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This study explores factors that have affected the decision of Black African families to donate cadaveric organs. Semi-structured interviews were conducted with ten families living in greater Cape Town, South Africa. Addresses were obtained from records of the transplant co-ordinators at Groote Schuur Hospital. The data were analysed according to broad themes emerging from the interviews. The most important themes were the influence of violent, criminal deaths; the need for a longer period of consultation among family members; belief in the integrity of the ancestor's body; lack of understanding of brain death; and experiences of grief and loss.