Organ donation is the process of surgically removing an organ or tissue from one person (the donor) and transplanting it into another person (the recipient) who needs a functioning replacement. A single deceased donor can save up to 8 lives through organ donation and improve more than 75 others through tissue donation. Right now, over 103,000 people in the United States are on the national transplant waiting list.
Deceased vs. Living Donation
There are two broad categories of organ donation: deceased and living. Most transplanted organs come from deceased donors, but living donation has become increasingly common, especially for kidneys and livers.
In deceased donation, organs are recovered after a person has died in a hospital setting, typically while on a ventilator that keeps blood flowing to the organs until they can be surgically removed. There are two recognized paths to deceased donation. In the first, the donor has experienced complete and irreversible loss of all brain function, including the brainstem. Even though the body may still be warm, with the heart beating and lungs ventilated by machines, this person is legally dead. In the second path, a patient with a severe brain injury who is not brain dead has life support withdrawn (either by their own advance directive or their family’s decision). After the heart stops on its own and a physician confirms no circulation for two to five minutes, the patient is pronounced dead and organ recovery begins.
Living donation is different. A healthy person voluntarily donates an organ or part of one to someone in need, often a family member or close friend, though strangers can donate too. Living donors can give one kidney, a segment of the liver, one lobe of a lung, or part of the pancreas or intestine. The liver is particularly suited to living donation because it regenerates. After surgery, living kidney donors typically spend two to three days in the hospital and return to normal activities within six to twelve weeks. Liver donors usually stay about five days and recover in eight to twelve weeks.
Which Organs and Tissues Can Be Donated
From a single deceased donor, the transplantable organs include the heart, both lungs, liver, both kidneys, pancreas, and intestines. Beyond those eight life-saving organs, dozens of tissues can also be recovered: corneas, skin, bone, tendons, heart valves, and blood vessels. This is why the total number of people helped by one donor can reach into the dozens.
During the surgical recovery process, the donor’s body is treated with the same care as in any operation. The surgical team carefully removes the intended organs, then replaces the blood with a cold preservation solution to slow the organs’ metabolism and keep them viable for transport. Hearts and lungs are typically removed first, followed by the liver and kidneys. After the solid organs are recovered, tissue recovery can follow. The process does not prevent a family from having an open-casket funeral.
How Organs Are Matched to Recipients
Matching a donor organ to a recipient involves several biological factors. Blood type compatibility is the starting point. Beyond that, medical teams analyze proteins on cell surfaces to gauge how closely the donor’s tissue matches the recipient’s. The closer the match, the lower the risk that the recipient’s immune system will attack the new organ. Body size, the severity of the recipient’s illness, time spent on the waiting list, and geographic distance between donor and recipient all factor into allocation decisions.
Once an organ is recovered, it can only survive outside the body for a limited window. A heart remains viable for roughly four to six hours. A liver or pancreas needs to be transplanted within about twelve hours. Kidneys are the most resilient, lasting up to twenty-four hours under standard cold preservation, though shorter times produce better outcomes. These tight windows are why geographic proximity matters so much in the matching process.
Who Can Be a Donor
Almost anyone can be a potential organ donor regardless of age or medical history. There is no age cutoff, and most chronic conditions do not automatically disqualify you. The medical team evaluates each potential donor individually at the time of death to determine which organs and tissues are suitable for transplant. People with conditions like diabetes, hepatitis, or a history of cancer have successfully donated organs that went on to function well in recipients.
The key disqualifiers tend to be active, widespread infections or certain cancers that could be transmitted to the recipient. But these decisions are made case by case, not by blanket rules. Signing up as a donor simply means you are willing to be evaluated when the time comes.
How to Register as a Donor
You can register as an organ donor online through your state’s donor registry, in person at your local motor vehicle department, or through the Health app on an iPhone, which sends your information to a national database. Registration takes only a few minutes.
Equally important is telling your family about your decision. When a potential donor arrives at a hospital, the medical team contacts the local organ procurement organization, which checks the donor registry. If you are registered, your legal authorization is on file. But families are still involved in the process, and if they don’t know about your wishes, the situation can become stressful and confusing at an already difficult time. A brief conversation now makes it far more likely your decision will be honored.
The Five Phases of Deceased Donation
The path from potential donor to successful transplant follows a structured sequence. First, hospital staff identify a patient who may be a candidate and refer the case to the regional organ procurement organization. Second, death is formally declared and consent for donation is confirmed, either through the registry or the family. Third, the donor is evaluated medically to determine which organs are healthy enough to transplant. Fourth, the donor’s body is carefully managed to keep the organs functioning until surgery. Fifth, the organs are surgically recovered, preserved on ice, and transported to the hospitals where recipients are waiting.
This entire process can move quickly. Because organ viability is measured in hours, procurement teams coordinate across multiple transplant centers simultaneously. A heart might be flown to one city while the kidneys travel to two others, all from the same donor, all on the same day.