Becoming an organ donor takes about two minutes. You can sign up online through your state’s donor registry, in person at your local motor vehicle department, or through the Health app on an iPhone. Once registered, your decision is recorded in a national computer system. With over 103,000 people currently on the national transplant waiting list, a single donor can save up to 8 lives and enhance over 75 more through tissue donation.
How to Register as a Donor
The most common way people register is at the DMV when getting or renewing a driver’s license or learner’s permit. You’ll be asked whether you want to be listed as an organ donor, and your choice is noted on your license. If you’d rather not wait for your next renewal, every state maintains an online donor registry you can access through organdonor.gov. iPhone users can also register directly through the Health app, which sends their information to the national system.
There is no minimum age to be a donor, but for anyone under 18, a parent or legal guardian must give permission for donation to proceed. Many states let teenagers indicate their wish to donate when they get a learner’s permit or driver’s license.
What You Can Donate
Most people think of organ donation as a handful of major organs, but the list is far longer than you might expect. After death, a donor can give kidneys, liver, lungs, heart, pancreas, intestines, and even hands and face. Tissue donation adds corneas, middle ear structures, skin, heart valves, bone, veins, cartilage, tendons, and ligaments. Blood, platelets, bone marrow, and cord blood stem cells can also be donated.
You don’t have to die to be a donor, either. Living donors can give one kidney, one lung, or a portion of the liver, pancreas, or intestine. Kidney donation is by far the most common type of living donation.
Who Is Eligible
Almost anyone can register regardless of age or health status. Medical suitability is determined later, at the time of donation, not at the time of signup. Doctors evaluate each organ individually, so even if one organ isn’t usable, others may be perfectly healthy.
For living donation, the eligibility bar is higher. Certain conditions will disqualify you: uncontrolled high blood pressure, active or incompletely treated cancer, diabetes (though restrictions on type 1 diabetes for kidney donors are being reconsidered), untreated psychiatric conditions, and certain infections. People living with HIV may be eligible to donate to HIV-positive recipients in specific circumstances. The transplant team makes the final call based on a thorough evaluation.
What Living Donor Screening Involves
If you volunteer to donate a kidney or part of your liver to someone you know (or even a stranger), expect a months-long screening process. The transplant hospital needs to confirm that donating won’t put your health at serious risk and that the organ is a good match.
The medical evaluation includes blood tests for blood type compatibility, tissue typing, cross-matching, and transmissible diseases. You’ll get a chest X-ray and an electrocardiogram to check your heart and lungs, plus CT or MRI imaging of the organ you plan to donate. Kidney donors undergo additional blood and urine tests for kidney function. Liver donors may need a small needle biopsy. Routine screenings like a colonoscopy, skin cancer check, and gender-specific exams round out the workup.
Beyond the physical tests, a psychosocial evaluation digs into your motivations and readiness. The team will ask why you want to donate, whether anyone is pressuring you, how well you understand the risks, and whether you can handle the recovery period financially and practically. They’ll want to know who will care for you during recovery, how your family feels about the decision, and whether you have mental health concerns that donation could worsen. An independent living donor advocate works separately from the transplant team to make sure your interests are protected throughout the process.
What Happens After Death
For deceased donation, the process begins only after every effort to save the patient’s life has been exhausted. Brain death is diagnosed as an irreversible loss of blood flow to the entire brain. After that determination, the body is kept on a ventilator and other support to preserve the organs.
A specially trained team from the local organ procurement organization (OPO) goes to the hospital to assess which organs are suitable for transplant. The donor’s blood type, height, weight, hospital location, and other data are entered into the national computer system run by the United Network for Organ Sharing (UNOS), which identifies the best-matched recipients. The organs are then surgically recovered and transported to the recipients’ hospitals, sometimes across the country.
The donor’s family is involved at every step. A representative from the OPO or trained hospital staff speaks with the family about the option of donation after the doctor has explained the patient’s death.
Costs to You and Your Family
Organ donation costs the donor’s family nothing. All expenses related to organ recovery, including operating room time, organ preservation, transportation, and surgical fees, are classified as organ acquisition costs and are covered by the transplant system, not billed to the donor or their family. For living kidney donors, even medical complications after surgery are billed under the transplant recipient’s insurance, with no deductibles or coinsurance charged to the donor.
The one area where living donors may face out-of-pocket costs is non-medical expenses: travel to the transplant center, lodging, lost wages during recovery, and childcare. The transplant team will discuss these financial realities during the screening process so you can plan ahead. Some programs and nonprofits offer grants to help offset these costs.
Your Legal Rights as a Donor
Under the Uniform Anatomical Gift Act, which has been adopted in some form by all 50 states, your decision to donate is legally binding. The 2006 revision of the act strengthened this by giving every individual the opportunity to donate at or near death and expanding the list of people who can consent on someone’s behalf if no prior decision was recorded. If you do not want to donate, you must explicitly state that refusal.
In practice, OPOs almost always discuss donation with the family even when the donor’s wishes are on record. While your registration is the legal authority, making your wishes known to your family ahead of time helps avoid confusion or conflict during an already difficult moment.
Religion and Organ Donation
If religious concerns are holding you back, most major faiths in the United States support organ donation. Denominations and traditions that have expressed support include Islam, Judaism, the Church of Jesus Christ of Latter-day Saints, Southern Baptist Convention, United Methodist, Presbyterian, Episcopalian, Evangelical Lutheran Church in America, and several others. The decision is ultimately personal, and speaking with a faith leader can help if you’re unsure where your tradition stands.