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This article examines the system of providing court approval for organ and tissue transplants from minor donors as it operates in Massachusetts. It focuses principally on the substantive interests of prospective donors and on the extent to which the current procedures afford them adequate protection. It begins by examining the requirement of consent and demonstrates the necessity of judicial authorization of minor donors' participation in transplant procedures. Next, it analyzes the current Massachusetts practice and assess its capacity to afford minor donors adequate protection from the possible dangers of serving as an organ or tissue donor. It suggests that the Massachusetts system has not adequately protected minor transplant donors.This article concludes by proposing a number of reforms in the present practice to increase its capacity to protect minor donors.