Organ donation is possible after cardiac death in some situations, primarily when the patient is severely brain injured and not expected to survive without artificial breathing and mechanical support. Independent of any decision to donate, a patient's next-of-kin may decide to end artificial support. If the patient is expected to expire within a short period of time after support is withdrawn, arrangements can be made to withdraw that support in an operating room to allow quick recovery of the organs after circulatory death has occurred.

Organ transplants are undertaken in both government and private hospitals in the Western Cape. In the early days, the majority of transplants were carried out in government hospitals. Most are now carried out in private hospitals.

However, a significant number are still carried out in government hospitals. For example, the Red Cross Children's Hospital in Cape Town still does the bulk of pediatric kidney, liver and heart transplants.

The first heart transplant in the world was carried out at Groote Schuur Hospital in 1967 by Professor Christiaan Barnard.

In the Western Cape today, transplants are undertaken in the following Government Hospitals: Groote Schuur Hospital, the Red Cross Children's Hospital, Tygerberg Hospital and George Hospital. Heart, kidney, cornea and liver transplants are carried out at these hospitals.

In some countries, there is an organ donor register. You sign up as an organ donor. If you are involved in an accident and are certified brain dead, they check the central register. They find you are on the list, and then can harvest your organs.

However, in South Africa, it is different. When you register with the Organ Donor Foundation, they will send you an organ donor card and stickers. You simply fill in the card and carry it in your wallet. You place your stickers on your driver's license and ID document. There is no central registration process in South Africa, and no central register of organ donors.

So, if you are involved in an accident and are certified brain dead, a transplant coordinator has to approach your next-of-kin and ask them for permission to harvest your organs. It is a requirement in South African law that the next-of-kin must agree to the donation. The organ donor card and stickers indicate your wishes, but it is a good idea to have already discussed your wishes with your family when you register with the Organ Donor Foundation.

The Organ Donor Foundation is a non-profit, non-governmental organization. Their aim is to promote the concept of organ donation in South Africa and to ensure that South Africa remains a centre of excellence for organ donation.

The Organ Donor Foundation also administers the Gerrie Brits Flight Fund. If a donor is certified brain dead in an outlying area, they may charter a plane to collect the donor's organs. A transplant team would then be flown to ex-plant the donor's organs, and then fly them to the transplant hospital. So for example, in 2004 on two occasions, organs were transported to Groote Schuur Hospital from outlying areas.