In the developed world, deceased donation is now a well-established source of organs for the unfortunate sufferers of end-stage disease of vital organs. As the science of transplantation grows and the success of transplantation improves, the rest of the world is keen to offer this life-saving procedure to its citizens. As Asia surges forward in attempting to meet the rising demand for replacing failed organs, efforts across the region to develop viable deceased donor programmes are visible. However, according to reports by contributors to this special theme issue, these efforts have met with limited success.