For some time now, there has been an international debate that significantly challenges the previously scientifically and socially accepted concept of brain death. At the same time, alternative approaches to organ procurement are gaining importance. These challenges are addressed and discussed by experts in the respective fields. Kniepeiss and Kahn present the donor situation and the state of organ transplantation in Austria, Germany, and Switzerland. Following this, Kopetzki discusses the fundamental aspects of the new organ transplantation law. This section concludes with the current recommendations from ÖBIG. Jox and Schaupp engage with the current criticism of the brain death concept, as well as the anthropological-ethical perspective and future developments from a philosophical viewpoint.