How Organ Donation Works

Organs are systems of cells and tissues that perform a specific task -- respiration, for example, or ridding the body of waste. Organs are equipped with higher than necessary capacity. For instance, a 20-year-old's heart can pump 10 times more than the amount of blood needed [source: NLM]. This reserve capacity diminishes as we age, however. The heart, lungs and kidneys especially diminish over time, more so than other organs.

While organs deteriorate over a lifetime along with the rest of your body, disease or genetics may ultimately destroy one specific organ while the rest of your body remains relatively healthy. Depending on which organ is wearing down, there are many life-sustaining measures short of transplantation that can be taken to improve your health. For instance, dialysis helps a person with damaged kidneys. However, the rest of the body is negatively affected by these measures. A person on dialysis has a higher risk of cardiovascular disease because the process can reduce the amount of antioxidants that normally fight toxins within the body.

In many cases, the best (and sometimes the only) answer is to replace the damaged organ with a healthy one. Healthy organs aren't easy to come by, though. As of 2015, there were more than 116,000 people on waiting lists for organs [source: OPTN]. The wait period for 53.2 percent of the people added to transplant waiting lists in 2006 was longer than one year [source: UNOS].

Each organ has its own waiting list, but the lists share a common characteristic -- there are more organs needed than are available. Though many lives are saved through organ donation, many people die while waiting on a list. On average, about 106 people are added to an organ waiting list every day, and 18 people die each day waiting for an organ [source: LifeShare].

A person, living or dead, who provides an organ is called a donor. The person into whom the organ will be transplanted is the recipient. Collecting an organ from a donor is known as retrieval or procurement.

Almost anyone of nearly any age and average health can donate an organ. Anyone who has cancer, HIV or disease-causing bacteria in the bloodstream or body tissues is exempt from donation. Decisions about an organ's usability are made at the donor's time of death or, in the case of living donors, in the process leading to donation.

Most religious and spiritual groups either strongly endorse the act of donating organs or believe it's up to the donor to decide. Only a very few -- namely gypsies and Shinto -- are opposed to organ donation. (Gypsies do not have a formalized religion but do have a shared belief system in which the body is still needed in the first year of the afterlife as the soul retraces its steps.) The Amish support organ donation if there's a relative certainty of success for the recipient, but they're more reluctant if the probable outcome is questionable. Jehovah's Witnesses are not opposed to organ donation or transplantation, so long as the organs are first emptied of all blood [source: [Transplant for Life].

So how can you become an organ donor? And what organs you can donate before you give up the ghost? We'll find out next.

While making the decision to become an organ donor takes some time and thought, actually registering as a donor requires little effort. Most states let you register as an organ donor when you register or renew your driver's license or state ID. Additionally, the majority of states have organ donation registries that can be accessed online. Signing and carrying an organ donation card will also provide consent for organ donation in the case of your death.

When registering, you'll designate whether you wish to donate all of your organs upon death, or just certain ones, as well as your tissues and eyes. Being a designated or potential organ donor will not affect medical care that's provided to you. And once your organs have been removed, the incisions are sewn back up and your body remains visually unaltered for viewing in open casket.

When registering as an organ donor, it's important to notify your family about your decision. That way, your family won't be surprised by the news shortly after your time of death. If you're planning a whole-body donation, you'll need a designated person to contact the institution you've selected once you have died.

There are two different types of donors: living and deceased. Deceased donations result from either cardiac death or brain death. These donations require prior consent from the potential donor or the donor's family. In some states, the medical examiner can provide consent in the case of an unclaimed body. To date, there have been more deceased donations than living donations [source: OPTN].

Donations following a cardiac death are the least common type of deceased-donor transplants. Once a donor dies, the organs must be quickly removed, packaged and transported. In the case of cardiac death, organs begin to lose function quickly, sometimes resulting in imperfectly matched donations -- and, it's a scramble to find a match for the organs.

When it's determined that the brain has ceased working (no electrical activity, blood flow or function in the brain) and the condition is irreversible, a person is declared brain dead. It's possible to sustain organ function through use of a respirator and other means. For this reason, more donations are made in the case of brain death because it offers time to find matches for the organs as well as to prepare for the removal of the organs while maintaining their functional capacity. Organ donation doesn't affect the medical care or considerations given to a brain-dead patient.

Between 1998 and 2008, there were more than 91,000 living donations. In 2006, nearly 46 percent of organ donors were living donors, and accounted for 21.6 percent of all organs donated [source: Burdick]. Organs you can donate while still alive include: a kidney, part of the pancreas, part of a lung, part of the liver or part of the intestine. The majority of living donations are made up of single kidneys. Overall, more females than males become living donors, although there are more males on organ waiting lists. The 35-to-49 year demographic contributes the most living donors, followed by 18-to-34-year-olds and 50-to-64-year-olds [source: OPTN]. Living donors should not be afflicted with H.I.V., diabetes, high blood pressure, cancer, heart or kidney disease, or other infectious diseases.

Why do donated kidneys have so much company in their new homes? Next, we'll learn more about donated organs.

Let's take a closer look at the different organs that can be donated and examine the organ donation statistics for each one. There are six organs that can be donated and transplanted:

1.  Kidney -- The functioning lifespan of a transplanted kidney is about nine years. Of all organs, kidneys are most in demand and the most frequently donated [source: LifeShare]. Most diseases that affect the kidneys affect both at the same time, so a living donor is generally not at a greater health risk with only one kidney.

2.  Liver -- The liver is necessary for vitamin storage, removing waste from blood and digestion.

3.  Heart -- A heart will beat about 2.5 billion times in the course of an average lifetime. Once removed from the donor's body, a heart can only survive for about four hours.

4.  Lungs -- Single or double-lung transplants can be performed. Additionally, living donors can donate a single lobe from the lungs, though it will not regenerate.

5.  Pancreas -- It's possible to make a living donation of a portion of the pancreas and still retain pancreas functionality.

6.  Intestine -- Although quite rare, a living donor can donate a portion of the intestine.

Now that we know more about the organs that can be donated, in the next section we'll see just how recyclable a human body is. 

In addition to organs, you can also donate tissue, blood stem cells, blood and platelets, and even your body. 

Tissue is composed of layers of cells that function together to serve a specific purpose. It must be donated within 24 hours of death. Some types of tissue donations include:

Blood stem cells are immature blood cells that can produce more blood-forming stem cells, or mature into white blood cells, red blood cells or platelets. Blood stem cells can be taken from bone marrow, the bloodstream or the umbilical cord. Stem cells within bone marrow -- the spongy tissue inside of bones -- produce blood cells. Donated bone marrow can be infused into the blood stream to fill cavities in depleted bones and resume production of normal blood cells.

The most common donation made is blood and platelets. In addition to donating blood for others, you can also donate blood to yourself before going into surgery. Donated blood (after being screened for disease or abnormalities) is separated by blood type and can be transplanted whole, or separated into plasma, platelets or red blood cells.

You may donate your full body to science (or more precisely, the research institute or university of your choice) by legally inserting the wish to do so in your will. Full body donations are used for training doctors, studying the human body and perfecting forensic research and investigative techniques. In most cases, organs cannot be removed from a body that is to be used for research purposes. At the time of your death, the institute is notified, and a representative will inquire about the cause of death and the state of the body to determine if the donation can be accepted. Funeral ceremonies are often encouraged, but require a slightly different embalming process. Afterward, the body is shipped to the institution.

Getting the right organs to the right person is a complicated process. What organizations help streamline organ donation?

Organ donation is a very complicated and well-coordinated process. At any given moment, organs become available, and a series of individuals, groups and organizations must swing into action. Organs cannot be stored, and most die within 4 to 24 hours of being removed from the human body. In order to maintain a streamlined, efficient and lawful process, several nonprofit entities have been established to facilitate organ donation.

Organ Procurement Organizations (OPOs) are federally designated, nonprofit local entities throughout the United States. They're responsible for organ donor awareness, donor recruitment and evaluation, organ removal and its subsequent transportation. Each state has its own OPO, often with a central location as well as satellite offices throughout the state. When a patient dies, hospitals are required to contact the local OPO. A representative determines whether the person is registered as an organ donor and if his or her organs can be used. If consent is given -- either by the patient prior to death or by the next of kin after the patient's death -- the OPO collects the donor's relevant medical history and arranges to have the organ or organs removed from the body in the operating room, packaged and shipped to the receiving hospital.

The United Network of Organ Sharing (UNOS) is responsible for placing donated organs as well as maintaining the national waiting lists for them. It's based in Richmond, Va., and is open 24 hours a day, 365 days a year. On an average day, organ placement specialists at UNOS find 15 recipients for organs, match 12 organ donors with local OPOs and take 350 phone calls relating to organ donation and transplantation logistics.

In 1984, the Organ Procurement and Transplantation Network (OPTN), a unified transplant network, was established. UNOS is responsible for administering the OPTN. The OPTN collects organ donation and transplantation data, drafts organ transplant policies and maintains a national computer network that matches donors with recipients. The OPTN maintains organ waiting lists, determines who has priority on the lists in each individual case and contacts the appropriate transplant hospitals.

The Scientific Registry of Transplant Recipients (SRTR) is a statistical database for organ transplant information. The SRTR maintains data on every facet of the donation and transplantation process that it collects from hospitals, the OPTN and local OPOs. This information is used by researchers, analysts, doctors and policy-makers to determine priorities and possible improvements in the organ donation process. The database is maintained by the Arbor Research Collaborative for Health in Ann Arbor, Mich.

Continue reading to find out the exact route your donated organ will take once it's removed from your body.

When any patient dies, the hospital is required to contact the local Organ Procurement Organization (OPO). A member of that organization then determines if you are a designated donor or a potential donor and whether your organs are candidates for donation. Your family is contacted about donation, asked for consent if you didn't register as an organ donor and asked about your medical history.

If it's determined that your organ can be used, it's removed, carefully packaged and delivered to the transplant hospital. If the transplant hospital is in the same geographic area as the location of your body, a representative from the OPO transports your organ in a cooler. However, if the organ's destination is farther away, a contracted team from that hospital or OPO will fly to the organ, take possession of it and deliver it to the transplant hospital. Your organ will then be transplanted into the waiting recipient.

Though you won't be paid for a living donation, the National Living Donor Assistance Center helps people who can't afford the expenses they may incur when donating. This isn't done as an incentive or payment for the donation itself but rather to remove financial obstacles for interested donor candidates. Available assistance includes reimbursement for travel costs and certain nonmedical expenses (such as lodging or meals). Assistance isn't provided for cases in which expenses have been or will be paid by any other state or federal agency, insurance policy or the organ recipient. The organ recipient carries some expectation of compensation for the donor's expenses. However, if the recipient's income is under 300 percent of the federal poverty guidelines or if hardship can be determined on a case-by-case basis, the program will compensate the donor. Additionally, in some states it's possible to receive a state income tax deduction for lost wages.

Living donors must strive toward good health get regular medical checkups to stay on top of any potential side effects that may develop from donation. And living donors continue to be at financial risk well after the expenses affiliated with donation are paid off. Most health and life insurance companies will not change rates for a donor, although a living donor may encounter higher rates if seeking to change policies or insurers. Additionally, health conditions resulting from organ donation may not be covered by insurance companies. If a living donor ever needs an organ donation himself or herself, the United Network of Organ Sharing (UNOS) will designate the person with points for more immediate attention. While this provides some preference toward the donor, he or she will still have to wait behind more pressing cases.

If you're short on this month's rent, the next section might be of interest to you.

Though the organ and tissue donation market are highly regulated in the United States, underhanded dealings between shadowy operators are not unheard of. It's illegal in the U.S., and most other nations, to offer or receive compensation for an organ donation. But a black market for human organs does exist.

Citizens of impoverished nations or regions are often tempted to sell one of their kidneys on the black market. In some cases, these entrepreneurial donors are recruited (or learn through word-of-mouth and volunteer) and flown to another nation, where the organ is removed in a makeshift operating room. In 2003, an illegal kidney-procurement network was uncovered in South Africa. The donors were recruited mostly from the slums of Brazil, flown to South Africa where the operation was performed, compensated between $6,000 to $10,000 and returned home [source: Rohter]. The South African middlemen were then able to sell the organs for as much as $100,000 [source: Handwerk].

Villagers in a destitute part of India who sold their kidneys in a similar scheme received about $800 for their organs [source: Handwerk]. At one time, Israeli organ brokers were obtaining kidneys from people in former Soviet-bloc nations and transplanting them into patients who traveled to Turkey for the operation. For the broker, there was money to be made -- one Israeli middleman in the organ trade made $4 million before being caught [source: Rohter].

In the U.S., a black market for human tissue exists. It usually involves bodies about to be cremated. A black market broker may enter into a financial arrangement with a criminally minded funeral home director and carve up the bodies before they're cremated. Falsified papers -- such as consent forms and death certificates -- are produced, and the tissue can then be sold to an American research facility. Sometimes, the tissue may be from a body with an infectious disease, but is sold with documents that claim a different cause of death or medical history. Illegally obtained tissue from just one cadaver has been known to reach 90 tissue recipients [source: Bauer].

In one high-profile case, Michael Mastromarino, an oral surgeon in New York, opened Biomedical Tissue Services with an embalmer, Joseph Nicelli, in 2000. For many years, they harvested human tissue from bodies provided by funeral homes and sold it to research facilities. One of the plundered bodies belonged to Alistair Cooke, host of "Masterpiece Theatre." The "body snatchers" were eventually arrested and charged with numerous crimes.

For more information on organ donation and related topics, transplant yourself to the links on the next page.