Organ donation takes healthy organs and tissues from one person for transplantation into another. Experts say that the organs from one donor can save or help as many as 50 people. Organs you can donate include

• Internal organs: Kidneys, heart, liver, pancreas, intestines, lungs
• Skin
• Bone and bone marrow
• Cornea

Most organ and tissue donations occur after the donor has died. But some organs and tissues can be donated while the donor is alive.

People of all ages and background can be organ donors. If you are under age 18, your parent or guardian must give you permission to become a donor. If you are 18 or older you can show you want to be a donor by signing a donor card. You should also let your family know your wishes.

When you die, you can give an organ—or part of an organ—to someone in need. You can improve and save lives.

How to Register as a Donor

First, decide to donate your organs, eyes, or tissues. Next, register as a donor in your state. Signing up doesn't mean you will be able to donate your organs, eyes, or tissues. Registering usually takes place many years before donation becomes possible. But it is the first step to being eligible to save lives.

Medical Care Provided to Potential Donors

Doctors treat all patients the same. The medical team will do everything possible to save your life. A doctor may put you on life support. This keeps blood flowing to the organs.

Doctors Test for Brain Death

Doctors run tests to find out if there’s brain death. A patient with brain death has no brain activity, can’t breathe on their own and can’t recover.

Doctors confirm brain death and note the time of death. Then organ donation is possible.

The Organ Procurement Organization

If you’re near death or die, the hospital tells the local Organ Procurement Organization (OPO). This follows federal rules. The hospital will tell the OPO about you. The OPO decides if you’re a possible donor. If so, someone from the OPO travels to the hospital.

Authorizing Donation

The OPO needs your legal consent. They’ll review your state’s registry. If you’re in it, that’s legal consent for donation. If you’re not, they may check your driver’s license, or another legal form. The OPO may ask your closest blood relative (next of kin) for approval.

Once they have approval, they do a medical evaluation. This is your complete medical and social history. They get this from your family.

How Donors Are Matched to Recipients

If the evaluation allows you to donate, the OPO contacts the Organ Procurement and Transplantation Network (OPTN).

The OPTN is a national database. It has all patients in the U.S. waiting for a transplant. The OPO enters information about a donor into the system and the search begins.

The system creates a list of patients who match the donor (by organ). The system offers each available organ to the transplant team of the best-matched patient.

The transplant surgeon makes the final decision. They decide whether the organ is good for their patient. They may refuse the organ if their patient is too sick or they can’t reach them in time.

Most organs go to patients in the area where doctors recovered the organs. Other organs may go to patients in other parts of the country.

What Happens When Doctors Remove and Transplant Organs

Doctors will keep your organs on artificial support. Machines keep oxygen going to the organs. The medical team and OPO official will check the condition of each organ.

A transplant surgical team will replace the medical team that treated the donor before they died. (The medical team trying to save your life and the transplant team are never the same.)

The surgical team will remove the donor’s organs and tissues. They remove the organs, then they remove approved tissues such as bone, cornea, and skin. They close all cuts. Organ donation doesn’t prevent open-casket funerals.

Organs only stay healthy for a short period of time after removal. Minutes count. The OPO official plans for the moving of the organs. The organs go to the hospitals where the patient(s) who need them are. Organs may go by ambulance, helicopter, or commercial airplane.

How Surgeons Transplant Organs

The operation takes place after the transport team arrives at the hospital with the new organ. The person getting the organ is at the hospital. They may be in the operating room waiting for the organ.

Surgical teams work to transplant the new organs into the waiting patient.

You can donate a kidney, a piece of your liver, and certain other organs and tissues while alive. About 6,500 living donation transplants take place each year.

Unlike deceased donors, a living donor can decide who to donate their organ to, helping a recipient get an organ transplant faster. Most living donations happen between family members or close friends. Other people choose to donate to someone they don't know. 

Living donation is typically safe for the donor. Most living donors go on to live active, healthy lives and can see the positive impact of their donation.

Benefits of living donation

• As a living donor, you can choose who receives your organ.
• You can reduce someone’s waiting time for an organ transplant.
• Living kidney donation can prevent—or shorten—the need for kidney dialysis.
• Research has shown that recipients of organs from living donors have better outcomes than those who receive organs from deceased donors.

Organs That Can Be Donated While Alive

Kidneys are the organs most frequently needed, followed by livers. Both of these organs can be donated by living donors to save someone’s life.

You may be able to donate:

• One kidney
  85% of people awaiting a transplant need a kidney. A kidney is the most commonly donated organ. Your remaining kidney removes waste from the body.
• Segment of the liver
  Remaining liver cells grow or refresh until your liver is almost its original size. This happens in a short amount of time for both you and the recipient.
• One lobe of the lung, part of the pancreas, or part of the intestine
  These donations are rare. While these organs don’t regrow, the portion you donate and the portion that remains can function fully.

Tissue That Can Be Donated While Alive

You may be able to donate:

• Skin—after surgeries such as a tummy tuck
• Bone—after knee and hip replacements
• Healthy cells from bone marrow and umbilical cord blood
• Amnion—donated after childbirth
• Blood—white and red blood cells—and platelets

You can donate blood or bone marrow more than once. The body replaces them after you donate.

Understanding living donation

• Most living donors go on to live healthy and active lives.
• Most living donors report living donation as a positive emotional experience.
• Living donors tend to have similar or better quality of life than before the donation.

Who can be a living doner?

Parents, husbands, wives, friends, co-workers—even total strangers—can be living donor candidates.

To be a living donor, you must:

• Be at least 18 or older (some transplant hospitals require donors to be at least 21)
• Have good physical and mental health
• Know the risks and benefits of living donation
• Make an informed decision that living donation is right for you

What should I think about before I donate?

• Recovery from surgery takes time, and donors may have to take off work and stop certain activities for a while.
• Living donors do not have to pay for medical costs because the recipient’s insurance usually covers expenses.
• You may experience medical problems that delay your return to work.
• You may face lost wages from being out of work, or incur additional costs for childcare or other expenses, depending on your situation.
• Some living donors have had problems keeping insurance coverage at the same level and rate.

Potential risks of living donation

Transplant centers follow-up with living donors after the transplant. They report, on average, living donors do well over the long term.

As with most medical procedures, there are possible risks for living organ donation surgery. These risks differ depending on each individual donor as well as the type of organ donated. Short-term effects may include pain or infection from the procedure. Long-term effects can include hypertension for kidney donors, or intestinal problems for liver donors.

As more research emerges on the impact of donation on living donors, the more we can fully understand the risks and benefits to living donors.

If You Need Financial Help

The National Living Donor Assistance Center (NLDAC) provides financial help to living donors.

They may be able to help you with:

• Travel, lodging, meals, and extras
• Lost wages
• Childcare and eldercare costs related to your evaluation, surgery, and follow-up visits

Organ donation is the act of taking healthy organs and tissues from one person and giving them to someone else. Making the decision to donate your organs is one of the most generous gifts you can give.

Find answers below to commonly asked questions about what it means to be a donor and how to become one. You’ll also find a list of federal resources to help you learn more about the donation process and how to get started.

Is there an age limit to becoming an organ donor?

No: There is no age limit for donation or to sign up. In 2021, one out of every three people who donated organs was over the age of 50. You’re never too old to make a difference — as of 2021, the oldest organ donor in the United States was 92.

How can someone register to be an organ donor?

You can register to be an organ donor at the time you renew your driver’s license or state ID at your local Department of Motor Vehicles. You can also register online.

Visit organdonor.gov to select your state and follow the steps to sign up.

Is my brain included when I sign up to donate my organs?

No. It’s common for people to think that signing up to be an organ donor includes brain donation, but the purpose and the process are different. This is because brain donation is only used to advance scientific research, versus helping another person stay alive through a transplant. Depending on the circumstances of death, it may be possible to donate organs for transplant as well as the brain for scientific research.

Brain donation is important in helping researchers to better understand how different disorders, like Alzheimer’s disease and related dementias, affect the brain, and how we might better treat and prevent them across different groups of people.

What happens after I sign up to be an organ donor?

After you sign up to be an organ donor, be sure to tell your family and friends. It’s important to let them know your wishes so they can honor your decision at the end of life. Also be sure to keep your information, such as a current mailing address, up to date in your state’s donor registry.

Who is responsible for determining if organs can be donated?

Organ Procurement Organizations (OPOs) are nonprofit organizations responsible for recovering organs from donors for transplantation in the United States. If you are near death or die, the hospital informs the local OPO. The OPO decides if you’re a possible donor based on your medical and social history.

Can I donate an organ or tissue while I’m still living?

Most donations occur after the donor has died, but it is possible to donate certain organs or tissue to someone in need while still living. Living donation has a different process than that of a deceased donor donation. To learn more about living donation, visit organdonor.gov.

Do any medical conditions exclude someone from becoming an organ donor?

Yes, some conditions such as an actively spreading cancer or infection, or heart disease, may prevent a person from becoming a donor. But you can still sign up as an organ donor regardless of any preexisting or past medical conditions. A doctor will conduct tests to determine the viability of your organs for transplant at the time of death.

Does it cost money to donate your organs?

No. The organ donor’s family is not charged for donation. Insurance or the people who receive the organ donation pay those costs. However, the donor’s family is still responsible for any costs associated with medical care at the end of life, and funeral and burial arrangements.

Can family members choose to donate their loved one’s organs after they die?

If a person is not registered to donate their organs, their family may make the decision on the dying person’s behalf to donate their organs. A member of the OPO must obtain consent from the family before organ donation. However, the family cannot override the person’s decision to donate their organs if they have registered to donate or stated it in their advance directives.

It can be challenging to think about organ donation at the end of life, both for the family and the person who is dying. Making and documenting this decision ahead of time as part of advance care planning and by registering to donate can help lessen stress during a difficult time.

Is organ donation possible if someone prefers to die at home?

In most cases, organ donation is not logistically possible when someone dies at home. Vital organs — such as the heart, lungs, kidneys, and liver — are only viable for a short time once oxygen stops flowing through the body. However, tissue and eye donation may be an option since these remain viable without oxygen for several hours.

Can a person have a viewing if they donate their organs?

Yes, it is possible to have an open casket funeral, or viewing, after organ donation. Hospital workers treat the body with care and respect during the donation process.

How many people are waiting for organs?

The number of people waiting for organs changes every day. As of January 2022, the number was over 106,000. Every 9 minutes, another person is added to the waiting list.

You can find the recent data from the Organ Procurement and Transplantation Network. The number of people who need a lifesaving transplant continues to go up faster than the number of available organs.

Why do minorities have a higher need for transplants?

More than half of all people on the transplant waiting list are from a racial or ethnic minority group. Some diseases that cause end-stage organ failure are more common in these groups of people.

For example, African Americans, Asians, Native Hawaiians and Pacific Islanders, and Hispanics/Latinos are three times more likely than whites to suffer from end-stage renal (kidney) disease, often as the result of high blood pressure.

Native Americans are four times more likely than whites to suffer from diabetes. An organ transplant is sometimes the best — or only — option for saving a life.

How old do I have to be to sign up? 

All adults in the United States (U.S.) — and in some states, people under age 18 — can sign up to be an organ donor. Doctors decide at the time of death if someone is a good fit. Often, a parent or guardian needs to give permission to allow someone under age 18 to donate.

Is there an age limit?

There’s no age limit to organ donation. Newborns and older adults have been organ donors. The health of your organs is more important than your age. The transplant team will decide at the time of death if donation is possible.

Do you have to be a U.S. citizen to donate or receive organs in the U.S.?

No. You can donate and receive organs in the U.S. even if you don’t live in the country or aren’t a U.S. citizen. Doctors give organs to people based on medical need, not citizenship.

If I have an illness, can I still donate?

 You may be a donor even if you have an illness. When you die, doctors will decide if donation is possible.

Can I be an organ and tissue donor and donate my body to medical science?

Total body donation is often not an option if you choose to be an organ and tissue donor. You may still be an eye donor. Some medical schools and research groups may accept an organ donor for research. 

If you wish to donate your entire body, arrange that with the medical school of your choice. 

There's no age limit to donation or to signing up. People in their 50s, 60s, 70s, and older have donated and received organs.

FACT

People of all ages can be organ donors. One of the oldest organ donors in the United States, Carlton, was 92. He was a liver donor and saved the life of a 69-year-old woman.

FACT

Being older doesn't mean you can't be a donor. When you die, doctors will decide if you can donate.

FACT

In 2019, about 63% of all the people who received organ transplants were 50 or older. Over 21% of all receiving patients were 65 or older.

FACT

In 2019, one out of every three people who donated organs was over age 50. You're never too old to make a difference.

Many religions in the United States (U.S.) support organ donation.

The decision to become a donor is personal. If you have questions about your religion and organ donation, ask your faith leader.

Religions that support organ donation include:

• Disciples of Christ
• Episcopalian
• Evangelical Covenant Church
• Islam
• Judaism
• Evangelical Lutheran Church in America
• Mormon Church of Jesus Christ of Latter-day Saints
• Presbyterian
• Southern Baptist Convention
• United Methodist

Organ donation by children is a difficult subject. The loss of a child or infant is tragic. The option to donate organs, eyes, and tissues is especially hard on parents, as they make the decisions. These are the facts about teen, child, and infant donation.

FACT

Right now, over 1,900 children under the age of 18 are on the national transplant waiting list.

FACT

Over 1,700 children received transplants in 2020.

FACT

In 2020:

• There were over 860 child organ donors. Although they ranged from newborns to age 17, most were age 11 to 17.
• Over 121 child organ donors were babies under the age of 12 months.

FACT

The size of the body and the organ matter when matching donors to receiving patients. That's why very small children most often receive donations from other young people. Older children and adults can often match as well. Sometimes, children can receive donations of partial organs such as a piece of a liver or lung.

FACT

The organs that children tend to need most varies by age:

• Most children under age one are waiting for a liver or a heart, followed by liver.
• Most children age 1 to 10 are waiting for a kidney or liver, followed by a heart.
• Most children age 11 to 17 are waiting for a kidney, followed by a heart.

FACT

Young organ donors under 18 years old:

• must always have parent or legal guardian permission to donate
• must have parents make the donation decision if they die before age 18 in most states

can sign up as organ donors when they get their learner's permit or driver's license in many states.

The list of organs and tissues that you can donate continues to grow. You can save up to eight lives and improve over 75 more.

• Organs
• Corneas
• Tissues
• Hands and face
• Blood stem cells, cord blood, and bone marrow
• Blood and platelets

Most often, you donate organs once you’ve died. You can donate some organs while you’re alive.

What organs can I donate after I die?

• Kidneys (2)
• Liver
• Lungs (2)
• Heart
• Pancreas
• Intestines
• Hands and Face

Get answers to your questions about donating after death.

What organs can I donate while I’m alive?

• One kidney
• One lung
• A part of the liver
• A part of the pancreas
• A part of the intestine

You can donate your corneas when you sign up as an organ, eye, and tissue donor. This lets you leave behind the gift of sight.

• In 2018, doctors performed over 85,000 corneal transplants.
• The cornea is the clear part of the eye over the iris and pupil. Damaged corneas can result from eye disease, injury, or birth defects.
• More than 97% of all corneal transplants restore the receiving patient’s vision.
• Corneal donors don't have to "match" receiving patients like organ donors do. Donors are universal. Age, eye color, and the quality of your eyesight don’t matter.
• Doctors can remove and store corneas several hours after death. They can do the corneal transplant three to five days after donation.

Donated tissues enhance the quality of life for the people who receive them. Each year, about 30,000 donors provide tissue.

The hospital, medical examiner, or funeral home notifies the local tissue bank. The American Association of Tissue Banks can help you understand tissue banks better.

Doctors must take out the tissue within 24 hours after death. But tissue banks can store the tissue for a long time.

What can tissue banks store?

• Corneas
• The middle ear
• Skin
• Heart valves
• Bone
• Veins
• Cartilage
• Tendons
• Ligaments

Doctors use these to restore sight, cover burns, repair hearts, replace veins, and mend damaged connective tissue and cartilage.

These are difficult surgeries. They call them vascularized composite allograft (VCA) organ transplants.

Doctors move (“graft”) tissue. This can include bone, muscle, nerves, skin, and blood vessels.

• 2005: First hand transplant
• 2007: First face transplant

Anti-rejection drugs help the people who receive them to keep the transplants.

As of January 2018, there have been fewer than 200 VCA organ transplants around the world.

If you’re healthy and between age 18 and 60, you can donate blood stem cells.

It’s best when the donor and the receiving patient’s tissue type or human leukocyte antigen (HLA) match.

It’s easier to find a match in the same family or in the same racial or ethnic group.

What are the three sources of blood stem cells?

• Bone marrow: This soft tissue is inside your bones. It produces many blood cells. Doctors remove it to get stem cells.
• Cord blood stem cells: The blood in the cord that connects a newborn to the mother during pregnancy has high levels of blood stem cells. Doctors can collect and store these in freezers for a long time.
• Peripheral blood stem cells: You can get daily injections of a drug called filgrastim. The drug increases the number of stem cells in the blood. It helps push out the same types of stem cells found in marrow. Doctors can collect this in the same way as when you donate blood.

Your body makes blood and platelets. You replace these repeatedly throughout your life. This means that you can donate blood and platelets more than once.

It’s safe to donate blood every 56 days and platelets every four weeks.

How do they store blood?

Blood banks store blood by type (A, B, AB, or O) and Rh factor (positive or negative).

How do doctors use blood?

Blood had different lifesaving uses. Doctors can use it whole or they can separate it into packed red cells, plasma, and platelets.

How long does it take to donate blood?

It only takes about 10 minutes to collect one pint of blood. The entire process takes about an hour because they need to test and screen your blood.

What are platelets?

Platelets are tiny parts of cells. They move around in the blood and help blood clot.

How can I donate platelets?

You can donate platelets without donating blood. A patient may need platelets but not blood.

Doctors separate platelets from the rest of the blood. Then they return the blood to you. Your body will replace the missing platelets in a few hours.

Can I sign up as an organ donor?

Anyone over age 18 can sign up. In many states, people younger than 18 can sign up as well. There are several ways to sign up.

1. Sign up online now in your state. It’s quick and easy.
2. Visit your state motor vehicle office to sign up.

Let your family know about your decision. If the time comes, they won’t feel surprised and can help carry out your wishes. The transplant team may ask them for information.

What happens when I sign up in my state?

When you sign up in your state, you're giving permission to donate your organs when you die. Usually, that means dying in a hospital and on artificial support. You will stay on your state's registry unless you remove yourself.

I have an organ donor card. Is that enough?

No. You may not have the card with you or it may get missed in the event of your death. If you wish to be a donor, sign up in your state registry.

I have my organ donor status on my driver's license. Is that enough?

That’s an important step. It’s also important to share your wishes with your family. Most families want to carry out the wishes of their loved one. Be sure to tell them how you feel.

Can I choose what I want to donate?

Most states give you the option to choose which organs and tissues you want to donate, or to donate everything usable. Check with your state registry.

Can I remove myself from the registered donors list?

Yes. You can change your donor status at any time. Look for an option such as "updating your status" on your state's site.

If you have a donor mark on your driver's license, removing yourself from the registry will not change that. So, unless your state uses a removable sticker on the license to identify donors, you will need to change your license at your local motor vehicle office.

If I sign up as a donor, will doctors carry out my wishes?

If you’re over 18 and signed up as a deceased donor in your state registry, you have legally given permission for your donation. No one can change your consent. Signing a card isn't enough. If you’re under 18, your parents or legal guardian must give permission for your donation.

What organs and tissues can I donate? 

• Eight vital organs: heart, kidneys (2), pancreas, lungs (2), liver, intestines, hands, and face
• Tissue: cornea, skin, heart valves, bone, blood vessels, and connective tissue
• Bone marrow and stem cells, umbilical cord blood, and peripheral blood stem cells (PBSC)

If I'm a registered donor, will it affect the medical care I receive at the hospital?

No. When you go to a hospital, saving your life comes first. Donation doesn’t become a possibility until all lifesaving methods have failed. The medical team trying to save your life is separate from the transplant team.

Will donation damage my body? Can I have an open-casket funeral?

Hospital workers treat your body with care and respect during the donation process. You can donate your organs, eyes, and tissues and still have an open-casket funeral.

Will my family pay for donation?

No. Your family pays for your medical care and funeral costs. They don’t pay to donate your organs. Insurance or the people who receive the organ donation pay those costs.

Can I sell my organs?

No. You may not sell your organs. It’s against U.S. federal law to buy or sell organs. People who buy or sell organs may face prison sentences and fines. 

One reason Congress made this law was to make sure rich people do not unfairly receive donated organs and tissues. (Source: Organ Procurement and Transplantation Network (OPTN) white paper on bioethics — Financial Incentives for Organ Donation, June 30, 1993) 

Donor Screening

It is important to determine if the donor has an infection that could be transmitted to recipients through the transplanted organs and/or tissues.  The Organ Procurement and Transplantation Network (OPTN) policies (for organ procurement organizations [OPOs]) and FDA regulations and guidance (for tissue and eye banks) require a medical and social history interview to be conducted with the deceased donor’s next of kin or another knowledgeable person.

These interviews gather information about:

1. Risk behaviors that may have exposed the donor to certain diseases
2. The donor’s past medical history
3. Relevant travel history, which can be important for exposure to certain pathogens 

This interview is one of several ways to assess the donor’s risk for having an infectious disease; its usefulness depends on how well the person being interviewed knew the donor and the interviewee’s comprehension of the meaning of the questions

Laboratory Testing for Infectious Diseases

OPTN policy requires OPOs and hospitals that recover living donor organs to perform the following tests to see if the donor may have certain infections: human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, cytomegalovirus (CMV), Epstein Barr Virus (EBV), Chagas disease (for heart donors), and toxoplasmosis (for deceased donors only).  Living potential kidney donors at increased risk for tuberculosis are also tested for this infection.

In the past transplant centers were only prohibited from accepting and transplanting organs from donors infected with HIV.  In 2013, the HIV Organ Policy Equity (HOPE) Act was passed, enabling transplantation of solid organs from HIV-positive donors to HIV-positive recipients when following specified research protocols established by the Department of Health and Human Services under the direction of the National Institutes of Health. Because the number of donor organs is not sufficient to meet the need, intentional transplantation of organs from HBV– and HCV– infected donors is accepted medical practice. These organs are typically offered to transplant patients known to have the same infection, or in some circumstances, to uninfected patients in cases of urgent medical need.

FDA regulations require tissue and eye banks to adequately and appropriately test donor specimens for risk associated with HIV, HBV, HCV, and syphilis.  Living tissue donors must also be tested for West Nile Virus (WNV). Donors of tissues that may contain live white blood cells, such as semen and hematopoietic stem/progenitor cells (e.g., umbilical cord blood), are also tested for human T-lymphotropic virus (HTLV) and CMV).  A donor with positive test results for any of these infectious pathogens, but not necessarily CMV, is not eligible.

When possible, additional steps may be taken to rid tissue of pathogens that might be present on or within the tissue. For example, corneas are stored in a solution containing antibiotics to reduce bacterial growth.  Other tissue types can be cleaned and disinfected, and may be irradiated.  Some tissues, such as corneas, blood vessels, and heart valves cannot be sterilized because such treatment could damage the tissue.  The medical director, or designated person, of the tissue or eye bank performs a final review of available records  to determine donor eligibility, such as communicable disease test results, an autopsy report and tissue processing treatments when applicable, before deciding if tissues from a particular donor are safe to be released for transplantation.

Can people of different races and ethnicities match each other?

Yes. People of different ethnicities match each other.

How does a donor organ match to someone who needs it?

A national computer system matches donated organs to people who need them.

It bases matching decisions on things like blood type, time spent waiting, and geographic location.

I'd like to donate a kidney to someone. How can I find out if I’m a match?

In the U.S., you can donate a kidney to a family member, friend, or anyone on the waiting list while you’re alive. They will test to see if you’re a match and if you’re healthy enough to have surgery.

Remember that there’s a lot to do before they can consider you a living donor. Get a list of the living donation steps you need to take.

The Organ Procurement and Transplantation Network (OPTN) makes organ matches. It runs the national database of patients waiting for a transplant in the United States.

Policies control how the system matches donor organs to patients on the waiting list.

What are the common matching factors?

Blood type and body size factor into a match.

Other factors include:

• how bad the patient’s medical condition is;
• the distance between the donor's and the patient’s hospital;
• the patient's waiting time; and
• if the patient is available. For example:
  • If they can’t contact the patient.
  • If the patient has an infection or other reason that they can’t do the transplant.

The most important factor is the organ itself. Some organs can survive outside the body longer.

There’s a different policy for each organ. Read about how the system decides who gets which organs.

The OPTN assigns a status code to patients waiting for a heart transplant. The code relates to how urgently they need a heart. 

How long can a heart survive outside the body?

A heart can only survive outside the body for four to six hours.

How do they decide who gets the heart?

The transplant team offers a heart first to people near the donor's hospital. 

If no one near the donor is a match, the team searches farther away.

Body size is important in heart matching. The donor's heart must fit comfortably inside the receiving patient’s rib cage.

Lab values, test results, and disease diagnosis help decide the best person to get the lungs.

They use this information to create a score. The score depends on:

• how badly someone needs a transplant; and
• how long they expect the patient to survive after the transplant.

The common factors help decide who gets the donated lung(s).

How long can lungs survive outside the body?

Lungs can only survive outside the body for four to six hours.

What’s most important in deciding who gets the lungs?

These factors are most important:

• Body size — lungs must fit within the rib cage.
• Distance between hospitals.

The transplant team offers lungs first to people near the donor's hospital. If no one near the donor is a match, the team searches farther away.

Patients who need a heart-lung transplant on the OPTN Heart Waiting List and the OPTN Lung Waiting List.

If a heart becomes available, the patient will receive the donor’s lung too.

If a lung becomes available, the patient will receive the donor's heart too.

How long can both organs survive outside the body?

Heart and lungs only survive outside the body for four to six hours.

How do they decide who gets the heart-lung transplant?

The transplant team gives heart-lungs first to people near the donor. If no one near the donor is a match, the team searches farther away.

Livers can survive the body for 12 to 15 hours. They can travel farther than hearts and lungs.

Who gets priority for a liver transplant?

They offer a donor liver first to whomever matches the common factors and has the highest MELD or PELD score. This shows the most need. 

The first patient’s surgeon may not accept the organ. If this happens, they offer the liver to matching patients with the next highest MELD or PELD scores. They do this until someone accepts the organ.

They also consider the distance between the patient’s and the donor’s hospitals.

Use the common factors to understand how the OPTN matches possible donors to patients who need them.

This includes:

• blood type;
• length of time on the waiting list;
• if the patient who needs the transplant is a child; and
• the body sizes of the donor and receiving patient.

What else do they use to match kidneys?

• A negative lymphocytotoxic cross match
• The number of HLA antigens in common between the donor and the receiving patient based on tissue typing

How long can a kidney survive outside the body?

Many kidneys can survive outside the body for 36 to 48 hours.

This means they can consider more patients from a wider area.

A pancreas match depends on how well the blood types match. The system also looks at how long a patient has been on the waiting list.

Transplant teams perform a pancreas transplant at the same time as a kidney transplant. As a result, the kidney needs to match as well.

How long can a pancreas survive outside the body?

The pancreas can survive outside the body for 12 to 18 hours.

A donor intestine matches to someone on the waiting list when the ABO blood group is identical.

What can happen if the ABO blood group isn’t identical?

There’s a higher risk of graft-versus-host disease (GVHD). This is a violent immune reaction. It happens between the white blood cells in the donor organ and the body of the patient who received the organ. It can lead to death.

What else do they consider when making an intestines match?

The stomach shrinks in many patients waiting for intestines. Most of the time, the donor has to be smaller than the patient so that the intestine will fit.

People who get intestinal transplants can get a severe infection from cytomegalovirus (CMV) and Epstein-Barr virus (EBV).

• They usually match patients who have never had CMV with CMV-negative donors.
• They usually match patients who have never had EBV with EBV-negative donors.

How long can the intestines survive outside the body?

The intestines can survive outside the body for 8 to 16 hours.

A surgeon moves a donated organ to someone whose organ failed. This is an organ transplant. Certain diseases can lead to organ failure. So can injury or birth defects.

How do I get on the organ transplant waiting list?

1. Get a Referral

   Your doctor must refer you. A transplant center or program then checks if a transplant makes sense for you.

2. Gather Information

   Learn about transplant lists, costs, and recovery. The United Network for Organ Sharing (UNOS) created, What Every Parent Needs to Know (PDF - 5 MB). It gives you an overview of the process.

3. Select a Transplant Center

   Make sure the transplant center meets your needs.

   Consider its location, if your insurance will pay, how you pay, and if they have support groups. The Organ Procurement and Transplantation Network (OPTN) has a list of member transplant centers.

4. Make an Appointment

   Contact the transplant hospital. Set an appointment for them to evaluate you. They will decide if you qualify for a transplant.

   During the evaluation, ask questions. Learn about that hospital and its transplant team.

5. Get Listed

   If you qualify, the transplant team will add you to the OPTN waiting list. The transplant team will contact you in writing about 10 days after they list you.

   Direct any questions about your waiting list status to your transplant team.

How much will it cost me?

Transplants cost money before, during, and after the surgery. You pay these costs, not the donor.

Your health insurance may cover some costs. Call your insurance company or your employer's benefits office. Ask what costs your insurance will pay and how.

What do costs include?

• Lab tests, organ removal, transplant surgeons, and other operating room staff
• In-hospital stays, getting to and from the transplant hospital for surgery and checkups
• Recovery, including physical or occupational therapy
• Medicine (e.g., anti-rejection drugs)

Review questions you should ask your insurance provider and financial coordinator.

Why should I make a financial plan?

You must pay for any costs that insurance doesn’t cover. Think about how you’ll pay these costs. This may include savings, sale of property, etc.

Who can help me with the plan?

Members of the transplant team, such as the social worker and financial coordinator, can help you develop a plan. They may put you in touch with groups that help pay transplant costs.

How else can the financial coordinator help?

Speak with the financial coordinator before you make financial decisions about your transplant.

They can help you:

• understand how your insurance company's benefits apply to transplant surgery;
• make a plan to pay for your transplant;
• make a plan for nonmedical costs, such as living expenses;
• locate sources of funding; and
• understand bills from hospitals, doctors, pharmacies, and other providers.

Can Medicare or Medicaid help me?

Medicare is a federal program. States operate Medicaid. Both are health insurance programs that may help with your transplant costs.

What is Medicare?

Medicare is for people age 65 or older, people with disabilities, or people who have end-stage renal disease (ESRD).

What will Medicare cover for my transplant?

• Medicare Part A is free to those who qualify. It covers inpatient hospital care and some nursing home care.
• Medicare Part B participants pay premiums. Part B covers:
  • outpatient care;
  • doctor bills;
  • some home health care; and
  • prescription medicines including, in some cases, anti-rejection drugs.

Medicare certifies transplant programs throughout the country. You must use a Medicare-approved transplant facility to receive full Medicare benefits.

What is Medicaid?

Medicaid is an insurance program for people with low incomes. The federal government and states fund it. States decide who can get it and what benefits and services they’ll cover.

What does Medicaid cover for organ transplants?

Some states' Medicaid plans cover only transplants done in the state. That is, unless there’s no transplant center for that organ in the state.

Some states' Medicaid programs don’t cover transplants. Check what your state Medicaid program covers.

How can Social Security help?
Contact your local Social Security office online or call them at 800-772-1213. They can answer questions you have about Medicare or Medicaid. You may qualify for benefits after an organ transplant.

How does the system match organs?

The OPTN has rules for how donor organs match to patients on the waiting list.

This might include how sick a patient is. Their blood type may also be a factor. It depends on the organ.

What happens after my transplant?

Doctors will watch your health years after your transplant. Lab tests will be a regular part of your life.

Talk to your transplant team. Ask:

• what monitoring you’ll need;
• what you can have done at home; and
• what will require visits to the transplant center or other locations.

How will my body react?

Your body may reject a transplanted organ or tissue. It sees it as an invader and tries to destroy it.

Anti-rejection medicine can help. A weak immune system can be slower in defending against germs.

You may get infections more easily. You may find it harder to recover from infections and illnesses.

Protect your health. Follow good prevention practices to avoid illness and injury. Get treatment early when you do get sick.

What medicines can I expect to take?

You’ll probably need to take several kinds of medicine. You may take some medicines several times a day and others only on certain days. Your medicines or dosages may change.

Why should I get to know my pharmacist?

Get to know your pharmacist. They can help you:

• understand your medicines;
• manage your medication schedule;
• explain the effects and side effects of medicines; and
• recommend tools like timers and organizers. These help you keep track of medications.

What should I eat, drink, and avoid?

Eat

• High-fiber foods, such as raw vegetables and fruits;
• Calcium-rich foods, like low-fat dairy products and green, leafy vegetables. You could also take calcium supplements.
• Foods high in protein, such as meat, poultry, fish, eggs, unsalted nuts, and beans. Protein helps you build muscles and tissue. This helps you heal.

Drink

• Plenty of water, unless your doctor tells you to limit fluids.

Avoid

• A lot of salt, processed foods, and snacks. Use herbs and spices to add flavor.
• Eating too much.

What kind of exercise can I do?

Limit exercise and muscle strain when you first return home. Talk with your doctor. They’ll tell you what to expect. And they’ll tell you what activity to limit.

Most people feel weak after surgery. You’ll have to recover from the operation. You’ll also have to recover from the illness or injury that made you need a transplant.

When you feel better, exercise will help you regain your strength. You may feel tired at first. Take rest breaks during exercise. Gradually, increase the amount and type of physical activity you enjoy.

Can I contact my donor’s family?

You may want to thank your donor’s family. Sometimes donor families want to check on you. Federal law requires transplant centers and Organ Procurement Organizations (OPOs) to protect donors and receiving patients’ privacy. They can arrange for contact between the families when both sides agree. The process may begin with a letter from you to the donor family.