The May issue of Transplantation Direct features a very special series of articles resulting from an international organ and tissue donation and transplantation legislation and policies forum. In October 2021, Transplant Quebec and the Canadian Donation and Transplant Research Program organized this forum where 61 participants from 13 countries were invited to produce consensus recommendations aimed to assist nations and geographical regions to establish their own system of organ donation and transplantation, or to improve existing systems. Topics focused primarily on the following areas: baseline ethical principles, legal foundations, consent models and emerging legal issues, donation system architecture, living donation, tissue donation, and research and innovation systems and emerging issues. Consensus and recommendation reports from these topics are the subject of the 7 papers presented in this issue of Transplantation Direct, which will serve as a vital resource for the international organ and tissue donation community. Our editorial group is pleased to publish this important work, and to provide all articles in open access to everyone interested – see our Transplantation Direct website for full details. The videos from the Forum are also available for viewing, see further below for details.

Please also take a look at this May issue with regard to a variety of articles in other subject areas including specific topics in kidney, liver, pancreas and heart transplantation.