Organ and tissue donation is the process of giving your organs or tissues so they can be transplanted into someone who needs them. A single organ donor can save up to eight lives, and a tissue donor can help dozens more. Donation can happen after death or, in some cases, while you’re still alive.
What Can Be Donated
Eight organs can be transplanted from a deceased donor: kidneys (two), liver, lungs (two), heart, pancreas, and intestines. In rare cases, hands and faces can also be transplanted. Kidneys are the most frequently needed organ, followed by livers.
Tissue donation covers a broader range. Tissue banks can store corneas, skin, heart valves, bone, veins, cartilage, tendons, ligaments, and middle ear structures. The key difference between organ and tissue donation is timing and preservation. Organs must be transplanted within hours of recovery, while tissues can be processed and stored for much longer, making them available to more recipients over time.
How Donated Tissues and Organs Are Used
Transplanted organs replace failing ones. A new heart keeps someone alive who would otherwise die within days or weeks. A donated kidney frees a patient from dialysis. The need is enormous: every 10 minutes, another person is added to the national transplant waiting list.
Tissue grafts serve a wider variety of medical purposes that many people don’t realize. Donated bone promotes healing and can prevent amputation after severe injuries. Skin grafts protect burn victims from infection while they recover. Heart valves repair cardiac defects without requiring a full heart transplant. Cornea transplants restore sight to people with damaged or diseased corneas, and doctors can perform these transplants up to five days after the cornea is recovered.
Living Donation
You don’t have to die to be a donor. Living donors most commonly give one kidney or a segment of their liver, since both organs can regenerate or function well at reduced capacity. Less commonly, living donors can give one lobe of a lung, part of the pancreas, or part of the intestine. Tissues like skin (after cosmetic surgeries such as tummy tucks), bone (after knee or hip replacements), bone marrow, blood, platelets, and even the amniotic membrane after childbirth can all come from living donors.
To qualify as a living donor, you must be at least 18 (some hospitals require 21), and in good physical and mental health. The evaluation is thorough: a full physical exam, lab tests, cancer screenings, a mental health evaluation, a review of your medical history, and a discussion of your social support system and ability to take time off work for recovery.
How Deceased Donation Works
Deceased donation begins with a determination of death, which happens in one of two ways. In most cases, doctors confirm brain death, meaning all blood flow to the brain has permanently stopped and the person cannot breathe on their own. In other cases, donation occurs after the heart and lungs stop functioning, with the agreement of the family and care team that nothing more can be done.
Once death is confirmed, a representative from the local organ procurement organization (OPO) evaluates whether the person is medically suitable to donate. The OPO then checks donor registries. If the person registered as a donor, that serves as legal consent. If not, the OPO asks the next of kin for permission.
When consent is confirmed, the OPO enters the donor’s medical information into a national computer system run by the Organ Procurement and Transplantation Network (OPTN). The system generates a list of the best-matched recipients. A separate surgical team, completely independent from the team that treated the patient, then recovers the organs and tissues in an operating room. The OPO coordinates transport to the hospitals where recipients are waiting.
How Recipients Are Matched
Matching is not first-come, first-served. The national system weighs several factors to find the best medical match for each organ. Blood type compatibility is the starting point for virtually every organ. Body size matters too, especially for hearts and lungs, which must physically fit inside the recipient’s chest cavity.
Beyond those basics, each organ has its own scoring system. Heart recipients are assigned an urgency status code based on how critically ill they are. Lung candidates receive a score that reflects both how badly they need the transplant and how long they’re expected to survive afterward. Liver allocation uses a severity score (called MELD for adults, PELD for children) that prioritizes the sickest patients. For kidneys, waiting time, distance between hospitals, and immune system compatibility all play a role. Pancreas matching focuses heavily on blood type compatibility, and intestine transplants require an identical blood group match, with the donor typically being smaller than the recipient so the organ fits.
Who Can Be a Donor
Almost anyone can potentially donate, regardless of age or most medical conditions. There is no strict age cutoff. Medical teams evaluate each potential donor individually at the time of death to determine which organs and tissues are viable.
The main disqualifiers are certain active infections. Donors are screened and tested for HIV, hepatitis B and C, syphilis, and prion diseases like Creutzfeldt-Jakob disease. West Nile virus and active sepsis (a body-wide blood infection) are also screened for. Having a history of cancer or other chronic conditions doesn’t automatically rule someone out. The decision depends on the specifics, and transplant teams weigh the risk for each organ individually.
Costs and Legal Protections
Donor families pay nothing for organ or tissue donation. Federal regulations require that organ recovery costs are billed to the OPO, not to the donor’s family or their insurance. The OPO and the transplant system absorb these expenses. Costs unrelated to the medical recovery process, like funeral and burial expenses, remain the family’s responsibility as they normally would.
Legally, if you register as an organ donor (through your state registry, a driver’s license designation, or another official document), that decision is binding. Under the Revised Uniform Anatomical Gift Act, adopted in some form by every state, your first-person authorization cannot be overridden by family members. Only you can revoke your own decision. That said, OPOs often still speak with families to inform them and ensure a smooth process, even when legal consent already exists.
Religious Perspectives
Most major religions in the United States support organ and tissue donation. This includes Islam, Judaism, the Mormon Church of Jesus Christ of Latter-day Saints, several Protestant denominations (Southern Baptist Convention, United Methodist, Presbyterian, Episcopalian, Evangelical Lutheran Church in America, Evangelical Covenant Church, and Disciples of Christ), among others. While individual beliefs vary, the broad consensus across faiths treats donation as an act of generosity and compassion. If you have specific concerns, speaking with a faith leader in your community can help clarify your tradition’s stance.