It may have been something you idly agreed to the last time you went to the DMV, maybe you've never given it an ounce of thought, or maybe you've specifically avoided doing it: registering to be an organ donor.
Death is probably far from your mind, but whether or not you're in tip-top shape or are battling health conditions, you qualify to be an organ donor. Signing up to be a donor can be one of the most impactful things you ever do—just look at how it would change the lives of those on the waiting list.
About 118,000 people in the US are waiting for an organ transplant, and 8,000 people die each year when they don't receive a transplant in time. That's 22 people every single day. And while 95 percent of people support organ donation, only 48 percent are registered. Some states lag even further behind: Only 27 percent of people in New York are registered donors.
Your heart, kidneys, pancreas, lungs, liver, and intestines are all organs that can be donated, along with tissue (cornea, heart valves, bones), and bone marrow and stem cells. Donating your organs after you die makes a bigger difference than you think: You could save as many as eight lives, according to Donate Life America. There's also living donation to consider: About 100,000 people waiting for an organ need a kidney, and most people can donate one and still live a long, healthy life.
And, yes, while there are tons of organ donors out there—more than 125 million people have registered, according to Organdonor.gov—there are still those 100,000-plus people waiting. That's because only about three in 1,000 people will be able to donate after death. Pause and think about those numbers for a minute: We need as many people as possible to sign up.
But there are so many myths and misnomers about what it means to become an organ donor. So we asked David Klassen, chief medical officer for the United Network for Organ Sharing (UNOS), a nonprofit organization, what everyone needs to know.
Are there health conditions that preclude me from being a donor?
In general, anyone can be a donor—the oldest deceased organ donor was 90 years old, Klassen says. No matter your medical history, you can still be considered for organ donation. For instance, if you have heart disease, you can still donate your kidneys, liver, and lungs. "It's not just limited to one organ," says Klassen, who was the medical director of the kidney and pancreas transplant programs at the University of Maryland Hospital for almost 30 years. Donating is all about the medical condition at the time of death.
The instances that may prevent you from donating include if you have a potentially transmissible disease, including an active bacterial infection or a viral infection like hepatitis, for one. Certain cancers may also impact your ability to donate, particularly metastatic cancer (when cancer cells have spread to distant parts of the body), as this can also be transmitted to a recipient. That said, Klassen stresses that each donor is carefully assessed with standardized testing. "The risk of disease transmission is very low," he says.
Can health issues prevent me from being a living donor?
UNOS notes that nearly 6,000 transplants last year happened through living donation—where you donate an organ like a kidney or portion of the liver to a loved one, a friend, or anonymously to a stranger. If you're interested in that, there are a few additional health considerations. Of course, a living donor is screened for transmissible conditions, but there's the extra concern for the donors themselves and long-term risks to their health. A donor who has type 2 diabetes may not be accepted because having diabetes is a risk factor for heart and kidney disease down the road, and donating can therefore pose a risk to their health, Klassen notes. Other conditions might include high blood pressure, cancer, being HIV-positive, or certain psychiatric conditions.
If I'm a registered donor, does my family still have to give consent?
No. "If a person signed up to be a registered donor that is a legally binding agreement," Klassen says. "Legally, that...takes precedence," he says, adding that in the real world, very strong family objections would be taken into consideration by the organ procurement organization (OPO). If a family is worried that organ donation might affect funeral arrangements, they don't have to be concerned. Surgery is used to remove organs, and incisions are closed, making an open-casket funeral a possibility. If potential costs are a concern, that won't be an issue either as the recipient pays the costs of donation through their insurance, or Medicare or Medicaid.
All that being said, it's still smart to tell your family that you're registered so they're aware of your decision and can stand behind it.
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Are experimental uterus and penis transplants covered by standard registration?
No. You've no doubt seen the well-publicized headlines of the nation's first uterus transplant at the Cleveland Clinic and the first penis transplant for a cancer survivor at Massachusetts General Hospital, both in 2016.
If you've been hesitant to sign up because you're worried that anything could happen with your organs or body parts, rest easy. "These are specifically excluded from the standard organ donor consent," Klassen says. Same goes for donating the hands and face. All of these are considered "vascularized composite allografts," or VCAs. They require a specific kind of consent that's typically discussed between an OPO, which runs a VCA program, and the family. Still, these transplants remain pretty rare. Though the stories—like the little boy who received a double hand transplant—are undoubtedly heartwarming. (I'm not crying, you're crying.)
What happens if I registered in one state and I die somewhere else?
You're still a donor! OPOs have access to all state registries, Klassen explains, so if you die in California but you registered in New York, they'll still be able to find your name in the donor database. You can also register through national organizations like Donate Life America, but it truly doesn't make a difference if you do it through one of these or through your state.
Is becoming an organ donor the same as donating my whole body to research?
Not at all. "That's separate and distinct from what we do for organ donation and transplant," Klassen says. Even though individual state registries will give you the option of what you'd like to donate, checking the box to "donate everything that can be used" is not the same thing as donating your entire body.
These are two different entities, and you typically have to decide if you'd like to donate your entire body or organ/tissue donation. If you'd like to donate your body for research (which is still important as these facilities study the human body in search of cures for diseases and to train doctors), contact your state anatomy board or your local medical school about their anatomical donations program.
Is there any truth that doctors won't work as hard to save my life because I'm a donor?
Absolutely not. You'll still get the same top-notch, life-saving treatment whether you're registered as a donor or not. "A doctor's first obligation is to treat patients to the best of their ability and the wishes of the patient and their family," Klassen says. It's a common fear that a doctor will be less interested in providing care, but it's simply not true. The OPOs are in no way involved in the care of a donor prior to a donor being declared brain dead. "It is an absolute requirement that the OPO is not involved at all," he says.
Can rich people really buy their way to the top of organ donor lists?
No. Some people are hesitant about signing up to donate because they worry that the system may be rigged with the wealthy buying their way to the top of the transplant list. "Socioeconomic status doesn't factor in," Klassen says. "The criteria for who gets a transplant is strictly defined and there is a lot of oversight," he adds.
Okay, I'm in. How do I sign up?
You can register to be a donor through your state here in just minutes, or you can do it at the DMV when getting or renewing your driver's license. (Just know that carrying around an organ donor card that you signed doesn't cover your bases—you need to register.) You can also help spread the word through one of the 58 organ procurement organizations in the US. And: Thank you, seriously.
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