.

It is an uncontested fact, that deceased organ donation is the best way ahead in organ transplantation as it helps in covering organ shortage, in expanding transplantation practices and in fighting its darker side of commercialism.

A fully comprehensive law for organization of cadaveric organ donation with acceptance of brain death criteria, approved by the highest religious authorities, was passed by the national assembly in 2010. The Opt in system was chosen. This law also comprised regulatory rules for living organ donation to fight commercialism and transplant tourism.

However, Deceased organ procurement has not picked up and living donation has been the only mode of organ transplantation. The big question is WHY???

We try to analyze the reasons for this delay but we also present the reasons for a diminished drive to push for it compared to earlier years.

In conclusion, efforts to promote and initiate cadaveric transplantation should not stop. Following the clear success stories around the world, and recently in China which has been a complete turnaround, gives a clearly delineated path.