Organ donation is defined as the process when a person authorizes an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive, through a legal authorization for deceased donation made prior to death, or for deceased donations through the authorization by the legal next of kin. Donation may be for research or, more commonly, healthy transplantable organs and tissues may be donated to be transplanted into another person. When the donor is still living, this is called a living organ donation; about 6,500 of these occur in the U.S. each year. Common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Some organs and tissues can be donated by living donors, such as a kidney or part of the liver, part of the pancreas, part of the lungs or part of the intestines. In 2019, Spain had the highest donor rate in the world at 46.91 per million people, followed by the US (36.88 per million), Croatia (34.63 per million), Portugal (33.8 per million), and France (33.25 per million). As of April 21, 2026, there were 103,223 people waiting for life-saving organ transplants in the United States. More than 48,000 organ transplants were performed in the U.S. in 2024. While views of organ donation are positive, there is a large gap between the number of registered donors and the number of people awaiting organ donations on a global level. To increase the number of organ donors, especially among underrepresented populations, current approaches include the use of optimized social network interventions, exposing tailored educational content about organ donation to target social media users.
Process in the United States
Organ donors are usually dead at the time of donation, but may be living. For living donors, organ donation typically involves extensive testing before the donation, including psychological evaluation to determine whether the would-be donor understands and consents to the donation. On the day of the donation, the donor and the recipient arrive at the hospital, just like they would for any other major surgery. For deceased donors, the process begins with verifying that the person is undoubtedly deceased, determining whether any organs could be donated, and obtaining consent for the donation of any usable organs. Normally, nothing is done until the person has already died, although if death is inevitable, it is possible to check for consent and to do some simple medical tests shortly beforehand, to help find a matching recipient. The verification of death is normally done by a neurologist (a physician specializing in brain function) who is not involved in the previous attempts to save the patient's life. This physician has nothing to do with the transplantation process. Verification of death is often done multiple times, to prevent doctors from overlooking any remaining sign of life, however small. After death, the hospital may keep the body on a mechanical ventilator and use other methods to keep the organs in good condition. The donor's estate and their families are not charged for any expenses related to the donation. The surgical process depends upon which organs are being donated. The body is normally restored to as normal an appearance as possible, so that the family can proceed with funeral rites and either cremation or burial. The lungs are highly vulnerable to injury and thus the most difficult to preserve, with only 15–25% of donated organs used. Potential vulnerabilities and opportunities related to the limits of reliably assessing consciousness in critically ill, behaviorally unresponsive patients undergoing controlled organ donation after circulatory determination of death have been identified, and neurologically informed safeguards in this setting were advanced.
History
The first living organ donor in a successful transplant was Ronald Lee Herrick (1931–2010), who donated a kidney to his identical twin brother Richard (1931–1963) in 1954. The lead surgeon, Joseph Murray, and the nephrologist, John Merrill, won the Nobel Prize in Physiology or Medicine in 1990 for advances in organ transplantation. The youngest organ donor was a baby with anencephaly, born in 2014, who lived for only 100 minutes and donated his kidneys to an adult with renal failure. The oldest known cornea donor was a 107-year-old Scottish woman, whose corneas were donated after her death in 2016. The oldest known organ donor for an internal organ was an Italian woman, who donated her liver after she died in 2022 in Florence at the age of 100 years, 10 months and one day. The oldest altruistic living organ donor was an 85-year-old woman in Britain, who donated a kidney to a stranger in 2014 after hearing that many people needed a transplant. Researchers were able to develop a novel way to transplant human fetal kidneys into anephric rats to overcome a significant obstacle in impeding human fetal organ transplantations. The human fetal kidneys demonstrated both growth and function within the rats.
Brain donation Donated brain tissue is a valuable resource for research into brain function, neurodiversity, neuropathology and possible treatments. Both divergent and healthy control brains are needed for comparison. Brain banks typically source tissue from donors who had registered with them before their death, since organ donor registries focus on tissue meant for transplantation. In the United States, the nonprofit Brain Donor Project facilitates this process.
Legislation and global perspectives
The laws of different countries allow potential donors to permit or refuse donation, or give this choice to relatives. The frequency of donations varies among countries.
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