The records of all donor referrals to Groote Schuur Hospital over a 5 1/2-year period were retrospectively examined to determine which factors influenced the families' decision on organ donation. In 35% of these referrals the families were not approached for consent. The reasons for this included the potential donor being unsuitable for organ donation or not meeting all the criteria for brain death. The effects of the age, sex, race and the cause of death of the potential donor on whether the family gave consent were investigated. This study demonstrates that consent was given more readily when the potential donor was aged less than or equal to 10 years, that the sex of the potential donor appeared to have no effect on the decision by the family about organ donation, that black families gave consent for organ donation less frequently than families of other race groups and that consent was obtained more easily when death was due to suicide.