Organ Donation: Everything You Need to Know
Most people have seen the little heart or donor symbol on a driver's license.
But what actually happens if you're registered as an organ donor?
Can doctors donate your organs if you're older? What if you have a medical condition? Does being a donor change the medical care you receive? How do doctors decide who gets your organs? And is brain death actually the same thing as being in a coma?
There is a lot of misinformation surrounding organ donation.
So let's break down what organ donation actually means, how it works in the United States, and what you should know before deciding whether it's right for you.
First... What Is Organ Donation?
Organ donation is the process of giving an organ—or part of an organ—to another person whose organ is failing or no longer functioning well enough to sustain their health.
Donation can occur after someone dies, but some organs can also be donated while a person is still alive.
Organ transplantation can be lifesaving for people experiencing end-stage heart, lung, liver, kidney, intestinal, or other forms of organ failure.
And the need is significant.
More than 100,000 people in the United States are currently waiting for an organ transplant, although the exact number changes every day.
See current organ-transplant information from the U.S. government
One deceased organ donor has the potential to save up to eight lives through organ donation and may help many additional people through tissue and cornea donation.
That's a pretty incredible impact from one person.
What Can Actually Be Donated?
Organ donation is much broader than just hearts and kidneys.
After death, donation may include the heart, two kidneys, liver, two lungs, pancreas, and intestines. Certain specialized transplants can also involve vascularized composite tissues such as hands or the face.
Tissue and eye donation are different from solid-organ donation but can also help restore function or improve someone's quality of life. Donated tissues can include corneas, skin, heart valves, bone, blood vessels, cartilage, tendons, and ligaments.
See everything that can be donated
This is why someone may be able to help people through tissue donation even when solid-organ donation isn't possible.
Can You Donate Organs While You're Still Alive?
Yes.
This is called living organ donation.
The most common living donation is a kidney. A healthy person can donate one kidney and continue living with the remaining kidney.
A living donor may also donate part of their liver. The liver has a remarkable ability to regenerate: after surgery, both the donor's remaining liver and the transplanted portion can grow substantially.
Less commonly, living donation may involve a portion of the lung, pancreas, or intestine.
Learn about living organ donation
Living donors don't necessarily have to be related to the recipient, either.
A donor could give an organ to a family member, partner, friend, or—in some circumstances—a complete stranger.
There are even non-directed donors, who volunteer to donate an organ without choosing a specific recipient.
What If You Want to Donate a Kidney but You're Not a Match?
Being incompatible with the person you want to help doesn't always mean donation is impossible.
One option is called kidney paired donation.
Imagine Person A needs a kidney and Person B wants to donate to them, but they aren't compatible.
Meanwhile, Person C needs a kidney and Person D wants to donate to them—but they aren't compatible either.
If Donor B matches Recipient C and Donor D matches Recipient A, the donors can essentially “swap” recipients.
Sometimes several donor-recipient pairs can be linked together, creating a donation chain.
Learn about living donation and paired donation
Pretty cool, right?
But Is Living Donation Safe?
Living donors undergo extensive medical evaluation precisely because healthcare teams are operating on someone who does not medically need the surgery themselves.
Potential donors typically undergo physical examinations, laboratory testing, medical-history review, mental-health evaluation, and assessment of their social and financial situation before being approved.
Most living kidney donors do well long-term, but donation is still surgery and it isn't risk-free.
A systematic review and meta-analysis involving more than 118,000 living kidney donors found no evidence of increased overall mortality, cardiovascular disease, type 2 diabetes, or several other major chronic conditions compared with control populations. However, kidney donors did have an increased relative risk of end-stage kidney disease and, among donors who later became pregnant, preeclampsia.
Importantly, the absolute risks remained low.
Read the living-kidney-donor systematic review on PubMed
Living liver donation involves a larger operation and carries its own risks.
A 2024 meta-analysis involving 60,829 living liver donors estimated an overall complication rate of approximately 25%, although most were classified as minor. Major complications occurred in about 5.5% of donors, and donor death was rare—approximately 0.06% in the pooled data.
Read the living-liver-donor meta-analysis on PubMed
So while living donation can be lifesaving for another person, it is still a serious medical decision that requires informed consent and careful evaluation.
How Does Organ Donation After Death Work?
This is the part that tends to create the most confusion.
When someone arrives at a hospital with a catastrophic injury or illness, the healthcare team's first priority is simple:
Save the patient's life.
Doctors and emergency personnel provide medical treatment regardless of whether someone is registered as an organ donor.
According to the U.S. Health Resources and Services Administration (HRSA), the medical professionals attempting to save the patient are separate from the transplant team that would later recover donated organs. Donation becomes a consideration only after lifesaving efforts have failed and the appropriate medical and legal requirements are met.
See how deceased organ donation works
In the United States, deceased organ donation generally occurs after death has been determined using either neurologic criteria or circulatory criteria.
And that brings us to one of the biggest misconceptions.
What Exactly Is Brain Death?
Brain death is death.
It is not the same thing as being unconscious.
It is not a coma.
And it is not a vegetative state.
The medical term is brain death/death by neurologic criteria.
Current U.S. consensus guidelines describe it as the permanent loss of function of the brain as a whole, including the brainstem. The clinical determination involves strict prerequisites and testing, including assessment of coma, brainstem reflexes, and the ability to breathe independently.
Read the 2023 consensus brain-death guideline on PubMed
A person who is brain dead cannot recover brain function or breathe independently.
Machines may temporarily keep oxygen circulating through the body, which can make the situation confusing for families because the person's chest may still rise and their heart may continue beating.
But the ventilator is artificially supporting those functions.
This is very different from a coma, in which some brain function remains and recovery may be possible.
Is Brain Death the Only Way Someone Can Donate Organs?
No.
Some deceased donations occur through donation after circulatory death, commonly abbreviated DCD.
In DCD, the patient does not meet the criteria for brain death but has a devastating medical condition with an extremely poor prognosis.
A decision is made to withdraw life-sustaining treatment based on the patient's medical situation and wishes—not because organs are needed.
If the person subsequently dies because their heart and breathing permanently stop, organ donation may sometimes occur afterward.
The decision to withdraw life-sustaining treatment is separate from the decision to donate organs.
That's an important distinction.
Donation after circulatory death has become an increasingly important source of donated organs in the United States. In 2025, approximately half of U.S. deceased donors with at least one recovered organ donated through DCD.
Research continues to evaluate transplantation outcomes from DCD donors. A 2025 systematic review and meta-analysis of heart transplantation found similar short- and mid-term survival among recipients of hearts donated after circulatory death and those donated after brain death, although researchers noted that additional comparative research remains important.
Read the DCD systematic review and meta-analysis
How Do They Decide Who Gets an Organ?
No, doctors don't just look down the hospital hallway and decide who they like best.
The United States uses a national organ-matching system through the Organ Procurement and Transplantation Network (OPTN).
When a donated organ becomes available, information about the donor is entered into the matching system. Potential recipients are then ranked according to organ-specific allocation rules.
Depending on the organ, factors may include blood type, body size, immune compatibility, medical urgency, time spent waiting, pediatric status, and distance between the donor and transplant hospital.
The rules differ depending on the organ because a heart, for example, has different medical and transportation requirements than a kidney.
Learn how donors and recipients are matched
And no:
Being rich, famous, or socially important doesn't move you ahead of everyone else.
Personal characteristics such as celebrity status and income are not used to determine transplant priority.
Does Race Determine Who Gets Your Organs?
No.
People can and do receive organs from donors of different races and ethnicities.
However, some aspects of organ matching—including blood and tissue characteristics—are influenced by genetics. This means certain compatible matches may be more likely among people with similar genetic backgrounds.
That's one reason having a large and diverse donor pool can improve the chances of finding compatible organs for people from many different backgrounds.
But there isn't a system where an organ from someone of one race can only go to someone of that same race.
What If You're Older?
Don't automatically rule yourself out.
There is no universal age limit for deceased organ donation.
Newborns and older adults have both become organ donors.
Instead of using age alone, medical professionals evaluate the condition and function of potential organs at the time of death.
So being 60, 70, or even older doesn't necessarily mean your organs couldn't help someone.
Let the medical professionals make that decision.
What If You Have a Medical Condition?
Same idea.
Having a medical condition doesn't automatically mean you can't register.
The transplant and donation teams determine what can safely be donated based on your medical history and the condition of individual organs or tissues at the time donation becomes possible.
Someone may not be able to donate one organ but could potentially donate another organ, corneas, or certain tissues.
So you don't need to medically “qualify yourself” before signing up.
Myth: “If I'm an Organ Donor, Doctors Won't Try as Hard to Save Me”
This is probably one of the most persistent fears about organ donation.
But organ-donor registration does not change your right to lifesaving medical treatment.
The healthcare professionals treating you are responsible for you.
The donation and transplant process is separate, and the surgical transplant team is not the same team responsible for the patient's lifesaving treatment.
Simply having a donor symbol on your driver's license does not mean an ER doctor is going to stop treating you because someone else needs a kidney.
Your life comes first.
Myth: “My Family Will Have to Pay for My Organ Donation”
No.
The donor's family is not charged for the cost of deceased organ donation.
Families remain responsible for the person's normal medical care and funeral expenses, but costs associated specifically with recovering and transplanting donated organs are not charged to the donor's family.
Living donation is slightly different.
The recipient's insurance usually pays the donor's medical expenses associated with evaluation and donation, but living donors may still face indirect expenses such as travel, lodging, childcare, or lost wages.
Federal assistance is available for some living donors. HRSA's Living Organ Donation Reimbursement Program can reimburse qualifying donors for certain expenses related to evaluation, surgery, and follow-up care.
Learn about financial assistance for living donors
Myth: “They'll Take My Organs and I Can't Have a Normal Funeral”
Organ recovery is performed surgically and the body is treated with care.
After organ and tissue recovery, incisions are closed.
Organ donation generally does not prevent someone from having an open-casket funeral.
Donation organizations also work with funeral professionals to avoid unnecessary delays in funeral arrangements.
Can You Sell an Organ?
No.
Buying or selling human organs for transplantation is prohibited under U.S. federal law.
This is very different from reimbursing a living donor for legitimate expenses such as travel or lost wages.
Reimbursement is intended to prevent someone from losing money because they donated.
It isn't payment for the organ itself.
Does Your Religion Allow Organ Donation?
This is something people sometimes assume the answer to without actually asking.
Many religious traditions support organ donation or consider it an individual decision, but beliefs can vary between denominations, communities, and individuals.
HRSA encourages people who have religious concerns about donation to discuss them with a trusted faith leader.
So if religion is important in your decision, you don't have to guess.
Ask.
How Do You Actually Become an Organ Donor?
In the United States, the most important step is to register with your state's official donor registry.
You can usually register through your state's motor-vehicle department or online donor registry. Organdonor.gov provides links to each state's official registration system. On compatible iPhones, registration can also be completed through the Health app.
Register as an organ donor through your state
Most states also allow registered donors to specify which organs or tissues they are willing to donate.
And you aren't locked into your decision forever.
You can update or remove your donor registration later if you change your mind.
Tell Your Family Too
Registering is important.
But there's another conversation worth having:
Tell the people close to you what you want.
Organdonor.gov specifically encourages registered donors to discuss their decision with their families. That way, if a medical crisis ever occurs, your family isn't learning about your wishes during one of the most stressful moments of their lives.
You can literally just say:
“By the way, I'm registered as an organ donor, and that's what I want.”
It doesn't have to be some giant dramatic conversation.
Does Signing Up Guarantee You'll Become a Donor?
Actually, no.
And this is one of the reasons donor registration matters so much.
Organ donation after death requires very specific medical circumstances.
According to the federal organ-donation website, only about 3 out of every 1,000 deaths occur in circumstances that allow deceased solid-organ donation.
Someone who dies at home from a condition that makes their organs medically unsuitable, for example, may not be able to become a solid-organ donor.
Tissue or cornea donation may still sometimes be possible under circumstances where organ donation isn't.
Signing up therefore doesn't mean your organs will definitely be donated.
It means:
If donation is medically possible when you die, you've made your wishes known.
What Happens After an Organ Is Donated?
Once an organ has been matched to a recipient, the organ is surgically recovered and transported to the recipient's transplant hospital.
Timing is incredibly important because organs cannot simply be placed in a freezer and stored indefinitely.
Different organs can tolerate different amounts of time outside the body, which is one reason distance between donor and recipient hospitals can matter during allocation.
The recipient then undergoes transplant surgery.
Afterward, most solid-organ transplant recipients require ongoing medical monitoring and medications that suppress the immune system.
That's because your immune system is designed to recognize things that don't belong in your body.
Unfortunately, that includes a lifesaving transplanted organ.
Rejection occurs when the recipient's immune system attacks the transplanted organ. Anti-rejection medications—also known as immunosuppressants—help reduce that risk, although they can also increase susceptibility to infection.
Organ transplantation isn't simply:
new organ → problem solved forever.
It's lifesaving healthcare that usually requires lifelong follow-up.
What About Donating Your Body to Science?
Organ donation and whole-body donation are not necessarily the same thing.
Some medical schools and research programs do not accept whole-body donations after organs or tissues have been removed, although policies vary between programs.
If donating your body to medical education or research is something you specifically want to do, you should contact the medical school or body-donation program directly and ask how organ donation affects eligibility.
Don't assume that registering as an organ donor automatically registers you as a body donor.
It doesn't.
The Bottom Line
Organ donation is a personal decision.
But it should be an informed one.
Being a registered donor does not mean doctors will provide you with less medical care.
Brain death is not the same thing as being in a coma.
Your family isn't charged for donating your organs after death.
You don't have to be young or perfectly healthy to register.
People of different racial and ethnic backgrounds can donate organs to one another.
And becoming a donor doesn't guarantee that donation will actually be medically possible.
What registering does is make one thing clear:
If the circumstances allow it, you want the possibility of helping someone else live.
With more than 100,000 people in the United States waiting for organ transplants and only a small percentage of deaths occurring under circumstances that permit organ donation, every potential donor can matter.
Whether you ultimately choose to register or not, learn how the system works, talk about your wishes with the people you love, and make the decision based on accurate information—not myths.
Sources
Greer, D. M., et al. (2023). Pediatric and adult brain death/death by neurologic criteria consensus guideline. Neurology, 101(24), 1112–1132. View on PubMed
O'Keeffe, L. M., et al. (2018). Mid- and long-term health risks in living kidney donors: A systematic review and meta-analysis. Annals of Internal Medicine, 168(4), 276–284. View on PubMed
Xiao, J., et al. (2024). The incidence of adverse outcome in donors after living donor liver transplantation: A meta-analysis of 60,829 donors. Liver Transplantation, 30(5), 493–504. View on PubMed
Jolliffe, J., et al. (2025). Donation after circulatory death transplantation: A systematic review and meta-analysis of outcomes and methods of donation. Annals of Cardiothoracic Surgery, 14(1), 11–27. View on PubMed
Girlanda, R. (2016). Deceased organ donation for transplantation: Challenges and opportunities. World Journal of Transplantation, 6(3), 451–459. View on PubMed
U.S. Health Resources and Services Administration. Organ donation and transplantation information. Organdonor.gov
U.S. Health Resources and Services Administration. Deceased donation and the Organ Procurement and Transplantation Network. View HRSA guidance