Transplantation Proceedings, v. 53, n. 2. Abstract: Background: Organ transplantation has been for years one of the best treatment options for several medical conditions, and, all over the world, thousands of people need an organ transplant. However, the process through which an organ goes from a brain-dead patient to a new recipient is a complex and delicate one. Research questions: This study aims at identifying and assessing the main risks, their impact, and their relevance on the organ donation-transplantation (ODT) process in Brazil. Design: To identify and to assess the risks of the process, we interviewed coordinators at the 10 State Transplantation Centers in Brazil, which is responsible for over 90% of donations that occurred in Brazil in 2019. We applied the Failure Mode and Effect Analysis method to calculate the risks in terms of severity, occurrence, and detection. The scores obtained from each risk were used to elaborate a ranking comparing the impact of 1 risk in relation to the others. Main findings: The interviewees identified 30 risks throughout the ODT process in Brazil. Most of them are related to insufficient human and material resources, lack of staff training and commitment, and poor infrastructure or logistical aspects. Conclusions: This study complements findings from previous studies and add new risks, based on the Brazilian state coordinators’ point of view. It highlights the most critical weaknesses of the process and serves as a basis for future studies to delve deeper into each of those risks.