Organ Donations
Stan, Clarence, Barry, and the Health Chatter team chat with Susan Mau Larson, Chief Administrative Officer at LifeSource, and Sarah Sonn, Director of Communications at LifeSource, about life saving organ donation.
Susan Mau Larson has spent her career leading strategic and policy efforts to strengthen organ donation systems nationwide and support donor families through the process. She has held leadership roles across national donation advocacy and public education organizations.
Sarah Sonn leads communications at LifeSource and focuses on public education, storytelling, and community partnerships to increase donor registration and address misinformation.
Join us for an insightful conversation about how every individual and institution plays a role in making life saving organ donations possible.
Find out more about LifeSource's life saving work here.
Join the conversation at healthchatterpodcast.com
Brought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.
More about their work can be found at https://www.huemanpartnershipalliance.org/
Research
- Quick Facts
- Last year, there were more than 48,000 transplants in the US, but more than 103,000 people were on waiting lists.
- About 13 people in the United States die every day waiting for a transplant, according to the Health Resources and Services Administration.
- The majority of Americans—95% are in favor of organ donation. But only 58% are actually registered.
- less than 1% of donors end up meeting the specific medical criteria to donate their organs and tissue.
- Brief Overview of Organ transplant process
- Indication & Candidate Evaluation
- End‑stage organ failure: Transplantation is typically considered when native organ function (kidney, liver, heart, lung, etc.) fails and other therapies (e.g. dialysis, medical management) are no longer sufficient.
- Evaluation and listing: Patients undergo extensive medical, surgical, and psychosocial workups to assess suitability (e.g. comorbidities, infection risk, adherence). Those who pass are placed on a national (or regional) waiting list.
- Donor Identification & Organ Recovery
- Deceased donors: Most organs come from individuals declared brain dead or, less commonly, donation after circulatory death (DCD). Consent is obtained via donor registry or next of kin.
- Living donors: For kidneys (or parts of liver, lung lobes) a healthy person may donate, subject to stringent screening to minimize donor risk.
- Organs are surgically removed under sterile conditions, flushed with preservation solution, and stored (often cold) to reduce metabolic demand during transport.
- Matching & Allocation
- Compatibility: Matching involves blood type (ABO), human leukocyte antigen (HLA) or tissue typing, and crossmatch tests (to see if the recipient has preformed antibodies against donor antigens).
- Allocation policies: In the U.S., the Organ Procurement and Transplantation Network (OPTN), managed by UNOS (United Network for Organ Sharing), applies rules (the “Final Rule”) to distribute organs fairly across recipients.
- Preservation & Transport
- Ischemia time: The period when the organ is without blood supply (“cold ischemia”) must be minimized to reduce tissue damage.
- Preservation techniques: Use of cold preservation solutions (e.g. UW solution) and sometimes machine perfusion (normothermic or hypothermic) to maintain organ viability.
- Innovations seek to shorten or eliminate ischemic injury (e.g. “beating heart” transplant techniques), though these are still emerging.
- Implantation / Surgery
- Transplant procedure: In the recipient, the failed organ is removed (if applicable), vascular and ductal (e.g. biliary) connections made, and blood flow restored.
- Surgeons must minimize time, maintain hemodynamics, and ensure good perfusion of the graft.
- Immunological Challenges & Rejection
- The immune system recognizes non‑self antigens on the graft and can mount rejection (hyperacute, acute, chronic).
- Monitoring for rejection is via biopsy, lab markers, or increasingly via molecular or biomarkers.
- Post‑Transplant Care & Long-Term Management
- Immunosuppression maintenance: Lifelong therapy with periodic adjustments.
- Complication monitoring: Infections, cardiovascular disease, metabolic disease, graft dysfunction, malignancy.
- HHS moves to shut down major organ donation group in latest steps to reform nation’s transplant system
- In September 2025, the U.S. Department of Health and Human Services (HHS) announced its intention to decertify / shut down the Life Alliance Organ Recovery Agency, a division of the University of Miami’s health system, which is one of the nation’s 55 Organ Procurement Organizations (OPOs).
- This marks the first time HHS (via CMS/HHS) has moved mid‑cycle to decertify an OPO — effectively pulling its contract to procure organs for transplantation.
- The move is part of a broader reform agenda being pushed by HHS and HRSA (Health Resources and Services Administration) to overhaul systemic problems in procurement, organ allocation, oversight, and public trust
- Per Kennedy: “Staffing shortfalls alone may have caused – it was a 65% staffing shortage consistently across the years – and may have caused as many as eight missed organ recoveries each week, roughly one life lost each day,” he said. “Our goal is clear: Every American must trust the nation’s organ procurement system. We will not stop until that goal is met.”
- Each year in the United States, more than 28,000 donated organs go unused and are discarded because of inefficiencies in the system, Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz said Thursday.
- Mehmet Oz: “We’re going to be tougher than ever before, because if we lose trust in the organ transplantation system of this country, tens of thousands of people are going to die yearly whose lives could be saved,” he said.
- Public trust of the organ donation system is essential since the system relies on people to volunteer to donate their organs when they die. Most sign up when they’re getting their driver’s license.
- Other political complexities that are impacting organ transplants: Ethical, Regulatory, and Systems Context
- Organ allocation must balance fairness, utility, and justice. Policies exist to prevent trafficking or organ tourism
- In the U.S., the National Organ Transplant Act (1984) created the legal framework for organ procurement and distribution via OPTN/UNOS.
- The Uniform Anatomical Gift Act governs consent/donation laws at the state level.
- Algorithmic fairness in organ allocation is an active area of concern, especially as more metrics and machine models guide priority.
- System reforms are underway; for instance, in 2023, the U.S. began modernizing OPTN’s contract structure and introducing continuous distribution for multiple organs.
- Disparities in access and outcomes are documented: for instance, a scoping review found that patients from minority or low‐income backgrounds in the U.S. are less likely to be referred, listed, or receive transplants.
- Limited access to the transplant waiting list combined with the scarcity of the organ pool result in over 100,000 deaths annually in the United States.
Sources
https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-024-01116-x
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01616-x?
https://www.hhs.gov/press-room/hhs-decertifies-miami-organ-agency-reforms-transplant-system
https://www.cnn.com/2025/09/18/health/hhs-organ-donation-groups-crackdown
https://donatelife.net/donation/statistics/
https://www.organdonor.gov/learn/organ-donation-statistics
https://www.donornetworkwest.org/about-donation/organ-donation-facts-statistics/
Stanton Shanedling: Hello, everybody! Welcome to Health Chatter! We all took a little break, and now we have an incredibly interesting show today. We're going to talk about organ transplants and the political complexities surrounding this subject. We have two great guests, and we'll get to them shortly.
I'd like to acknowledge our fantastic crew that has been with us from day one: Matty Levine-Wolf, Aaron Collins, DeAndra Howard, Matthew Campbell, and Sheridan Nygaard. Some of them live out of town, in Chicago and Denver, but they still connect with us. Thank you all; you're truly wonderful colleagues.
Clarence Jones is my partner in the Health Chatter Podcast. Thanks for being here, Clarence. We chat a lot during the week, so I appreciate your input. Barry Baines is our medical advisor, providing valuable perspectives on many of our topics. Thank you, everyone.
Today, we're discussing organ procurement, organ transplants, and the political complexities involved. Clarence, why don’t you introduce our guests?
Clarence Jones: I'm always honored to talk about LifeSource. They've been a great partner with Human Partnership in having difficult conversations about health issues and chronic diseases. Today, we have my friend Susan Mel Larson, the Chief Administrative Officer for LifeSource, and Sarah Sonn, the Director of Communication for LifeSource. They've been able to provide us with a lot of great information on this topic.
I'll let them introduce themselves and frame the conversation before we dive into questions.
Sarah Sonn: Thank you, Stan and Clarence, for having us. This is such an important topic. Susan and I have been with LifeSource for many years and are passionate about our work. We're here to talk about organ donation and transplantation, which is a unique area of medicine. You can't just schedule a transplant; you have to wait for someone else to give the gift of life. It's a community-oriented process, and we're here to discuss how everyone can support it.
There’s a significant need in our community—about 2,300 people are waiting for a life-saving transplant. As a mom, I often think about this. If one of my children needed a transplant, I would hope the community was signing up to be donors. Unfortunately, only about 55% of people are registered organ donors in Minnesota, and that number is declining due to misinformation. I’m excited for this opportunity to clarify some of those facts.
Stanton Shanedling: So, where do people sign up to be donors?
Sarah Sonn: In Minnesota, there are several ways to register. The most common is through your driver's license—about 90% of people do that when they get their first license or renew it. We were also the first state to add it to hunting and fishing licenses, which is a great opportunity during hunting season. You can also register on the iPhone Health app or online at life-source.org.
Clarence Jones: I understand that while a majority of Americans support organ and tissue donation, only 55% are signed up. What are some of the barriers or misconceptions that prevent people from registering?
Sarah Sonn: Great question, Clarence. Studies show over 90% of people support organ donation, but fewer are actually registered. Misinformation is a significant factor. Common myths include beliefs that people think they're too old or that no one would want their organs. That's not true—the oldest organ donor was 98 years old. We encourage people to let doctors decide what can be donated.
Another myth is thinking they’re not healthy enough to donate. Medical advancements mean that many past health issues don’t preclude someone from being a donor. So, we urge everyone to check that box and not rule themselves out.
Clarence Jones: Susan, you've worked a lot with the community. Can you discuss your engagement efforts and why this topic is so important?
Susan Mel Larson: Thank you, Clarence. It's been an honor to be your friend and colleague. At LifeSource, we began over 20 years ago focusing on being an inclusive organization that meets the community's needs. We know there are lower rates of support for donation among certain communities, particularly African American and Native American communities. We started engaging with these communities, especially through schools and churches, to increase awareness.
One successful project involved working with barbers in Minneapolis, providing them with information about donations and related health issues like high blood pressure and kidney disease. We're working hard to ensure that no one dies waiting for a transplant and to improve the overall health of the community.
Stanton Shanedling: Can you explain the organ donation process? For instance, what happens when someone needs a kidney?
Sarah Sonn: Great question! Kidney needs are high—about 80% of the waitlist is for kidneys. If someone needs a kidney, they get listed at a local transplant center and then wait for a call. LifeSource manages the donation process in our region. Once hospitals have done everything possible to save a patient who cannot survive, they call us. We evaluate the patient for donation potential.
One person can save up to eight lives through organ donation and many more through tissue donation. If there is potential for donation, we meet with the family to discuss their options. We start the matching process and coordinate with surgeons to recover the organs. We also support the family throughout the process, helping them navigate their loss.
Stanton Shanedling: Why are kidneys so prevalent in transplant needs?
Sarah Sonn: Kidney disease is widespread, contributing to the high demand for kidneys. The waitlist for kidneys is disproportionately composed of people of color, which is an important issue to address.
Barry Baines: I’d like to add that kidney transplants have become the standard of care since dialysis was introduced decades ago. With the aging population and increasing chronic diseases like hypertension and diabetes, the need for kidneys continues to rise, particularly in communities of color.
Stanton Shanedling: How does the waitlist work? If someone’s health changes, do they move down the list?
Susan Mel Larson: It’s not a straightforward list but a database. When a donor organ is available, we generate a list of potential recipients based on medical match, wait time, and how sick they are. If a recipient is too sick to undergo surgery, they don’t go off the list but may not receive that organ. Geography also plays a role, especially for organs like hearts and lungs, which have a time constraint.
Stanton Shanedling: What disqualifies someone from being a donor?
Sarah Sonn: Very few things disqualify someone. Active cancer is the main disqualifier. Conditions like diabetes don’t necessarily exclude you from being a donor, as medical evaluations happen at the time of donation.
Clarence Jones: What strategies have been successful in getting more people to sign up as donors?
Sarah Sonn: Some strategies include improving community engagement and partnerships with local organizations. States like California have implemented outreach campaigns and educational initiatives. We also emphasize the importance of sharing personal stories and experiences, which resonate with people and encourage them to consider becoming donors.
Stanton Shanedling: Okay, so let's say a loved one of mine suddenly needs a kidney. Do you ever get this question: "How much is this gonna cost?" Does LifeSource charge us?
Sarah Sonn: That's a question we get often. From the donation end of things, if you're a donor, LifeSource covers all those costs, so there's no cost to be a donor. From the transplant end, insurance gets involved, and your insurance covers your costs. Having insurance can be a barrier for certain potential recipients, which is a significant equity issue.
But I want to circle back to something Stan mentioned earlier about the myth that doctors won't save your life if you're an organ donor. Understanding the donation process helps address this myth. Organ donation is extremely rare. To even potentially be a donor, you have to die in a hospital on a ventilator. If you're in a car accident and pass away on the scene, you can't be a donor because your organs start to die immediately without blood and oxygen.
For you to be a donor, you must make it to the hospital, and the medical team has to work to save your life. Their focus is solely on that. They don't check your wallet or your license to see if you're a donor; they want to save your life. It's only after they've done everything they can that donation becomes an option.
Stanton Shanedling: That's interesting because many people think that if you’re in a car accident, you can become a donor.
Sarah Sonn: Statistically, it's about 1% of people who sign up to be organ donors that actually have the opportunity to donate.
Barry Baines: Correct. It's really, really rare, which makes the opportunity to donate and the number of available organs so limited. That's why it's our mission to address these myths and encourage as many people as possible to register, as that increases the potential to save more lives.
Stanton Shanedling: And it’s a healing experience for families to know something good came from their tragedy.
Barry Baines: I want to ask another question about living donors. Kidneys are the number one need for organs. We have two kidneys, and stories of living donors donating a kidney to a loved one are common. Has the number of people willing to donate a kidney been increasing?
Sarah Sonn: Yes, living kidney donation is a great way to address the shortage. LifeSource focuses on deceased donation, but we support anything that helps reduce the waitlist. There has been a slight increase in living kidney donations, aided by legislation that has removed some barriers, allowing people to take off work and receive some pay during recovery.
Susan Mel Larson: Absolutely! The exchange programs have also been significant. If someone wants to give a kidney to a loved one but isn't a match, they can donate to someone else, and it creates a chain of donations, which is incredible.
Stanton Shanedling: Do you maintain data on the average years gained by receiving a kidney transplant? How long do people typically live after getting one?
Susan Mel Larson: That data is tracked, but I don't have the specific numbers. I've met people who have had their transplanted kidneys for over 40 years. Transplants are only suggested when all other efforts to improve the organ have failed, so the outcomes tend to be extraordinary.
Stanton Shanedling: Are younger patients able to live longer after receiving a kidney compared to older patients?
Susan Mel Larson: That would be interesting to find out. Older patients may face additional complications, but overall, the transplant can significantly improve quality and length of life.
Stanton Shanedling: This has been an incredible discussion. Let's do a round-robin with some final thoughts. What key takeaways do you want to share?
Sarah Sonn: I want everyone to understand that organ donation and transplantation is a collective process, a beautiful part of humanity. I encourage people to seek reliable information and not let misinformation prevent them from participating. We're holding a community gathering in early December for anyone interested in learning more about organ donation.
Clarence Jones: I’m grateful we had this conversation, and I appreciate Susan and Sarah sharing their perspectives.
Susan Mel Larson: Thank you. LifeSource is committed to careful care for families and respecting the hospital's role in taking care of patients and donations. I encourage everyone to discuss their donation wishes with their families.
Barry Baines: We're fortunate to have a top-notch organization like LifeSource involved in organ donations. It's vital to keep these conversations front and center because there are actions we can take that genuinely save lives.
Stanton Shanedling: Thank you all for this important discussion. For many, organ donation isn't a priority until it becomes personal, but it’s essential to embrace the positive impact it can have. LifeSource does incredible work, and we should all support that moving forward.
We have more interesting shows coming up, including recent changes in blood pressure guidelines and discussions on autism and longevity.
For all of you in Health Chatter land, keep health chatting away!
