The need for organ transplantation is ever increasing. Currently there are 115,000 people on the waitlist and the number is still growing. Organs that are transplanted may be obtained via a living or deceased donor. The organs may be obtained from a deceased donor after either brain death or after cardiac death. The majority of deceased donor organ transplants occur via deceased donor after brain death; however, deceased donor after cardiac death organ donation is increasing. This concept of organ transplantation can be quite difficult to discuss with families, therefore, the anesthesiologist and the entire care team must be knowledgeable and respectful regarding the patient’s and families wishes. The team should also be familiar with the overall process and organ procurement protocols of the institution. By having respectful, thoughtful, early discussions regarding the potential for organ donation, families will be able to make better informed decisions.