The retrieval and allocation of donor organs involve many challenges. Although maximizing the use of available organs is one practice that can help, it is not a solution to the growing demand. This report has focused on the period of 1991 to 2004 in Canada, a period in which retrieval practices appear to have improved: fewer organs remain unused for non-medical reasons and multi-organ retrieval is increasing over time. It is unclear how long these trends will continue. The Canadian population is aging, and this may eventually reduce the number of viable organs available. Ultimately, a combined effort of increasing the number of potential donors and making effective use of all available organs will be required to meet the growing shortage of organs.