The history of kidney transplantation is thought to have originated at the early beginning of the previous century with several attempts of Xenografting, and experimental works on vascular sutures (Küss & Bourget, 1992)1. But it really started more than 60 years ago with first attempts of deceased donor transplantation (DCD) and the first successful kidney transplantation of homozygote twins in Boston (Toledo-Pereyra et al, 2008)2. Belgian surgeons contributed to that field of medicine by performing in the early sixties the first ever organ procurement on a brain dead heart beating donor (DBD) (June 1963) (Squifflet, 2003)3. Later on, in the eighties, they published a first series of living unrelated donor (LURD) transplantations, as well as ABO-Incompatible living donor (ABO-Inc LD) transplantations. With the advent of Cyclosporine A, and later other calcineurin inhibitors such as Tacrolimus, with the advent of more potent immunosuppressive drugs (IS), the gap between the number of renal transplant candidates and the number of transplanted recipients was and is continuously increasing in Belgium and most countries. It opened the search for other sources of organs such as donors after cardiac death (DCD) defined with the Maastricht conference and the extended criteria donors (ECD) compared to standard criteria donors (SCD). In Belgium another source of DCD was identified after the promulgation in 2002 of a law on euthanasia. The Belgian example and all its historical measures could help others to fight against organ shortage and its consequences, organ trafficking, commercialization and tourism.