Deceased donation
The donation process begins with you. You decide to donate your organs when you die. You won’t need them, after all.
Your organs can save and improve many lives. People often become organ donors after a stroke, heart attack, or severe head injury.
The basic steps in the deceased donation process are as follows:
Transport
First responders begin lifesaving efforts at the scene. They also contact the hospital where the person will be taken.
Medical treatment for potential donors
- When the person arrives at the hospital, the emergency medical team continues lifesaving measures. These can include breathing support, IV fluids, blood replacement, and drugs.
- After the patient’s vital signs are stable, the emergency team transfers the patient to the Intensive Care Unit (ICU). An ICU doctor performs special tests to see how much damage has been done to the brain and organs. The medical team continues advanced life support during the tests.
- Even though the hospital staff do everything they can to save the patient's life, sometimes the injuries are too severe and the patient dies.
- A patient who has no brain activity and cannot breathe on his or her own may be declared brain dead. This happens if all blood flow to the brain has stopped. Doctors perform a series of tests to determine if brain death has occurred. Organ donation is possible after brain death is confirmed.
- In some cases, people who will die very soon of heart and lung failure may be able to donate organs. This can happen only if their next of kin and the care team agree that nothing else can be done to save the patient’s life. In this case, with family permission, organ donation takes place after the person’s heartbeat and breathing cease.
Evaluation
A person from the organ procurement organization (OPO) goes to the hospital to see if the deceased person is medically able to donate. OPOs identify potential deceased donors and get authorization for donation.
Consent
The OPO representative searches organ donor databases to see if the deceased had registered as a donor. If so, that will serve as legal consent for donation.
If the deceased did not sign up on a registry, and there was no other legal consent for donation, such as a notation on the driver's license, the OPO will ask the next of kin for consent.
Matching process
The OPO enters facts about the donor into the Organ Procurement and Transplantation Network’s (OPTN's) national computer system to begin the organ matching process. The system locates candidates who are the best match for the donor. Timing is very important at this step and during recovery.
Organs can only be preserved for a fairly short time between removal from the donor and transplant into a recipient. They cannot be frozen and kept in storage for several days or weeks.
Organ recovery and transport
A transplant surgical team replaces the medical team that treated the patient before death. The medical team trying to save the patient’s life and the transplant team are never the same team. The surgical team removes the organs and tissues from the donor's body in an operating room. The OPO arranges for organs to be transported to the hospitals of the recipients. Transportation depends on the distance involved. It can include ambulances, helicopters, and commercial airplanes.
Funeral
The OPO works with the funeral director to avoid delays in the service. Donation does not interfere with having an open casket viewing. Surgical techniques are used to retrieve organs, and all incisions are closed.
Follow-up
A few weeks later, the OPO sends a letter to the donor's family. The letter informs the family about the organs transplanted but does not name the recipients. Most OPOs continue to provide support to donor families, such as grief counseling.