To combat the national shortage of donor organs and meet the needs of more than 60,000 patients awaiting transplant, many organ procurement organizations have devaluated non-heart-beating organ donation (NHBD) as one solution. Non-heart-beating donation is the process by which organs are racovered from patients after the pronouncement of death by candiopulmonary criteria. Recent media reports have misled health care providers to believe that this is a new donation procedure; however, NHBD provided the foundation for modern clinical transplantation. This article describes non-heart-beating donor evaluation criteria, the donation process, associated ethical considerations and the role of the advance practice nurse in assisting families with this ed-of-life; decision. A ease study will be presented Followed by a summary of transplant recipient patient and graft survival outcomes.