Brain-dead donor (BDD) organ transplantation has been accepted worldwide as the last line of treatment for end-stage organ failure. Heart transplantation (HT) is the key to this because it basically requires BDD. In Japan, HT was resumed under the transplantation legislation in 1999 at Osaka University and National Cardiovascular Center, almost 30 years after the first case at Sapporo in 1968. Initially, the number of BDD was very limited, but after the revision of the law settled in 2010, the annual number of HT from BDD increased to nearly 100 per year, and the cumulative number has reached 958 as of April 2025 in the national base. Lung transplantation (LT) from BDD in Japan also started in 2000 with two single LTs by Osaka University and Tohoku University groups with success. Thereafter, the number of LT from BDD has increased, reaching a total of 1037 as of April 2025. This review describes the historical development of heart and lung transplantation from BDD in the view of how people worked to the breakthrough for the new era of organ transplantation, and introduces our achievements during the early phase of organ transplantation from brain-dead donor at Osaka University.