This report presents a case series consisting of 2 individuals who served as organ donors after ecstasy-related fatalities and 3 individuals who experienced acute liver failure after ecstasy use. The two deceased were women who experienced hyponatremia after use of MDMA. Doses used were 1.5 tablet in a 15-year old woman and an unspecified amount combined with ethanol in a 19-year old woman, with MDMA detected in bodily fluids in the first case and amphetamines (unspecified) detected in the second case. Brain death resulted from cerebral edema in both cases. Recipients of organs from these donors did not experience any residual toxicity, and liver and kidney transplants caused no problems. There were problems with one lung and one heart transplant. Three cases of liver failure after ecstasy use occurred in 2 women and one man, age ranges 16-25 (25 year old woman, 17 year old man and 16 year old woman). No information was provided on doses used by these individuals and no specific tests for MDMA in bodily fluids were performed. Time elapsed until admission was from 2 to 5 days after last use. All 3 fared well after liver transplant, though treatable, mostly mild rejection was reported in all cases. On examining these cases, it would appear that processes leading to hyponatremia do not damage the liver or kidney, and usually do not damage the heart. Because body temperature was not measured in the cases of liver failure after ecstasy (largely due to admission at least 2 days after use), it is unclear whether hyperthermia played a role in these cases or not.