The Economist discusses this question:
But human kidneys are no ordinary commodity. Trading them is banned in most countries. So supply depends largely on the charity of individuals: some are willing to donate one of their healthy kidneys while they are still alive (at very little risk to their health); others agree to let their kidneys be used when they die. Unsurprisingly, with altruism the only incentive, not enough people offer.
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Taking organs to the grave is just plain stupid. Donating organs from the deceased is not altruistic. It is a form of social bargain. I sign my drivers license to offer something of value to others at a time when it has no value to me, hoping that I can convince others to do the same; they offer organs usless to them (deceased) at a time when I might require them to stay alive.
Nothing altruistic about that at all; merely a social bargain. Problem is there are a lot of freeloaders on the system, happy to take an organ, but unwilling to give upon death. Hence the development of closed organ sharing networks where organs are shared only among the participants who have affirmatively agreed to the social bargain
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