What Is the Tissue Donation Process?

Unlike organ donation, which only takes place under very limited circumstances, the tissue donation process has few limitations. The potential donor does not need to die in a hospital or a nursing home. As long as an organ procurement organization or tissue bank is promptly notified and can retrieve the body within 24 hours, almost all body tissues, including tendons, ligaments, blood vessels, bone, heart valves and corneas, can be removed and stored for use later on. However, the process will vary slightly depending on the location of the donor at the time of death. 

Death in a Hospital 

In the United States, the National Organ Transplant Act of 1984 mandates that hospitals report all deaths to a regional organ procurement organization or OPO. When a person dies and the OPO is notified, the transplant coordinator or a designated agent first checks with the hospital to learn if the person is a suitable organ or tissue donor based on their medical condition at the time of death. If the person meets the criteria, the OPO then checks the state and national donor registries to determine if the patient was a registered organ and tissue donor. If they are, a representative will contact the next of kin and explain the process to the family. (Families cannot override first-person consent, but are contacted before donation occurs.)

If the person who died was not a registered organ donor, an OPO representative will contact the family or designated healthcare agent to discuss donation with them. If the family consents, the rest of the process will proceed. The family will also be asked to fill out an infectious disease and behavioral screening for the deceased. 

Once consent is established, the organ procurement organization will arrange for the body to be removed to a tissue bank, where all eligible tissue will be removed by a specially trained technician under sterile conditions. At that time, blood samples will also be obtained and screened for infectious diseases, including HIV, tuberculosis, hepatitis B, hepatitis C, CMV, syphilis, cytomegalovirus, (CMV) and Epstein-Barr virus (EBV).

After all tissues are harvested, the medical director of the tissue bank will review the medical records. Only tissue that is safe for transplantation (e.g. free of infectious diseases that can be transmitted to the recipient) will be released. In the meantime, all incisions are closed and the body is returned to the funeral home or family for burial or cremation. Cosmetic implants are made where necessary so the family can have an open casket viewing if they so desire. 

Death at Home or in a Nursing Home 

Nursing homes are not mandated by law to report a death to the regional OPO, so the process for tissue donation when a person dies at home or in a nursing home is essentially the same. The next of kin or designated healthcare agent is responsible for contacting the regional organ procurement organization and notifying them that a death has occurred. The OPO will then check the state and national donor registries to determine if the person is a registered donor. If they are, the OPO will contact a tissue bank, which will send a technician to retrieve the body so that tissue harvest can proceed. The next of kin or healthcare agent can also consent to donation at this time. 

Although tissues are less dependent on a steady blood supply than organs, there is nevertheless a short window in which to notify the OPO since tissue must be harvested within 24 hours of death. The best way to facilitate this is to have the contact information for your local OPO available and to make sure you have your loved one’s donor registration information on hand. You can locate your regional OPO on OrganDonor.gov.

Sources

“How Donation Works”. Health Resources & Services Administration. https://www.organdonor.gov/learn/process 

“First Person Consent: OPOS across the country are adapting to the change”. United Network for Organ Sharing. https://unos.org/wp-content/uploads/unos/registires_combined.pdf  First 

“About Cytomegalovirus”. Centers for Disease Control and Prevention. https://www.cdc.gov/cytomegalovirus/about/index.html 

“About Epstein-Barr Virus (EBV)”. Centers for Disease Control and Prevention. https://www.cdc.gov/epstein-barr/about/index.html 

“Volunteer Locally”. Health Resources & Services Administration. https://www.organdonor.gov/get-involved/volunteer