How Donation Works

How Donation Works

It’s a decision you make while you’re alive to become an organ, eye, and tissue donor when you die. While you yourself will never see the impact of this personal decision, it is a legacy that will be seen and felt by your friends, family, community, and perfect strangers. Want to know how the donation process actually works? Read on.


Trauma & End-of-Life

Whether in a hospital or at the scene of an accident, emergency medical personnel immediately begin life-saving procedures. Every effort is made to save the patient at the hospital, regardless of designation status.



Once a patient is determined brain dead by a doctor(s) who are unrelated to the transplant process, the hospital must refer the patient to their designated organ procurement organization (OPO).



A specially trained organ recovery professional from the OPO goes to the hospital to see if the patient is medically suitable to be an organ donor. Even after the patient dies, the ventilator provides oxygen to the major organs until the family decides about donation. The OPO, not the physician, evaluates to determine if organ donation is an option.


First-Person Authorization

The OPO, The Living Legacy Foundation (LLF) here in Maryland, will check the state registry to determine if the patient is a registered donor. If he/she is a registered donor, The LLF will inform the family that their loved one decided while he or she was living to give the gift of life to someone who truly needs it. The LLF maintains a legal obligation to observe all end-of-life decisions, including donor designation. The state of Maryland recognizes this as a legally binding decision. The LLF and all hospitals are legally obligated to honor advance directives, including organ, eye, and tissue recovery decisions by the patient.



After the doctor talks to the family about the patient's death, a specially trained family services coordinator from The LLF discusses the option of organ, eye, and tissue donation. The family is given time to ask questions and think about it before they decide. This decision is much easier if the family has already discussed organ, eye, and tissue donation at an earlier time or if the deceased individual has already given authorization for donation by being listed on the Donate Life Maryland Registry.


Organ Recovery

Once authorization is granted, either by first-person authorization or family authorization, organs are recovered by the transplant surgical team and allocated to help save the lives of those on the organ transplant waiting list. Recipients are determined by a computer matching system based on a variety of factors such as blood and tissue type, time waiting, and location.


Funeral Arrangements

Families can proceed with regular funeral arrangements. The decision to donate does not affect the option of an open casket, nor does it delay funeral services.

How is Tissue Donation Different from Organ Donation?

While less than one percent of hospital deaths meet the criteria for organ donation (usually the patient must be brain dead), tissue donation is open to nearly everyone. Hospitals are required to report all deaths to their designated OPO.

If the tissue donor meets donor eligibility, the registry is checked. Once authorization is verified or consent is given by the potential donor’s family, a medical team is dispatched by the OPO. Each tissue donor can save and enhance more than 75 lives.

Watch this video produced by HRSA about the organ donation process.

What Organs and Tissues Can Be Donated?


One person can save up to 8 lives through organ donation and enhance more than 75 lives through tissue donation. 


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