Organ procurement and transplantation have been difficult in Italy for many years. However, recent initiatives at the organizational level led to the establishment of the National Reference Centre, which is working hard to accomplish its tasks. We describe the transplantation activity of the past 2 years, which shows an improved situation that is encouraging. We include a brief history on transplantation in Italy and give some information to enhance understanding of the changes that have occurred and their impact on transplantation.