It has more than its share of hospitals, so demand is high, and like most big cities, it has lower donation rates than small towns and rural areas.

Consider the South Carolina Organ Procurement Agency, which has increased its donation rate by 83 percent since 1997.

Adequate funding, strong political will to see transplant outcomes improve, and the existence of specialized training, care and facilities also increase donation rates.

Because of high demand and low donation rates, "we've been struggling in the last couple of weeks with a one- or two-day supply," said Dr. Robert L. Jones, the center's president.

That means, to change from ranking in intermediate-low positions in donation rates in Europe, to have by large the highest rate not just in Europe, but also worldwide.

Thus, there is little data to show that financial incentives would increase donation rates.

One study found that donation rates of children could be increased by punishing episodes of failure to donate.

We already have some good examples in Member States where the addition of transplant coordinators, for example, has had a positive impact on donation rates.

Common binding standards on the quality and safety of donations in the 27 Member States absolutely must be adopted in order to improve cross-border exchanges and to increase donation rates.

After Nicholas' death, donation rates increased dramatically in Italy, a country where organ transplants were almost non-existent.