Presumed consent legislation produces more donors and in particular more organs per donor. In cadaveric donation, the number of elderly donors is increasing, so the quality of organs available is getting poorer. There will be no substantial rise in transplantation unless there is a major breakthrough in the current programs. There will be an increase in the proportion of living (un)related donors and debate about ethics of transplantation. Adverse publicity and debate may affect cadaveric donation and refusal rates.