Tissue & Organ Donation FAQs

Yes, individuals can change their organ and tissue donation status after registration. Although the process for making changes varies depending on how the registration occurred, individuals can change their donor status at any time. If someone’s wishes regarding organ or tissue donation have changed, it is crucial to maintain updated documentation that reflects their current preferences. Anyone who registers to be an organ and tissue donor remains on their state’s registry unless they remove themselves by updating their status to indicate that they no longer wish to be a donor. 

It is important to note that most Department of Motor Vehicles (DMV) do not allow donors to update or change their status. Individuals who are interested in changing their donor status should refer to their local state registry to provide updated information. 

If registration occurred online, individuals can access their donor registry account and make the changes directly in their account. The online accounts for donor registration vary. Some states have their own sites, but there are also organizations, such as Donate Life America, that register donors in a national database. It is important to note that any updates made online will replace donor status records at the DMV, but will not result in reissued identification or licenses. 

Changes in donor status should be communicated to family and loved ones and updated as needed in other appropriate documentation. For example, some states include preferences regarding organ and tissue donation in statutory advance directives, so it would be important to update any changes in donor status in those documents. Ultimately, whether deciding to update online or at the DMV, it is crucial to ensure that all documents that include donor status are consistent and aligned with personal preferences. 

Sources
“Donation Facts.” Honor Bridge. https://honorbridge.org/about-donation/donation-facts/ 

“Organ Donation FAQ.” Health Resources & Services Administration. https://www.organdonor.gov/learn/faq

Thanks to greater public awareness and an increasing number of people willing to donate their organs, the number of organ transplants in the U.S. has been increasing each year. In 2024, U.S hospitals performed a new annual record of over 48,000 transplants from over 24,000 donors, averaging 132 transplants per day. These donations came from 16,988 deceased donors and 7,030 living donors.

The most commonly transplanted organs are kidneys, followed by:

• Liver
• Heart
• Lung
• Pancreas
• Kidney/pancreas
• Intestine
• Heart/lung
• Vascularized allograft transplants (VCA) – such as transplants of hands or faces

Yet, even given these promising numbers, the demand for organs far exceeds the supply. As of May 2025, there are nearly 104,000 people awaiting life-saving organ transplants in the U.S. At any given time, around 90,000 people are waiting for a kidney transplant, which can take an average of three to five years to receive. Sadly, many of those people–about 17 per day–will die before an organ becomes available. Meanwhile, a new name is added to the organ transplant waiting list every eight minutes. Still, progress has been continuing in the drive to find new organs. As of 2025, 60% of American adults are registered organ donors. This is due in large part to online registration systems and the ability to sign up as an organ donor at the DMV. 

Sources

“Organ donation from deceased donors continues 12-year record-setting trend”. United Network for Organ Sharing. https://unos.org/news/2022-organ-transplants-again-set-annual-records/

“’Opt Out’ Policies Increase Organ Donation”. Stanford. https://sparq.stanford.edu/solutions/opt-out-policies-increase-organ-donation 

“How many people are organ donors?” Donor Alliance. https://www.donoralliance.org/newsroom/donation-essentials/how-many-people-are-organ-donors/ 

“90,000 people are waiting for a kidney. Here’s one way to get them a kidney faster.” United Network for Organ Sharing. https://unos.org/news/90000-people-are-waiting-for-a-kidney-heres-one-way-to-get-them-a-kidney-faster/ 

“Organ Donation Facts and Statistics”. Donort Network West. https://www.donornetworkwest.org/about-donation/organ-donation-facts-statistic 

The decision to register as an organ and tissue donor can extend and save lives, as well as improve the quality of life for other individuals. Donation is often the deciding factor between life and death for individuals who need a transplant. Someone is added to the organ wait list every 10 minutes, and 17 people die every day while waiting for a suitable match for an organ transplant. 

Becoming an organ and tissue donor allows you to make a positive impact on someone’s life even after your death. Each donor has the potential to save eight lives and improve the quality of life for over 75 additional individuals. Your donation has the potential to allow transplant recipients to regain their health and mobility, increase their independence, reduce or alleviate pain or improve their overall well-being. 

Registering as an organ and tissue donor may also provide comfort and a sense of peace to bereaved family members after your death. The realization that your organs and tissues are going to help other people can demonstrate that there is a silver lining despite the difficulty of experiencing the loss. It can also be a powerful reminder of a legacy of compassion for others — a legacy that can extend into the lives that have been saved and improved through that initial choice to become an organ and tissue donor. 

There is a constant and ongoing demand for organ donors due to the significant number of organs needed in contrast to the immense shortage of suitable organs. Your decision to donate may mean offering a chance at a better life to someone who has waited for an organ donation for years. Ultimately, your decision to become a donor can be a final act of generosity with boundless opportunities to save and change lives. 

Sources

“Organ Donation Facts and Statistics”. UC Health. https://www.uchealth.com/en/media-room/articles/organ-donation-facts-and-statistics 

“Organ Donation Statistics”. Health Resources & Services Administration. https://www.organdonor.gov/learn/organ-donation-statistics 

Although sharing your decision to become an organ or tissue donor is a personal choice, experts recommend that you discuss it with your loved ones. Choosing to have an open conversation about your decision can ensure that your wishes will be respected and upheld after your death. It also provides your loved ones with the opportunity to understand the rationale behind your decision, which they might otherwise struggle to understand without having the additional context from your discussion.

Since some individuals may have concerns surrounding organ and tissue donation, talking about it ahead of time can help alleviate confusion and provide them with peace of mind regarding your choice. People are often hesitant about the topic of organ and tissue donation due to the myths about the donation process. Discussing your decision with your loved ones creates the opportunity for dialogue regarding common questions or concerns that they may have, such as implications for medical care or final arrangements. 

Finally, sharing your decision to donate your organs or tissues allows you to discuss the impact that your decision to donate has on other people’s lives. When an organ donor dies, they can save up to eight lives with their donated organs and more than 75 lives with donated tissues. Lives can be saved by being a match to patients who are on a transplant wait list, transitioning patients from dialysis, or providing skin and other important tissues that are essential in recovery from burns, blindness, trauma, reconstruction, and more. 

Sources

“Frequently Asked Questions About Organ Donation for Older Adults”. National Institute on Aging. https://www.nia.nih.gov/health/organ-donation/frequently-asked-questions-about-organ-donation-older-adults 

“Organ donation: Don’t let these myths confuse you”. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/organ-donation/art-20047529

“6 Quick Facts About Organ Donation”. Penn Medicine. https://www.pennmedicine.org/news/six-quick-facts-about-organ-donation?path=News&path=six-quick-facts-about-organ-donation 

Generally, families cannot override consent for organ donation. If an individual specified their desire to donate organs or tissue in an advance directive for healthcare or a legally executed will or was registered as a donor with the state, they are said to have granted “first-person consent” for donation after death. In every state in the U.S, the next of kin and/or authorized healthcare agent are barred from revoking first-person consent unless they have proof that the person revoked consent themselves. The only exception to this rule is if the potential donor was an unemancipated minor (for example, a 16-year-old child who signed up on the donor registry upon obtaining a driver’s license.) In that case, one or both parents may revoke consent. 

With that being said, if you want to be an organ and/or tissue donor, tell your family, your healthcare agent and your friends. This is the best way to avoid conflict and confusion at an already difficult time. It will also allow you to explain why donating is important to you and discuss any questions your family may have. The process goes much more smoothly and will be less traumatic for everyone involved if your family knows your wishes in advance. 

Sources

“First Person Consent”. United Network for Organ Sharing. https://unos.org/wp-content/uploads/unos/registires_combined.pdf

“Frequently Asked Questions About Organ Donation for Older Adults”. National Institute on Aging. https://www.nia.nih.gov/health/organ-donation/frequently-asked-questions-about-organ-donation-older-adults#

Although state laws may vary somewhat, under the Revised Uniform Anatomical Gift Act a designated healthcare agent or next of kin can consent to organ donation for a person who did not consent before their death. The act defines the decision-making hierarchy as follows:

1. Healthcare agent or Power of Attorney 
2. Spouse
3. Adult children
4. Parents
5. Adult Siblings
6. Adult grandchildren
7. Grandparents
8. Adults who exhibited special care or concern, except those who provided compensated health care for that individual (for example, a doctor)
9. Legal guardian
10. Whoever has the legal authority to dispose of the body

In some states, however, one individual may not make the determination if another person in the same class objects (for example, two adult children disagree). If that is the case, the majority of individuals in that class or subsequent classes must agree before the donation can proceed. So, for example, if three adult children survive the deceased and there is no surviving spouse, two of the surviving children must agree to donate the person’s organs over the objections of the third before the process can proceed. If there are only two adult children and they disagree, a parent of the deceased person can “break the tie.” 

Additionally, according to the National Academies of Sciences Engineering Medicine, many states allow a medical examiner or coroner to remove corneas from bodies that have come under their authority (for example, to perform an autopsy to determine the cause of death). These laws do not require express consent of the family or the person who has died. 

Can Family Override Consent?

If an individual specified their desire to donate organs or tissue in an advance directive for healthcare or a legally executed will or was registered as a donor with the state, they are said to have granted “first-person consent” for donation after death. In every state in the U.S, the next of kin and/or authorized healthcare agent are barred from revoking first-person consent unless they have proof that the person revoked consent themselves. The only exception to this rule is if the potential donor was an unemancipated minor (for example, a 16-year-old child who signed up on the donor registry when acquiring a driver’s license). In that case, one or both parents may revoke consent. 

With that being said, if you want to be an organ and/or tissue donor, tell your family, your healthcare agent, and your friends. This is the best way to avoid conflict and confusion at an already difficult time. It will also give you an opportunity to explain why donating is important to you and discuss any questions your family may have. The process goes much more smoothly and will be less traumatic for everyone involved if your family knows your wishes in advance. 

Sources

“Presumed Consent”. National Academies: Sciences, Engineering, Medicine. https://nap.nationalacademies.org/read/11643/chapter/9#228

“First Person Consent”. United Network for Organ Sharing. https://unos.org/wp-content/uploads/unos/registires_combined.pdf 

At this time in the U.S., there are four ways to register to be an organ or tissue donor. 

• Register when you apply for or renew a driver’s license. According to the Department of Health and Human Services, every state and the District of Columbia allows you to register as an organ donor when you apply for or renew your driver’s license. Most states give you the option to indicate which organs or tissues you want to donate.
• Register on your state donor registry. Every state in the U.S. maintains a central database of registered organ donors. To sign up in your state, click your state on Organdonor.gov and you will be taken to the registration form for your state. If you signed up when you got your driver’s license, you DO NOT need to register again. However, you can view your profile and make changes to your registration on the state donor registry at any time. However, if there is a “donor” designation on your driver’s license and you revoke consent in the registry, you may need to request a new driver’s license that indicates your new status. 
• Register online at Donate Life America, the organ donation national registry. This information will be shared with the registry in your state. 
• Sign up using the iPhone Health app: Using the Medical ID feature, you can sign up with Donate Life America by clicking an option and filling out a form. Your registration will go to your state donor registry and appear on your phone, where you, medical staff and first responders can access it. 

In addition to signing up in your state’s registry, it’s also important to tell your loved ones and healthcare agent that you want to donate so they can honor your wishes when you die. According to Donate Life California, 72% of Americans who are eligible to donate organs at the time of their death do so, even if they did not register as an organ donor before. This is almost entirely because families feel certain that their loved one would want to donate their organs to save other lives.

Sources

“Sign Up To Be An Organ Donor”. Health Resources & Services Administration. https://www.organdonor.gov/sign-up 

“National Donate Life Registry”. Donate Life. https://registerme.org/ 

The history of organ and tissue donation in the United States dates back to the 1950s. After years of failed attempts, the first successful human organ transplant occurred in Boston, Massachusetts when 23-year old Ronald Herrick donated a kidney to his identical twin brother, Richard, on December 23, 1954. The procedure opened a new avenue of hope for thousands of Americans with otherwise untreatable life-threatening conditions. Sixty-eight years following that famous day, the United States surpassed its one millionth organ transplant in September 2022. This success was made possible by advancements in science, technology and policies that continue to pave the way for improvements. 

Early 20^th Century Milestones 

Although a few experimental tissue transplants in animals occurred in the United States prior to the 20^th century, most were unsuccessful. In 1912, surgeon Alexis Carrel was awarded the Nobel Prize for his pioneer work on blood vessel suturing and organ transplantation in animals. This was reportedly the first successful homograft, or same species transplantation. Although the credibility of his experiments is questioned by some, Carrel is considered a trailblazer in organ transplantation. 

The early 20th century brought further experimentation around the world, including failed dog kidney transplantation. It was not until the early 1950s that homograft transplantation was even mildly successful in humans.

The more modern era of organ and tissue transplantation stems from a zoologist named Peter Medawar. In Medawar’s effort to understand why transplants between species were always rejected, he discovered that grafts exchanged between bovine fraternal twins were routinely accepted. Due to this discovery, Medawar was able to identify the immunological reaction that is the basis of rejection. In the early 1950s, this allowed surgeons to perform that landmark kidney transplant surgery between identical twins Ronald and Richard Herrick in 1954.

Key organ transplantation protocols and procedures established in the 1960s

Although most patients survived less than one year due to rejection of the kidney in the early 1960s, small advancements in immunosuppression were made and survival rates slowly increased.

Clinical advancements in transplantation that occurred in this decade include the following:

1962 – First successful kidney transplant from a deceased organ donor

1963 – First organ recovered from a brain-dead donor

1963 –  First successful long-term immunosuppression achieved

1966 – First successful pancreas transplant performed

1967 – First crossmatch text for kidney transplant donors and recipients introduced

1967 – First successful liver transplant performed

1967 – First successful heart transplant from a donor after cardiac death (DCD) performed

Three key government milestones followed suit in 1968

• The Uniform Anatomical Gift Act was approved, which established the right of a decedent or family member to donate organs after death and codified the first legally recognized Uniform Donor card 
• The first organ procurement organization, New England Organ Bank, was established to identify deceased donors in a local area 
• The first definition of “brain death” based on clinical criteria became law in all 50 states.

Transplantation advancements in the final decades of the 20^th century 

The 1970s did not produce much in the way of further advancement. In the 1980s, organ preservation and cold storage were improved and new immunosuppressive drugs were introduced to reduce incidents of organ rejection. In the early 80s, the first single-lung transplant, as well as several double-transplant organs or tissues were successfully performed.

The National Organ Transplant Act was passed in 1984, federally regulating the medical field of organ donation and transplantation. This policy was responsible for the creation of the Organ Procurement and Transplantation Network (OPTN) to ensure a fair and safe system for allocation, distribution, and transplantation of donated organs. OPTN is a unique public-private partnership that continues to function as the main hub for all transplantation professionals and organizations in the U.S. today. 

Congress also passed the Required Request Law enacted by all 50 states in 1984. This law established consent to organ donation, mandating that hospitals present families of all potential deceased donors with the option of donation.

The 1990s proved successful for many firsts, including the first hand transplant, the first living donor lung transplant, and the first laparoscopic kidney donor surgery. The first kidney-paired donation exchange transplant was also performed.  

Twenty-first century transplantation milestones 

Policies addressing children’s transplant criteria, the legal basis for kidney-paired donation exchanges, and reimbursement for ancillary expenses incurred by living donors are established. Clinical advancements include the first successful full-face transplant in 2010 and first live birth after uterus transplantation from a deceased donor in 2018. And in 2020, the first Covid-19 patient received a double lung transplant.

The growing field of possibilities in organ and tissue donation continues to improve or save lives. After a slight dip in donors due to the Covid-19 pandemic, donations rebounded, enabling a record-breaking 48,149 organ transplants in 2024, marking a 3.3% increase over 2023 and a 23.3% rise over the previous five years.

Sources

“Organ donation & transplant resources”. United Network for Organ Sharing. https://unos.org/resources/patient/ 

“Alexis Carrel: Biographical”. The Nobel Prize. https://www.nobelprize.org/prizes/medicine/1912/carrel/biographical/ 

“Peter Medawar: Biographical”. The Nobel Prize. https://www.nobelprize.org/prizes/medicine/1960/medawar/biographical/ 

“Organ Donation Legislation and Policy”. Health Resources & Services Administration. https://www.organdonor.gov/about-us/legislation-policy 

“Consent to organ donation: a review”. Progress in Transplantation. https://pmc.ncbi.nlm.nih.gov/articles/PMC6776471/