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OPTN information regarding deceased directed donation

Published on: Friday, May 29, 2009

Recent news events have sparked public questions regarding directed donation. The following information is intended to address common questions about the practice.

Directed donation is a request made by a donor or donor family to transplant a specific recipient. This practice is legally authorized by the Uniform Anatomical Gift Act (UAGA) and by most state anatomical gift laws, which use the UAGA as a guide. (A few state laws are silent on directed donation but do not specifically disallow the practice.)

The policy of the national Organ Procurement and Transplantation Network (OPTN), operated by United Network for Organ Sharing (UNOS) under federal contract, recognizes directed donation as long as the agencies involved take steps to verify the medical suitability of the organ offer for the specified recipient. The Federal regulation that guides the OPTN (the OPTN Final Rule) expressly allows directed donation to a named individual.

In recent years, at least 100 deceased donor transplants each year have occurred through directed donation. Such requests occur most frequently when the donor or donor family either are related to the recipient or know the recipient personally. Past instances of directed donation that have resulted in media coverage include a daughter-to-father heart transplant and a heart transplant from a church member to the church's pastor. In many instances, only one organ from a deceased donor is directed to a specific recipient; other organs from the donor are allocated according to OPTN policy.

In a number of instances, news reports of a celebrity needing a transplant have led to offers from the public to direct a donation to help that person. Given the power of celebrity status in our society, it must be expected that some individuals feel a connection to certain celebrities and will seek to help them personally. Most of the time either the celebrity has declined such offers or the person was not medically eligible to donate. In some instances involving a celebrity's need for a kidney transplant, the celebrity has already identified a living donor who is a relative or acquaintance and is in the process of testing, and thus there is no need for additional donor offers from the public.

The role of transplant professionals is to ensure that any donor offer is handled properly and that the safety and interests of the donor and donor family are protected. This is true in the rare instance of directed donation as well as the commonplace, non-directed allocation of organs to transplant candidates.