How donation works
Seven stages
Clear, careful, and always led by medical teams.
Gift of Life Alliance’s guide to donation after death follows seven stages. Lifesaving care always comes first.
Donor registration
Registering records your decision. In Texas you can register at donatelifetexas.org. A registered decision is legal authorization for donation, so your family does not have to guess.
Lifesaving efforts
Emergency personnel make every effort to save the patient’s life. Donation is not part of this stage.
Patient care
When doctors determine that a patient will not survive, the hospital refers the patient to the organ procurement organization (OPO), which assesses whether donation may be possible.
Donation evaluation
The OPO checks state and national donor registries to determine whether the patient has documented their decision to donate. If a registered decision is found, it serves as legal authorization for donation. If no registration is found, the OPO works with the patient’s legal next of kin to discuss donation.
Family discussion and compassionate support
The clinical team addresses a brain death declaration or a family decision to discontinue ventilation. Organ and tissue recovery does not happen before death. Donation staff support the family and answer questions.
Donation surgery
Recipients are identified through national matching. A surgical team recovers the organs first and then tissue, and the organs are transported to transplant hospitals.
Supporting donor families during the process
Families receive grief support materials and may choose to exchange optional correspondence with recipients.
Earning the public’s trust
Gift of Life Alliance is committed to earning the public’s trust every day. That means supporting a donation and transplantation system that is transparent, accountable, and centered on patients and families.
- We support efforts to modernize the organ procurement and transplantation network and the systems that support the donation process.
- We support transparency and accountability across the entire donation and transplantation system.
- We work alongside hospital care teams, keeping the care of each patient at the center of our work.
- We treat every donation opportunity with dignity, compassion, and respect, and support open, frequent communication with everyone involved.
Commitment to patient safety
We share a commitment to patient safety and the highest standards of care. At the start of the organ donation process, we inform hospital partners and donor families about speaking up when they have a safety concern.
If you observe or become aware of anything during organ donation or recovery that seems unsafe, inconsistent with standard medical practice, or could lead to an adverse event, please let a GOLA team member know. This includes concerns that a patient is experiencing increased neurological function or may be at risk of experiencing pain.
Who decides who receives an organ?
- The OPO’s role is managing the donation process, donor care, family support, and recovery. The OPO does not decide who receives a transplant.
- A national database produces the priority list, based on medical matching, geography, and severity of illness.
- Transplant centers decide whether to accept an organ offer for their patients.
Living donation
Living donors may donate a kidney or a portion of certain organs, most commonly the liver. Living donation is coordinated through transplant programs. If you are interested, contact a transplant program directly for evaluation and guidance.
Helpful resources
- Organ donation process video (AOPO, English)(opens in a new tab)
Published in 2021. Statistics in the video reflect its publication period.
- Donation process guide (PDF, English)(opens in a new tab)
- Register with Donate Life Texas(opens in a new tab)
Understanding donation
Clear answers to common concerns.
It’s natural to have questions about donation. Learn more about medical care, eligibility, funeral arrangements, and family involvement so you can make an informed decision.
Will registering as a donor affect my medical care?
What to know
Lifesaving treatment comes first. Your medical team works to save your life; registering as a donor does not change that priority.
Can I register if I am older or have a medical condition?
What to know
Do not rule yourself out based on age or health history alone. Medical professionals determine donation suitability at the time of donation.
Can my family still arrange an open-casket funeral?
What to know
Recovery is a surgical procedure performed with care and dignity. An open-casket viewing and other funeral arrangements remain possible.
How can my family be involved in my donation decision?
What to know
Share your donation decision with your family and loved ones so they understand your wishes. During the donation process, our teams provide information, answer questions, and support families.
Does donation cost my family anything?
What to know
Your family is not responsible for costs related to donation. Medical care before donation and funeral expenses remain separate.
Can I change my donation decision?
What to know
Yes. You can update or remove your registration through Donate Life Texas. Share any changes with your family so they understand your current wishes.
Questions people ask us
Gift of Life Alliance offers this educational guidance to help you understand donation. Details can vary by hospital and situation; our team can answer questions about your family’s circumstances.
Registration and your decision
How do I make my donation decision known?
Register with Donate Life Texas, the official state registry, and explain your decision to your family. You can register online or when applying for or renewing a Texas driver license or identification card. Registration opportunities are also available through vehicle registration and hunting or fishing licenses.
What does registering with Donate Life Texas mean?
Donate Life Texas records your authorization for organ, eye, and tissue donation after death. Your registered decision provides legal documentation of your wishes under Texas law. The donation organization checks the registry and informs your family of your decision; registration is not a guarantee that donation will be medically possible.
How can I check whether I am registered?
If you said yes when applying for or renewing your Texas driver license or identification card, the card displays a donor heart symbol. You can also visit Donate Life Texas to check your registration, including if you joined through another method.
Can I change or remove my registration?
Yes. Use Donate Life Texas to update or remove your donor registration. Tell your family about changes so they understand your current wishes.
How is the Donate Life Texas registry funded?
Financial contributions support the day-to-day operation of the registry and public education about organ, eye, and tissue donation. Financial gifts are separate from authorizing medical donation.
What if I die outside Texas?
A Texas registration remains an important expression of your wishes, but its legal treatment may differ in another state. Tell your family about your decision and ask the donation team about the applicable requirements.
About donation and recovery
What organs and tissues can be donated?
One donor can save up to eight lives through organ donation and help heal as many as 75 people through tissue donation. Medical professionals determine at the time of donation what is possible for each person.
How and where is recovery performed?
Recovery is carried out by trained surgeons and other specially trained personnel. It most often takes place in a hospital operating room, and sometimes in a specialized facility. Incisions are closed as they would be after any surgery.
Will registering affect the medical care I receive?
No. Medical professionals make every effort to save your life. Treatment decisions are made by your care team; donor registration does not reduce lifesaving efforts. Evaluation for possible deceased donation is separate from those efforts, and organ recovery cannot take place before death is declared.
Am I too old or too sick to be a donor?
Age or health history alone should not stop you from recording your wishes. Medical professionals evaluate the possibility of donation when the time comes; not everyone who registers will be able to donate.
Can an organ be donated to a specific person?
Most organs are allocated through the national matching process. Directed donation may also be possible for a specified person on the U.S. transplant waiting list who is medically compatible, subject to applicable policy. Discuss any request with our team; a particular recipient cannot be guaranteed.
Can I authorize organ donation for research?
You can review research authorization options when registering with Donate Life Texas. Transplantation is the first priority. When an organ is unsuitable for transplantation or a recipient match cannot be found, research donation may be possible if authorized. Review the registry options when recording your decision.
How long does the donation process take?
Recovery often happens about 24 to 36 hours after death, but timing varies. If your family has funeral or viewing plans, talk with our team about them. A specific timeline cannot be guaranteed.
For families
What happens after recovery?
Your loved one is released to the funeral home or mortuary your family chooses. Donation is performed with the utmost dignity, and open-casket viewing, funeral or memorial services, and cremation remain possible. Whole-body science programs are a separate choice and are not part of organ and tissue donation.
Can our family stay with our loved one after we consent?
Yes. Family members may stay with their loved one. You may be asked to step out during certain procedures, and you can visit again under the hospital’s rules. If you leave, the donation team can give you updates.
Can donor families and recipients meet?
It can happen when both parties agree. The organization can help facilitate it, but a meeting is not guaranteed.
Does donation cost the donor’s family anything?
The family is responsible for medical care before recovery and for funeral expenses. The family is not responsible for costs related to donation. Paying for, or offering incentives for, donated organs and tissues is prohibited.
What if my family does not support donation?
Record your decision with Donate Life Texas and talk openly with your family about why it matters to you. Sharing your wishes in advance can help loved ones understand and honor your choice during a difficult time.
Does my religion allow donation?
Many religious traditions support organ and tissue donation or consider it a personal decision. Beliefs and requirements vary. Explore the faith section on our How donation works page and speak with your own religious leader about your questions.
General information does not replace guidance from your medical team. Resources linked from this page may be managed outside this site.