Transplantation is the treatment of choice for the terminal evolution of many organ failures. This recent solution has been deployed in France, essentially from deceased donors, in a state of encephalic death or after circulatory arrest. The ethical issues raised by these practices are strictly regulated. The Agence de la biomédecine, in conjunction with healthcare professionals and supervisory authorities, is the public operator in charge of organizing and developing the procurement activities. The volume of activity, severely disrupted by the Covid-19 pandemic, is now back on the rise. The 2022-2026 transplant plan sets ambitious but realistic targets to meet the needs of waiting patients.