Over the last century, organ transplantation, which began as a lofty and far-fetched idea, has been transformed into a real and practicable triumph of modern medicine. The idea behind organ transplantation is simple: replace a failing organ with one that is functional. Despite this simple premise, organ transplants are scientifically complex. From innumerable botched or failed attempts we have reaped unprecedented knowledge and achieved tremendous successes. Two Nobel prizes and much of modern day immunology have been based on knowledge discovered in the effort to make organ transplantation feasible. Now transplant medicine has blossomed to the point where more than 95 percent of patients with kidney transplants survive beyond 1 year, and the majority of the tissue grafts last for the recipient's entire lifetime. Incredibly, 74 lives are saved each day as a result of this medical innovation. Yet, as these scientific innovations have enabled us to perform more complicated procedures, the ethical issues they engender have become more complicated.