So You Need A New Heart, Lung, Kidney –The Process

The tissue and organ donation/transplantation process in the United States is highly structured, regulated and complex.  It isn’t as simple or corruptible as the entertainment industry would like to make it.  It is unfortunate that Television shows distort the process in order to be more dramatic and get better ratings.  Too often popular TV shows like Grey’s Anatomy depict manipulation of the process where a seriously ill person is placed at the top of the national transplant list by the attending surgeon or worse yet, a medical student.  This is folly, no one person has that much influence over where an individual patient might be placed on the list.  I’m sure you have also seen TV shows where there are two unrelated patients in a room, one is in a coma and the other needs a new heart.  The TV doctors then, declare the coma patient brain dead and give the heart to the person in the next bed, more folly.  

For accurate information on how organ donation/transplantation is regulated and how hospitals address the issue in your area it would be best to contact your local Organ Procurement Organization (OPO).  Barring that you might visit  This site provides easy to understand information about donation/transplantation issues. notes that donors can range in age form newborn on up. People who are 65 years of age or older may be acceptable donors, particularly of corneas, skin, bone and for total body donation.   Age should not be a barrier to becoming an organ donor.  Interestingly, an estimated 10,000 to 14,000 people who die each year meet the criteria for an organ donation, but less than half of that number becomes actual organ donors.

Generally, here’s how it works.

To get on the list, you need to visit a transplant hospital.  Every transplant hospital in the United States is a member of the United Network for Organ Sharing (UNOS). You can use the UNOS directory at to find a transplant hospital, or just visit for additional information. 

A doctor or doctors will examine you and order a variety of tests to determine if you meet the criteria to be listed.  His/her findings may then be brought to the hospital transplantation committee to determine if your name should be submitted to UNOS to be placed on the national list. You can get on the waiting list at more than one transplant hospital. Each hospital has its own criteria for listing patients. If you meet their criteria, they will add you to the list but that doesn’t mean they can dictate where you will be on the list.

Once listed your name will be added to the national pool of names. When an organ donor becomes available, all the patients in the pool are compared to that donor. Factors such as blood and tissue type, size of the organ, medical urgency of the patient’s illness, time already spent on the waiting list, and distance between donor and recipient are considered.

The organ is offered first to the candidate who is the best match locally.  If no local match is found the organ will be offered regionally and then nationally until a recipient is found.


All hospitals are required by law to have a “Required Referral” system in place. Under this system, the hospital must notify the local Organ Procurement Organization (OPO) of all patient deaths. If the OPO determines that organ and/or tissue donation is appropriate in a particular case, they will have a representative contact the deceased patient’s family to offer them the option of donating their loved one’s organs and tissues. By signing a Uniform Donor Card, an individual indicates his or her wish to be a donor. However, at the time of death, the person’s next-of-kin may still be asked to sign a consent form for donation. It is important for people who wish to be organ and tissue donors to tell their family about this decision so that their wishes will be honored at the time of death. It is estimated that about 35 percent of potential donors never become donors because family members refuse to give consent.  Refusal is usually attributed to the fact that the deceased person never told family members of the desire to be a donor.


I recognize that the above explanation is simple and incomplete but I hope it answers some of the questions you have about the process.   Your comments/corrections/additions are encouraged.


Posted on February 5, 2009, in The Donation/transplantation process. Bookmark the permalink. Leave a comment.

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