With the increasing number of transplantable organs and tissues, as well as improvements in transplantation results, has come a severe shortage of organ donors. Consequently, new ethical dilemmas, related to the fair allocation of available organs and the use of alternative sources of donor organs, are of growing concern. Establishing fair allocation priorities is a serious problem in organ transplantation. Ethically, they should be defined by society as a whole rather than exclusively by the medical profession. Proposed solutions for the organ donor shortage, each with their unique ethical constraints, include the use of related donors, partial organ transplantation, cell transplantation using fetal tissue, and the use of animal organs "xenotransplantation ". Commercial trading in donor organs must be regarded as an unethical activity rather than an ethical dilemma since the donors are motivated by monetary rather than by humanitarian reasons. These ethical dilemmas could be largely avoided by an effective reduction in the severe shortage of postmortal organ donations.