No one wants to think about organ donation.

Sure, we love to read the feel-good stories about a baby getting a new heart. We enjoy seeing interviews of people who received a kidney from a family member, or even a total stranger. And, when we renew a driver's license, perhaps we get a small sense of unity with humankind when we indicate our willingness to be an organ donor.

But the reality is that most organ donations begin in tragedy. Family members, at the worst moment in their lives, must choose whether to donate the organs of their dead or dying son, daughter or spouse so that other people may live.

It's an unthinkable situation – but this week, the Post Bulletin asked readers to take a long, hard look at the complexities of organ donation.

Investigative reporter Nora Eckert's three-part “Organ Failure” series pulls back the veil on the nationwide organ-procurement system, which until very recently had operated largely under the radar, in a no-man's land between the health care industry and government regulators.

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In a nutshell, Eckert's work explains that the United States is divided into 57 organ procurement zones, each of which is served by one organ procurement organization (OPO). Employees of these organizations, which receive federal funding, are the people who go to the hospital and ask family members to donate organs from their loved ones. If the go-ahead is given, staff from the OPO take over the tasks of testing to ensure organ viability, removal of organs and their rapid transportation to transplant centers.

It's a high-stakes, time-sensitive, emotionally complex and logistically challenging process – and it turns out that LifeSource, the OPO tasked with meeting this middle-man challenge in Minnesota and the Dakotas, has been doing a less-than-stellar job.

To be fair, LifeSource isn't alone. By some estimates, the U.S. utilizes just one-fifth of viable organs, missing 30,000 potential donors each year, and in 2019 the government agency that funds the non-profit OPOs released a report that the system lacked transparency, accountability and incentives for improvement.

To address these issues, the Centers for Medicare and Medicaid Services has now created a new regulatory framework that relies more on hard data, rather than OPO's self-reporting about their efficiency – and when those new metrics were applied, LifeSource ranked 38th out of the 57 OPOs.

Its overall grade was “Underperforming.”

We're not going to criticize LifeSource for that grade. Geographically speaking, this OPO serves a massive territory – 226,487 square miles – which is among the largest regions in the nation. This size alone presents logistical challenges that most OPOs do not face -- although it is also probably fair to say that every OPO has some unique challenge.

But we do object to LifeSource's initial response to the new system of outside monitoring, even before the new rules were imposed. LifeSource posted alarmist predictions on its web site, saying the new rules “would result in significant damage to organ donation and tremendous loss of life.” It asked the public to write to their representatives in Congress in opposition to the new rules, and it paid lobbyists to fight the changes.

That was wrong.

Organ procurement organizations should welcome outside oversight. They should see “report cards” as motivation to adjust their tactics, to learn from OPOs that are doing well, and to abandon or re-think procedures that are familiar and comfortable but also might be outdated an inefficient.

The good news is that LifeSource appears to have come around. It has added 20 additional staff members this year, and since 2019, its ranking, donation rate and annual number of organs transplanted have improved.

This improvement must continue, because lives are at stake. In Minnesota alone, 2,500 people await transplants, and when LifeSource's “procurement rate” goes up, that increase translates into more years with dads, more birthday parties for children, more joyous family reunions and more quiet, hand-in-hand walks in the moonlight.

Ultimately, of course, LifeSource and the other 56 organ procurement organizations can only do so much to eliminate the national waiting list for organ donations, a list which currently contains 106,751 names.

In the 24 hours after you read this editorial, 31 of those people will die.

We all can do our part to reduce that number – and it all begins with a conversation. The first talk about organ donation shouldn't happen in the emergency room. It should happen around the kitchen table, or in the family room.

Don't rely on a mark on your driver's license. Tell your loved ones that if the unthinkable should happen, you want your last act to be one of life-giving generosity.

By having this conversation, not only might you help others, but you will also prevent your family from having to make an extraordinarily difficult decision at a time when the world seems to be falling apart.


How do I confirm I’m an organ donor?

  • You can register to be an organ donor with the national Donate Life registry or your local state registry. Both should be checked to confirm if you are a registered donor, and you can register in both.
  • According to Donate Life America’s website, “Any adult age 18 or older can register to be an organ, eye and tissue donor – regardless of age or medical history. 15-17 year olds can register their intent to be organ, eye and tissue donors in the National Donate Life Registry. However, until they are 18 years old, a parent or legal guardian makes the final donation decision.”
  • For Minnesota residents, you can register here: https://www.lifesourcedonorregistry.org/.
  • To register on the national registry, visit this link: https://registerme.org/. Contact customerservice@donatelife.net with any questions.