Almost anyone can be an organ donor, regardless of age or medical history. There is no upper age limit, no automatic disqualification for common health conditions, and no requirement to be in perfect health. The oldest organ donor in the United States was 92 years old. What matters most is the condition of your organs at the time of donation, not your age, lifestyle, or diagnosis on paper.
More than 103,000 people are currently on the national transplant waiting list, and over 48,000 transplants were performed in 2024. Every potential donor counts. Here’s what actually determines whether you can donate.
Age Is Not a Barrier
There is no minimum or maximum age for deceased organ donation. In 2021, one out of every three organ donors was over 50. Newborns have donated organs, and so have people in their 90s. What the transplant team evaluates is the health and function of individual organs, not a number on your birth certificate. A 75-year-old with healthy kidneys is a better candidate than a 30-year-old with kidney disease.
For living donation, the general age range is 18 to 60, though this varies by transplant center. The lower limit exists because legal consent requires adulthood, and the upper limit reflects a more cautious approach to elective surgery in older adults.
Medical Conditions That Affect Eligibility
Very few medical conditions permanently disqualify someone from donating. The short list includes active, spreading cancer and certain infectious diseases: HIV/AIDS (with an important exception discussed below), active hepatitis B or C, active tuberculosis, MRSA infections, and prion diseases like Creutzfeldt-Jakob disease. These conditions pose a direct transmission risk to the recipient that can’t be managed.
Beyond that short list, most conditions are evaluated on a case-by-case basis. Diabetes, heart disease, and high blood pressure don’t automatically rule you out. A person with heart disease might still donate kidneys or a liver. The transplant team assesses each organ individually, so even if one organ isn’t usable, others may be.
Cancer History
Having had cancer does not automatically disqualify you. Whether your organs can be used depends on the type of cancer, how long ago treatment ended, whether the cancer has returned or spread, and your overall health. Active cancer that is growing or has metastasized typically rules out organ donation. But someone who completed treatment years ago and remains cancer-free may still be eligible. Even when organ donation isn’t possible, people with a cancer history can often donate tissues like corneas or skin.
HIV-Positive Donors
Since 1988, donating organs while HIV-positive was banned in the United States. That changed with the HIV Organ Policy Equity (HOPE) Act, which lifted the federal ban in 2015. HIV-positive individuals can now donate organs to HIV-positive recipients. These transplants currently take place under research protocols with oversight from the National Institutes of Health, and transplant centers must receive specific approval to participate. This shift has opened a new source of organs for HIV-positive patients who previously faced longer waits.
Smoking, Alcohol, and Drug Use
A history of smoking, drinking, or drug use does not disqualify you from donating. Research shows that organs from donors with these histories can be transplanted successfully in most cases. Heavy alcohol consumption does not appear to adversely affect heart transplant outcomes. Cannabis and cocaine use have no clear effect on survival after heart or lung transplantation. Opioid-related causes of death produce equivalent transplant outcomes compared to other causes.
Smoking does carry a slightly higher risk for lung transplantation specifically, but even then, receiving a lung from a smoker tends to produce better outcomes than remaining on the waiting list for a nonsmoking donor. In every case, the transplant team carefully evaluates the organ itself. Drug or alcohol use prompts closer examination, but it is not a reason to remove yourself from the donor registry.
Living Donation Requirements
Living donors go through a more rigorous screening process because the surgery is elective and the donor’s safety is the top priority. You need to be in good overall physical and mental health, generally between 18 and 60, though standards vary by transplant center. The most common living donations are a kidney (you can live with one) or a portion of the liver (which regenerates).
The evaluation at a transplant center includes tests for conditions like diabetes, cancer, infectious diseases, and heart disease, any of which could disqualify you. The team also checks that the specific organ you’re donating is healthy and that removing it is unlikely to cause long-term health problems. A psychological evaluation ensures you understand the risks and are donating voluntarily. The criteria are stricter than for deceased donation because the goal is to make sure the surgery poses minimal risk to you.
How Deceased Donation Works
Deceased organ donation happens through one of two pathways. The first is brain death, where all brain function, including the brain stem, has permanently ceased. The donor’s body can be kept on life support to maintain organ function until the organs are recovered. This pathway allows the widest range of organs to be donated, including the heart, lungs, liver, kidneys, pancreas, and intestines.
The second pathway is circulatory death. This applies when a patient has a severe brain injury but is not brain dead, and the family or the patient’s advance directive calls for withdrawing life support. After life support is removed and the heart stops, physicians wait a brief observation period (typically two to five minutes) to confirm the heart will not restart. Once death is confirmed, the transplant team recovers organs, usually the kidneys and liver. Because these organs go without blood flow for a short period, not all organ types can be recovered through this pathway.
A single deceased donor can save up to eight lives through organ donation and improve many more through tissue and cornea donation.
How to Register
You can sign up as an organ donor through your state’s donor registry, typically when renewing your driver’s license or ID, or online through your state registry at any time. All 50 states and Washington, D.C., have first-person authorization laws, meaning your documented decision to donate is legally binding. If you’ve registered, organ procurement organizations can verify your status electronically at the time of death, and donation can proceed based on your wishes alone.
That said, letting your family know your wishes matters. Family members are often unaware of a loved one’s donor status, and while your registration is legally sufficient, a family that understands your decision can make a difficult moment less complicated. If you haven’t formally registered, your next of kin will be asked to make the decision on your behalf.