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Organ Donation: What You Need to Know

Nearly 117,000 people nationally are waiting for an organ transplant, yet fewer than 1 percent of all in-hospital deaths in the United States occur under circumstances that allow for organ donation. On average, 19 people in need of a transplant die each day while waiting for a suitable organ to become available.

In short, the need for organ donations remains high – despite medical advances and greater awareness of the need for both deceased-donor organs and living kidney donations. Consequently, the number of people on the national organ waiting list continues to grow.

UAB Medicine offers many innovative ways to help match deceased-donor and living-donor organs with patients who need them. We work closely with the Alabama Organ Center (AOC), which in 2016 opened a Donor Recovery Center that helps save lives by increasing the number of organs recovered for transplant and making the process faster and more seamless. The AOC is one of very few organ procurement organizations in the nation with an in-house recovery center.[MT1] 

For anyone considering organ donation or who has a family member considering it, the following information can help you make an informed decision.

Living Kidney Donation

Approximately 30-40% [DM2] of the kidney transplants performed at UAB Medicine involve living donors. Since 1987, we have performed more living-donor kidney transplants than any other kidney program in the United States, according to the United Network for Organ Sharing (UNOS).

In 2006, UAB Medicine became the first transplant center in the Southeast to pursue “paired kidney exchanges,” a special type of living donor arrangement. Because blood type and tissue incompatibility can be barriers to a successful donor-recipient match, this unique program allows incompatible donor and recipient pairs to be matched with other pairs for compatible transplant. In some cases, medical advances can even overcome blood and tissue mismatches, allowing for successful transplants between incompatible people. Our Kidney Paired Donation and Incompatible Kidney programs have significantly increased the number of patients able to move from organ waiting lists to transplantation.

Deceased-Organ Donation

Lifesaving organs for transplant include the heart, kidneys, lungs, pancreas, and liver/intestines. Hospitals are required to call their local organ procurement organization (in Alabama, the AOC) when a death occurs or is imminent. AOC staff will determine if the patient is a potential organ and/or tissue donor. If the patient is medically suitable, someone from the AOC or a specially trained member of the hospital team will discuss the option of donation with the family.

Prior to speaking with the family, the AOC will determine if the patient indicated his or her wishes to donate via the Legacy Organ & Tissue Donor Registry and share that information with the family. Once authorization is confirmed, the AOC will evaluate the donor more thoroughly for medical suitability and coordinate the recovery of organs and tissue. The AOC also will support the donor’s family as needed.

Within roughly two weeks of donation, the donor’s family will receive a letter from the AOC expressing its condolences and thanks. The family will be told which organs and tissues were recovered and what the AOC knows about the recipients. The donation and transplant processes are anonymous, so no identifying information about the recipients or donors will be released without consent.

Managing the Waiting List

Individuals waiting for organ transplants are listed by the transplant center in their area.
UNOS maintains a computerized waiting list of potential transplant recipients in the United States. Potential recipients are ranked based on geography, degree of match with the donor, severity of their illness, and other factors. The AOC uses that list to identify the recipients for a specific donor. When an organ becomes available in Alabama, the AOC offers it to the patient in the greatest need who most closely matches the donor. Race, income, religion, and other demographic factors are not considered.

Directed Donation

A family may request that a loved one’s organ go to a specific recipient. If that choice is made, the AOC must respect it. If the organ is not a suitable match for the requested recipient, most families will allow the organ to be transplanted into another recipient.

Donor Registry and Making Decisions with Family

Because there is no guarantee that a donor card, driver’s license, or other ID that indicates donation preference would be on one’s person (or examined) in the event of death, other documentation is needed. If you support donation, you should sign the Legacy Organ & Tissue Donor Registry. Because families typically want to carry out the wishes of a loved one, it is equally important to inform your family and/or caretaker of your decision to donate.

Funeral Arrangements

Donation is a surgical procedure performed by trained medical specialists who take great care and treat the body with respect, so an open-casket funeral is possible after donation. In addition, the AOC works closely with the medical examiner or coroner and the funeral director to ensure that the donor is released in a timely fashion.

Learn more about UAB Medicine’s Comprehensive Transplant Institute and how you can share the gift of life by becoming an organ donor.