At present, Australia has a non-commercial, altruistic system of tissue and organ donation backed by criminal and professional sanctions. However, the demand for transplantable tissue far exceeds the supply of suitable donors, and creation of a commercial market for human tissue has been suggested. This seems unwarranted both politically and ethically and may not even achieve the desired objective of increasing the rate at which tissue and organs are made available for transplantation. It appears that greater benefits would accrue from enhancing the existing altruistic system, including improving public knowledge about the need for tissue donation and the operation of the existing system. In addition, health care workers need better instruction in the process of obtaining consent for organ donation. Finally, biotechnology may provide alternative solutions to the shortage of transplantable tissues and organs. Tables, references