Introduction: Since its origins in the 1960s transplantation in children became a routine procedure with 310 deceased donor organs being transplanted in paediatric patients in the Eurotransplant-countries in 2019 [web-source Eurotransplant].Today’s main issues arise in the availability and accessibility of organs as well as the justifiability of their transplantation. Children play a special role in this context as they are not meant to consent to whatever medical procedure is applied to them. Rather their next-of-kin and medical staff are to decide. In the context of transplantation thus it needs to be reflected under which circumstances a child can become an organ donor or receive an organ.
Methods:  Data are drawn from a systematic comparison of  various national organ transplantation laws and tissue acts in Europe. Ethical reflections are based on a thematically targeted literature search using PubMed Central and PhilPapers databases.
Results: This presentation will not provide answers to current questions in transplantation medicine but give an overview of present European practices and juxtapose divergent courses of action which are based on an assumed similar social-cultural background.
Organ donation and transplantation are no straight forward processes by the means of psychology, sociology or ethics. Some challenges may only be approachable on an individual base and ask for thorough frameworks that facilitate just decision making. Other challenges may be addressed by legal guidelines, however,  jurisdiction can vary considerably even in what is thought a common European socio-cultural background. Broadening the discussion to other geographical, cultural, religious or societal contexts might add to the complexity of the topic by adding further ethical ideas and legal frameworks, e.g., the acceptance of organ trading, and drawing a widely heterogeneous picture.
Conclusion: Advances in medicine have the potential to raise chances but with increasing options also more challenges may occur. An interdisciplinary discourse is needed to tackle the issues addressed.