Understanding the Process
How Organ Donation Works
Anyone could be a potential donor and everyone should consider registering, at any age. It’s important because less than 1% of the population are able to donate organs after death based on the clinical criteria that must be met. More people can donate tissues and corneas, and EVERYONE is encouraged to register to give hope and healing to those in need.
Organ recovery takes place like any other surgery—in a sterile operating room with careful, experienced surgeons. After the surgery, recovery professionals perform routine reconstruction and preservation so customary funeral arrangements are possible.
Organs that can be donated include: kidneys, heart, liver, lungs, pancreas and small intestine. There are various organs on the list, for a variety of transplant needs. Today, approximately 104,000 Americans, 1,000 Kentuckians and 1,200 Hoosiers are awaiting one of these lifesaving organs.
Cornea transplant is the most common of all transplants performed, exceeding 46,000 per year in the United States. Thanks to advances in pharmacology, medical instruments, and surgical techniques, cornea transplants exceed a 95% success rate.
Bone, cartilage, fascia, heart valves, ligaments, pericardium, skin, tendons, and veins are all included with tissue donation. One tissue donor can heal more than 75 lives. These donations are used for many reasons to save and heal recipients:
- Burn victims: The gift of skin is recovered from a donor and used as a biological bandage, preventing infection and allowing the recipient to heal until their own skin can grow back.
- Cancer patients: Bone tumors, which would have required amputation in the past, are now replaceable due to donated bone. Bone can also be used in spinal surgeries, hip replacements, and dental surgery.
- Babies: Donated heart valves are often used to save the lives of babies born with defects and heart conditions.
- Athletes: Donated ligaments and tendons often help restore mobility for athletes with an irreversible injury.
Different from living donation, deceased donation is donating after one’s death. Death occurs when the heart or brain stops functioning and the patient is declared dead with a legal time of death. The cessation of cardiopulmonary (heart-lung) function is called circulatory death. The cessation of brain function is called brain death.
What is donation after brain death?
Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes all brain activity to permanently stop.
When someone is in a coma, there are some portions of the brain still functioning. Being in a coma is different than brain death. A patient can never recover from brain death. The standards for determining brain death are strict. The patient’s physician(s) declare death and give a time of death.
The heart and lungs are able to function after death because the patient is still on artificial-support machines (such as a ventilator). The machines are kept on for a temporary time to allow the option of donation.
A family support coordinator will engage in a donation conversation with the legal next-of-kin or legal representatives that provides full information on the power, meaning and life-transforming nature of donation. If the patient is registered, the family will not need to provide authorization because the Registry is legally binding and holds the same significance as a will. If the patient is not registered, the family will be given the opportunity to provide authorization. The process of donation begins after these decisions. The donation process takes approximately 48-72 hours. The family support coordinator will answer any questions about any aspect of this process. The recovery of organs happens in the operating room.
What is donation after circulatory death?
Donation after circulatory death (DCD) is a pathway to organ donation when brain death criteria is not met.
A potential DCD donor patient has a non-survivable injury or illness and is on a ventilator. When the physician determines that the patient has no chance for recovery, the legal next of kin or legal representative can decide to withdraw life-sustaining therapies (such as a ventilator). After that decision, the next of kin may be offered the opportunity of organ donation. A family support coordinator will engage in a donation conversation that provides full information on the power, meaning and life-transforming nature of donation. If the patient is registered, the family will not need to provide authorization because the Registry is legally binding and holds the same significance as a will. If the patient is not registered, the family will be given the opportunity to provide authorization. The process of donation begins after these decisions. The donation process takes approximately 48-72 hours. The family support coordinator will answer any questions about any aspect of this process.
The withdrawal of life-sustaining therapies is most often moved to the operating room so the organ recovery process can begin as soon as possible after the patient’s heart stops and the patient’s doctor has declared their time of death. The patient’s physician and nurse will be in attendance, providing end-of-life support and care exactly as they would in the critical care unit. After the patient’s death, the organs are recovered expeditiously so they remain viable for transplant. Learn more by going to the National Kidney Foundation website here.
Yes. The Donor Registry ensures your desire to be an organ, tissue, and cornea donor is honored after death, as long as donation is clinically possible. First person authorization is always followed after the donor’s death, if the patient is registered and clinically able to donate. All recovery organizations are directed by law to inform the next of kin of the donor’s decision to donate. Being a registered donor eliminates the need for a family to make the decision about donation during their time of grief and ensures your decision to be a hero after your death is honored. According to the Uniform Anatomical Gift Act, statewide electronic registry for organ, eye and tissue donation includes authorization for transplantation, therapy, education, and research for the advancement of donation and transplantation science. You are encouraged to talk with your next-of-kin about your end-of-life decisions.
Join the KY Donor Registry at www.registermeky.org or the National Donor Registry at www.registerme.org. When you say “YES” when obtaining your driver’s license, you are joining the KY Donor Registry.
Yes, someone may join the Donor Registry under age 18. However, if they die before they turn 18, the next of kin may revoke that decision. Although minors can join the Registry, their next of kin must give authorization at the time of death.
At any point in time, you can update your personal information or remove yourself from the Donor Registry by going into your personal record. Removing your name from the state registry is a permanent removal.
To update or remove your name from the Kentucky Donor Registry:
- Go to www.RegisterMeKY.org.
- Click “Change Registration”
- Log-in with your Driver’s License Number and Zip Code of when you first registered.
- Once in your record, you may edit your information or click “Not a Donor” to update your decision. You are immediately and permanently removed from the Kentucky Donor Registry. Although the license may still reflect a heart icon, you are not a registered donor. The Registry is the legal authorization, not the driver’s license.
- Call the Donate Life Kentucky/Trust For Life staff at 1-866-945-5433
- Talk to staff or leave a voicemail including your driver’s license number, date of birth, and name.
- Staff will go into your record for you and click “Not a Donor”. This immediately and permanently removes your name from the Kentucky Donor Registry.
If you registered on the National Donate Life America Registry, go to www.registerme.org and follow instructions provided.
No. When an individual registers, it is legally binding and treated with the significance of a will. Families and legal representatives cannot overturn your decision to donate if you are registered on the state or national registry. Kentucky is a first-person consent state and first-person authorization is always followed after the patient’s death, if donation is clinically possible. You are encouraged to talk to your next-of-kin and legal representatives about all of your end-of-life decisions.
Learn more by going to KYJustice.org.
Once a person turns 18, their decision to register as a donor is considered a legal, advanced directive. Just like a living will or will, the decision to register is legally binding and followed as your deliberate decision. Your decision to register as a organ, eye, and tissue donor will be honored upon your death, if donation criteria is met. The recovery organization will inform your legal next-of-kin or legal representatives of your decision to be a donor and will involve them in the donation process but will not ask them for authorization. You are encouraged to talk to your next-of-kin and legal representatives about all of your end-of-life decisions. If you need help and would like to speak with a community educator about donation, please email [email protected] or call 1-866-945-5433.
No. Income and celebrity status are not considered when determining who receives an organ. Also, it is a federal crime to buy or sell organs and tissues in the United States. Donor organs are matched to potential recipients by blood type, tissue type, size, medical urgency, time on waiting list and geographic location through a national computerized waiting list operated by the United Network for Organ Sharing (UNOS).
Not always. While organ, eye and tissue donation involves saving lives in the real world, the entertainment industry often invents dramatic situations for sensational purposes that could perpetuate misconceptions about donation.
Fact or Fiction
Donor families don’t pay hospitals for organ donation surgery.
Organ and tissue recovery agencies assume expenses—donor families are never responsible for medical costs associated with donation.
Organ donation doesn’t interfere with the donor’s funeral.
Donation does not prohibit the customary funeral process, including the ability to have an open-casket funeral.
Doctors won’t try as hard to save patients who are registered donors.
Doctors have no influence on donation, and would lose their medical license if they didn’t make every attempt to save a patient’s life. They do not have access to the confidential donor registry.