This report documents changes since the ODT 2008 report. It records significant improvements that have been made to infrastructure and projected 34% increase in donation rates over 4 yrs to April 2012. The report notes, however, that even if Taskforce’s target of a 50% increase in donation rates by 2013 is achieved, people will still be dying unnecessarily while waiting for an organ. We believe that we now need to decide whether we should be satisfied that we have done all we can or whether we should seek to build on what has already been achieved by shifting our attention to additional ways of increasing number of organ donors. The report examines a range of options that have been suggested for increasing the number of donors including a system of mandated choice, reciprocity, a regulated market or paying the funeral expenses of those who sign up to the ODR and subsequently donate organs. The report also explains why we remain convinced that an opt-out system with safeguards is best.