More than 100,000 people are on the organ transplant waiting list in the United States, and 13 people die every day waiting for an organ that never comes. This shortage makes organ donation one of the most urgent public health issues in the United States.

“There is a big gap between demand and supply of organs,” says Juan C. Caicedo Ramirez, MD, director, Northwestern Medicine Living Donor Liver Transplant Program. “There is a huge need, and there are very few organs available.”

How Organ Donation Works

Organs can come from either a living or a deceased donor.

Living donation

Living donors most commonly give a kidney or a portion of their liver. They must be at least 18 years old so they can make informed and independent decisions about donation. Living donation allows individuals to donate while continuing to live full, active lives.

Because living donors are available immediately, transplant candidates may receive organs faster than waiting for a deceased donor match.

Deceased donation

For deceased donors, the process begins with the donor registering ahead of time. The United Network for Organ Sharing (UNOS), which is the private, nonprofit organization that manages the nation’s organ transplant system under contract with the federal government, reports that people most frequently become donors after a stroke, heart attack or severe head injury. Registration does not expire, so donation may be possible even decades later.

Being a registered donor means you have chosen to help others. However, medical teams determine organ eligibility at the time of donation based on organ function and safety.

Research and Education

Not every donated organ is suitable for transplantation. Donors (or their families, if the donor is not registered) may authorize the use of organs and tissues for medical research and education. Even when transplantation is not possible, donated organs and tissues can help scientists better understand disease and develop new treatments.

What Makes a Good Organ Donor

Regardless of whether someone is a living or deceased donor, many factors affect whether an organ can be used for transplant. There is no single “perfect” donor, and most people can be considered. What matters most is medical suitability at the time of donation, not age or lifestyle alone.

“A good donor or a match depends on the type of transplant,” says Dr. Caicedo Ramirez. “And compatibility isn’t necessarily the biggest issue; it’s that you are willing to do it and that you’re healthy.” 

Overall health and lifestyle choices can affect organ quality, but they rarely rule someone out automatically. Transplant teams look at the full picture, including organ function, medical history and current health.

Age and Chronic Conditions

Many may assume that age or chronic illness disqualifies them from being an organ donor, but that is often not true. Older adults and people with conditions like high blood pressure or diabetes may still be able to donate organs or tissues. Even a history of cancer does not always prevent donation.

Each potential donor is evaluated individually to ensure donation is safe and appropriate.

How Transplant Teams Protect Donors

Transplant teams follow strict medical and ethical standards to protect donors at every step. Living donors complete thorough physical and mental health evaluations before donation and receive long‑term follow‑up care after. National policies are also in place to safeguard living donors’ health and well‑being.

If you are considering living donation, start by talking with your physician. “It’s our job to help people figure out if they can donate or not,” says Dr. Caicedo Ramirez. “We have to do a very thorough evaluation of the donor to make sure that we can proceed.”

The Importance of Donor Diversity

While shared ethnicity is not a requirement for organ donors and recipients to match, a more diverse donor registry gives more people on the transplant waiting list a better chance to find a good match. The immune system markers used for organ matching are inherited, so people with rare markers are more likely to match someone from a similar ethnic background.

According to Donate Life America, people of African American/Black, Asian/Pacific Islander, Hispanic/Latino, American Indian/Alaska Native and multiracial descent make up nearly 60% of the national transplant waiting list.

“People from diverse racial and ethnic backgrounds are the majority on the waiting list,” says Dr. Caicedo Ramirez. “A diverse donor pool helps ensure fair access to organ transplants for everyone.”

How To Become an Organ Donor

You can register to be a donor through the Health Resources & Services Administration or your state registry. It is important to talk with family members about your decision to donate. Clear communication helps ensure your wishes are respected, even during difficult moments.

About 170 million people in the U.S. are registered organ donors. However, only about three in 1,000 people die under circumstances that allow for organ donation, which is why the need remains urgent.

“You can give life to so many people when you donate organs or you donate tissues,” says Dr. Caicedo Ramirez. “But it’s important for people to understand how the process works.”