A donor after cardiac death (DCD) is a donor who has suffered devastating and irreversible brain injury and may be near death, but does not meet formal brain death criteria. In these cases, the family has decided to allow a natural death. When the patient's heart stops beating, the organs are then recovered in the operating room. The surgeons involved in transplantation cannot be part of the end-of-life care or in the declaration of death. This type of donation does not cause or hasten death. Organs recovered from a donor after cardiac death have some degree of oxygen deprivation during the time after the heart stops beating. This may make kidneys from this type of donor "slow to start".

Donors after cardiac death can fall into the SCD or ECD category, depending upon the donor's age, cause of death and creatinine levels.