The increased number of donors from other countries leads to language, cultural, and communication barriers during the donation interview. Understanding how people have acquired their attitudes and beliefs will help create better intervention strategies. We studied the interviews performed during the last 7 years with the families of 90 donors who came from various countries. Our objectives to improve this situation were: first, to overcome language barriers with translators; second, we sought to bridge the cultural barrier by gaining knowledge of the cultures and religions via cultural mediators; and third, we prepared the professionals on methods to properly conduct the interview. We studied the impact of the introduction of cultural and linguistic mediators: health professionals with knowledge of various languages, which in some groups were of the same nationality as the family and had been trained in the donation interview. We also translated the information to be given to the family. Among 90 donors, 52% came from the European Union (65% British); 29% Latin America; 13%, Eastern European countries; and 5%, Northern Africa, totaling 26 nationalities. The average donor age was 54.16 +/- 20.1 years (range, 1-69 years); 42% were females and 58% males. Since the introduction of the cultural and linguistic mediators, family refusal of donation decreased from 40% to 7.1%.