The Medical Minute: Six organ donation facts knock down six myths

Right now, more than 100,000 people in the U.S. ― nearly two times the population of Harrisburg ― are waiting for organ transplants.

Doctors helped 42,887 of them last year, up 3.7% from 2021. Donated kidneys, hearts and livers helped them survive what was once incurable ― old death sentences like heart failure, lung cancer and cirrhosis of the liver.

Seventeen of the people waiting for their chance will die today. Their names will be removed from a list, and 100,000 others will go on hoping and praying. 

“We have an organ shortage crisis,” said Dr. Johnny C. Hong, chief of the Division of Transplantation and director of liver transplant surgery at Penn State Health Milton S. Hershey Medical Center. 

The reasons for the shortfall in organs available for transplants are many, but among them is misinformation. Many potential donors are failing to check the organ donation box on driver’s license applications or choosing not to register. And some are doing it for the wrong reasons.

The consequences of each lost opportunity can be far-reaching. A single deceased organ donor can save as many as eight lives, Hong says. 

Below, Hong debunks six myths about organ donation. He discusses why the benefits are enormous and why giving is getting easier.

Myth 1: Doctors won’t revive you if you’re near death if you have signed up to be an organ donor because they want to harvest your organs.

“There is absolutely no truth to that,” Hong said. 

If someone arrives at any hospital emergency department in the U.S. and is unresponsive, the words “organ donation” aren’t even mentioned until the patient meets very specific legal criteria for being past the point of no return. The heart has stopped or the brain is dead.

The patient in question, of course, could decide much earlier that after death they want to donate their organs and determine certain courses of action they want medical staff to perform with their remains when they die. But health care workers are entirely concerned with saving the person’s life.

“Organ donation is highly regulated,” Hong said. “There are multiple layers of regulatory requirement.” Visit the Organ Procurement and Transplantation Network website for details.

Doctors have time to get it right, because current medical technology allows for organs to be preserved and viable after someone dies. The heart can still be transplanted four hours after death, according to donatelife.org. A liver can last 24 hours. Corneas can still be donated 14 days after someone dies. Bones and skin are still viable for five years and heart valves can still be used 10 years after they’ve been removed from living tissue.

“A huge focus in our medical research today is geared toward developing new therapies to allow donated organs to remain viable for an extended period,” Hong added.

Myth 2: There’s a fee for donating organs.

Like the regulations and laws governing when organs may be harvested from a deceased donor, the law also covers what hospitals and doctors can charge people making the donation.

Nothing. 

In the U.S., “it is against the law to be paid for donating your organs,” Hong said. That goes for both living donors and the families of deceased donors.

Myth 3: There are already enough organ donors out there – my registering as a donor won’t make a difference.

“That is a myth, because we don’t have enough,” Hong said.

In the U.S., approximately 105,000 patients are on the waiting list for lifesaving transplants yearly; however, there are only about 22,000 organ donors annually.

“The demand definitely outpaces the supply of organs,” Hong said.

And that’s all types of organs – heart, lungs, livers, kidneys, pancreas, intestines and others. Some patients are lucky enough that medical science has developed methods to buy them more time. Dialysis treatment can help replace some functions of the failed kidneys while patients wait for their transplants, for example. If you’re waiting for a liver transplant, there isn’t much you can do but wait and hope an organ becomes available before you become too sick and die.

Using the national lists, transplantation experts search for matches in blood type and immunology. They also need to match the correct size of organ – for example, you cannot use a massive liver to replace a small one or vice versa.

Myth 4: If I donate an organ my life span will be radically shortened.

No. A living donor can donate one of two kidneys and part of a liver. Doctors are experimenting with using a portion of a living donor’s intestines.

If you have two healthy kidneys, one kidney will take up the job of its missing counterpart with no ill effects. Likewise, you’d only donate a portion of your liver, and you’d still have a perfectly viable liver. The remaining portion of the liver grows and takes over the entire function.

Living donors have to be validated before giving, and doctors put them through a vigorous battery of testing. During the procedure, the medical team is worried about protecting two lives ― the living donor and the transplant recipient ― not just one.

That said, it’s surgery, and donors will have to recover from the procedure. But even that is becoming easier as medical science progresses, Hong said. In the past, donating a kidney meant a five- to seven-day hospital stay. Now, physicians can use laparoscopic procedures to remove the organ, and donors usually go home within three days.

Acquiring a portion of someone’s liver is a more invasive procedure, Hong said. The remaining portion of the liver must be nurtured to regenerate what was lost. Hospital stays can last a week or more and home recovery can take two to three months. Doctors are beginning to move toward more minimally invasive methods for liver donation.

Myth 5: I can’t donate if I had an illness.

In general, there’s some truth that an illness can preclude your ability to donate, but “we need to look at what the illness is,” Hong said.

“The number one priority for a living donor program is the safety and well-being of the living donor,” he said. “So, if there’s anything that would subject the donor to an additional risk, like a chronic illness, then most likely the person will not be able to donate. But again, we have to define that illness clearly.”

Even if you have an illness, register to donate. Let the medical experts make the call.

Myth 6: I’m too old to be a donor.

“The criteria we use is the physiological age rather than the chronological age,” Hong said. “We don’t have an absolute cut off to be a donor.”

Deceased donors are sometimes 70 to 80 years old. What matters is the donor’s overall health at the time of death and the organ function. Living donors must be healthy enough to undergo the operation safely and be well after donation, and the organ being donated must be able to do its job in its new host.

Related content:

• The Medical Minute: Living donors may benefit transplant patients
• The Medical Minute: Become an organ donor, save a life

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.