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This article considers the organization and social construction of post-mortem organ donation in order to highlight the central role played by the family. It goes on to compare organ donation to proposals advocating a market for transplantable organs. A striking similarity is apparent between the two, since the former arrangement limits or prevents social relationships due to the principle of donor anonymity, and the latter seeks to rule out social relationships in favor of contractual ones. The article goes on to compare the current arrangement for organ donation to two others that resemble it: inheritance laws and life insurance. This comparison makes it clear that family relationships play an important part in three processes in which wealth and resources are transmitted at the owner’s death. In anthropological terms, the current arrangement for organ donation is a “gift” characterized by its societal dimension: it is given to an unknown person via the intermediary of the family, who, as it stands, receive nothing in return.