In the United States, there are several transplant registries and databases. Most are voluntary and may be organ specific, disease or condition specific, organ and disease specific, or specific for a certain demographic patient group. There is one compulsory and comprehensive registry, the Scientific Registry of Transplant Recipients (SRTR). These databases all have strengths and weaknesses. There is no doubt, however, that they contribute significantly to the scientific analyses of transplant outcomes and complications and provide important data through publications and presentations that can improve patient care and influence local, regional, and national transplant policies. Audits can and should be performed to guarantee the reliability of the data and accuracy of the conclusions drawn from this data as was done by the European Liver Transplant Registry.