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Participants to the third WHO Global Consultation on Organ Donation and Transplantation urged for self-sufficiency. Far from that, about sixty thousand European citizens were waiting for an organ or composite tissue transplant by the end of 2014, out of which eleven died every day due to organ scarcity.The study analyses the impact of two combined factors on self-sufficiency in nine different countries:Public national and/or regional organ procurement organizations or competent authorities (and delegated bodies), as referred to in the EU Directive 2010/53/EU, that encompass the functions required to authorize, organize and monitor the donation and transplantation process.Continuous medical education of health care professionals about to join or already involved in the process.Six European countries (Croatia, France, Italy, Portugal, Slovenia, Spain), two from Asia (China, Thailand) and 1 from Middle East (Iran) were compared over a period of five to twenty years. Some of the countries enlisted took measures to improve their organ donation system even earlier. Steady increase in deceased donors per million population (pmp) was reported in all countries as following: Croatia from 4,3 (1996) to 38,6 (2016), France from 15,1 (1996) to 27,5 (2015), Italy from 11 (1996) to 24,3 (2016), Portugal from 21,2 (1996) to 32,6 (2016), Slovenia from 11 (2000) to 20,3 (2016), Spain from 26,9 (1996) to 43,4, Thailand from 0,7 (2005) to 3,2 (2015) and Iran from 0 (1999) to 11,5 in 2016.As for China, the number of organs donated almost doubled from 2015 (2766) to 2016 (4080), as a result of building the organ donation system, optimizing the legal system, banning the organ procurement from executed prisoners in 2015, and implementing continuous medical education.Continuous multifactorial approach leads to a steady increase of donation rates and better self-sufficiency.