This chapter describes the legal and operational frameworks that are necessary at a national or supra-national level in order to support and regulate organ donation and transplantation. Although there are differences in detail between countries, all those with a well established donation program have in place a legal framework, a national donation system, and processes to ensure quality and safety of organs. The UK Code of Practice is based on the essential prerequisite that the cause of the patient's deep coma must be known. In all European countries, organ transplantation is guided by the overarching ethical requirement known as the dead donor rule which states that patients must be declared dead before the removal of any vital organ for transplantation. Organ allocation rules vary substantially between the different European countries. There are several specific databases in the UK, such as that on antibody-incompatible transplants and the paired-exchange living donor program.