Abstract Public awareness campaigns have minimal impact on transplant waiting lists. Why? There is no substantial Australian-based research on the attitudes of stakeholders, or the public. An explanation is awareness groups may have a negative impact either by promoting public fatigue about organ donation or, for want of professionalism and training, lack the tact to convey a balanced message. The nascent Australian Organ and Tissue, Donation and Transplantation Authority is a welcome influence to the administration of transplantation, with a promise of an evidence-based approach to tackle a pragmatic appraisal of the problem and implementing practical methodologies to increase transplantation.