The highest organ donation rate in Chile was 10 donors per million population in 2017, which is low compared with other countries. Local experts attribute the low rate to population's lack of education and generosity, distrust in procurement/allocation system, inadequate legislation and insufficient encouraging campaigns, although without much empirical support: None of the countries from the OECD is also an organ donation leader. Latin Americans who migrate to Spain improve their donation rates, suggesting that the possible explanation is trust in the system where personalities do not have fast access to organs and common people do not have a sense of inaccessibility. Legislation changes in Chile did not have the expected results. Mega campaign did not reduce family refusal, but increased actual donors, probably due to health personnel sensitization. Real problems are inefficiencies in search and procurement processes, because procurement coordinators do not have enough time, dedication or priority to detect possible donors. Eighty seven percent of the latter are not notified to the procurement coordinator. Also, the services that care for possible donors are not adequately aligned. Procurement nurses do not have enough empathy or communication abilities and do not fulfil the professional profile required by the national coordination entity, which is unable to demand for results. The management of procurement coordinators should be improved, and their operational limitations should be visualized. Tools should be provided to the national agency in charge of organ procurement to have more political influence and credibility. Information technologies could ease warns, control and standardize, in real time, the procurement process.