Organ Donation and Tissue Donation

How to become an organ donor, donate tissue when you die and sign up to (or opt out of) the Organ Donor Register

Last updated: 22 January 2020
By: Ed Gallois

Doctor holding hand

Photo by Arvin Chingcuangco on Unsplash

Organ and tissue donation saves and improves thousands of lives every year. If you sign up to become an organ donor, there are many ways that you could help other people when you die.

With around 6,000 people in the UK on a waiting list for life-saving organ transplant at any one time, a single organ donor’s gift could save up to eight individual lives through transplant surgery and change up to 50 lives through donated tissue.

Tissue and organ donation after death can also help with research that can lead to the prevention of diseases, as well as the education of future doctors and nurses.

How do I become an organ donor?

Currently in England, Scotland and Northern Ireland, NHS organ donation is an opt-in scheme. You can sign up to the Organ Donor Register directly, or through your driving license.

Under the opt-in and soft opt-out donor schemes, when someone is close to death and clinically suitable for to become donor, their next of kin can ultimately grant, or refuse consent for their organs and tissue to be gifted.

How do I sign up to the organ donor scheme?

If you live in England or Wales, you can opt in or out of the donor scheme by registering on the NHS Organ Donor Register. If you opt in, you can express a wish to donate all of your organs and tissue, or certain organs only.

In Scotland, you can register at Organ Donation Scotland, where you can also register a wish to opt out, or update an existing registration with new personal details.

People registering on Organ Donation Northern Ireland can also express the wish to all their organs and tissue, or to donate certain organs only.

How can I opt out of the NHS organ donor scheme?

In Wales, the organ donorship register is now an opt-out scheme. Anyone aged over 18 who has lived in Wales for 12 months or more, must register to opt out of the organ donor scheme, if they would prefer not to be a donor when they die.

If donation is possible when someone is close to death, the organ donor register is checked and discussions are held with family members before an organ transplant or tissue donation takes place.

Under the opt-out organ donor scheme in Wales, anyone who has not signed up to the register, will be considered to have given “deemed consent” for organ donorship.

Under the organ donor scheme in Wales, you can also actively opt in, which enables potential donors to have a say over which organs or tissue they do – or do not– wish to be donated when they die.

A similar opt-out organ donor register scheme will be introduced in England in spring, 2020, followed by Scotland in autumn, 2020.

Consultations are also underway to move towards opt-out organ donor schemes in Guernsey and on the Isle of Man.

Which organs can be transplanted?

The following organs can be donated after death to patients awaiting a life-saving or life-changing transplant

Heart
Lungs
Kidneys
Liver
Pancreas
Small bowel

Can I donate tissue when I die?

When you sign the organ donor register, you can also choose to donate tissue. Organ donation requires a more limited and specific medical criteria to be possible, but tissue donation is much more feasible.

In fact, many body tissues can be taken for donation up to 48 hours after death and can be stored for several months until they are needed.

Which body tissues can be donated after death?

Skin
Corneas (from the eye)
Heart valves
Bone
Tendons.

How is donated tissue used?

Tissue donations can save lives and improve medical conditions such as heart defects, eyesight problems and serious skin burns.

Eye donation after death makes sight-saving surgery possible for many people. This procedure involves the removal or a clear, filmy layer called the cornea – there’s currently no transplant procedure which requires the donation of the iris or entire eyeball.

When are organs removed for transplant from a patient?

Removing someone’s organs for transplant only ever happens after either of the following signs have confirmed a patient’s death:

Brain stem death: The organ donor cannot breathe without a ventilator and has permanently lost any brain activity.

Circulatory death: This is when the heart and lungs are permanently unable to function and the patient cannot or should not be resuscitated. This procedure is known as a DCD transplant – donation after circulatory death.

Medical staff may begin conversations with the patient’s family about organ donation, when it is clear that the person is very close to the end of their life.

Organ donation can only happen when someone’s death takes place in the appropriate clinical environment, and medical staff have identified whether or not the organs are suitable for transplant.

Can you be an organ donor if you were ill?

Having a medical condition or illness doesn’t necessarily rule you out from being an organ or tissue donor.

There are certain conditions that might prevent organ donorship from going ahead, but all situations are decided on a case by case basis with the organ donation team.

How are donor organs removed?

Organ donation is a surgical procedure and, as with any operation, great care is taken by doctors to ensure the procedures are carried out with dignity and respect.

Before an organ transplant, deaths are confirmed by doctors at consultant level who are independent of the transplant team.

The person’s body is sewn up after their organs are removed, while skin tissue is usually removed from their back.

After the operation, families can arrange to view their loved one at the hospital. Any post-surgery marks will be covered by clothing, so families can still opt for their loved one to be laid out in an open coffin for a chapel of rest viewing before their loved one’s funeral. For some extra information, our guide on how to lay someone out is a great place to start.

Tissue can sometimes be donated up to 48 hours after someone has died. More people can be considered for tissue donation because, unlike organ donation, they don’t have to have died in hospital.

Am I too old to be an organ donor?

There is no maximum age limit for organ donation – nor a minimum age requirement. Children can even register themselves to be a potential organ donor, although parental consent is sought before any procedure involving a young person aged under 18 in the UK (or under 12, in Scotland) takes place.

Will my organ donation wishes be carried out?

Donating organs for transplant, can only happen if the person’s family has given consent. Alternatively, you can you can appoint a representative to convey your wishes, when you sign up to the Organ Donor Register.

If you’re a signed up member of an organ donation scheme, it’s worth letting family know about your wishes, as the circumstances in which they may have to make a decision may be difficult and distressing for them.

As a member of the NHS organ donor register, you can choose to appoint a representative who will be consulted over the donation of your organs or tissue.

To appoint an organ donor representative, you’ll need to fill in a form which will need to be signed by you, your chosen representative and a witness. You can appoint a family member or friend as a representative, and nominate or or two people for their role.

What happens after organ or tissue donation?

After someone has donated organs or tissue, their next of kin can arrange for their chosen funeral director to collect the person’s body from the hospital and prepare them for the funeral.

The Donor Family Network offers support and information to bereaved donor families who are grieving the loss of a loved one.

Living organ and tissue donations

You can donate a kidney, part of your liver, as a living transplant donor.

You can also donate blood and register to become a bone marrow donor on the bone marrow donor register.

If you are undergoing a hip replacement operation, you can donate the bone that’s removed during the procedure, while you can pledge to donate amniotic membrane (from the placenta) prior to an elective Caesarean.

Is organ donation permitted by my religion?

The NHS says that major religions in the UK support the principles of organ donation, but that this may be open to interpretation depending upon the school of thought you follow within your faith.

You may wish to talk matters over with your religious minister or adviser, and seek guidance before making a decision. In Islam, for instance, organ donation after death may be considered as a gift to save another human life, although the interpretation of Islamic law by other scholars is that organ donation after death is not permitted.