Objectives: Although organ donation has been steadily increasing, there remains great inequalities between different regions of the world. Formation of Organ Procurement Organization (OPO) is an essential step to increase the number of deceased organ donor transplantation in every country. Methods: In Bangladesh, only four deceased donor transplants were performed in 2023 and 2024. The 1st donor was a 24-year-old girl suffering from tuberous sclerosis and the 2nd donor was a 45-year-old man who suddenly develop brain stroke and died after 24 hours. Both the recipients were suffering from end stage kidney failure and on dialysis; 1st one for 6 months and 2nd one for 7 years. Results: 1st recipient who underwent transplantation on 18th January was is still alive but the 2nd recipient died after 6 months due to multiple infections. The 2nd deceased donor transplantation was performed on January 24th and both of them are well. South-East Asia (SEA) has much lower rates of deceased organ donors in the world. It varies widely in different countries; 10 PMP in South Korea, 3.56 in Thailand, less than 1 in Japan, 0.53 in Malaysia. In South Asia, there are more than 1.2 billion population although there are only 0.8 PMP deceased donor transplantation performed in India. Conclusions: This gap highlights the importance of establishing a solid framework for organ donation in SEA, which will rely on changes in legislation, education and health care. Although there is steady increase in economic growth but low rate of deceased organ donation remaining. Inadequate organ donation has led to struggles with organ trafficking and transplantation. There is need to improve hospital infrastructure, work force training, support brain dead donors, build awareness in the community and improve socio-cultural issues.