A limited supply of organs is the main obstacle for organ transplantation. The shortage reflects not only a shortage of donors but also a failure to make use of existing donors. The Basque Country Transplant Coordination Team is an organ procurement organization that operates in the Basque country, an area of 7260 km2 with 2.1 million inhabitants. From January 1, 1990, to December 31, 1995, the number of potential cadaveric organ donors found by the team increased, to 70 donors per million inhabitants in 1995. Since 1993, the organization has had more than 30 donors per million persons and has procured more than 90 cadaveric organs, including more than 60 cadaveric kidneys, per million persons. Because of these rates, the team coordinated 61.7 cadaveric kidney transplants per million persons during 1995. This paper describes some characteristics of the Basque organ procurement organization that might explain these results.