How organ donation works

Your decision to be an organ donor could save a life. How does it actually work?

Health Agenda
March 2017

Most of us think about organ donation only in two circumstances: ticking the box on our licence, or in a moment of trauma when a loved one dies. At that moment, it can be almost impossible to separate emotion from facts. But the facts matter.

At any one time there are 1,500 Australians on the transplant waiting list. In 2016, 1,447 Australians received transplants from 503 deceased donors. And of the 74,400 annual deaths in hospital, just 1% of those people are suitable for organ donation. 

The decision to donate organs – and the need to discuss it with your family – may well force us to face our own mortality, but the discussion is an important one to have upfront. And, while Australia’s 2016 donation rate of 20.8 people per million was our highest ever, it was dwarfed by rates in Europe, particularly Spain where the rate is 36 people per million.

Thanks to dedicated teams of doctors and nurses who work specifically in the organ and tissue donation field, the outcomes of organ donation in Australia are excellent and a single deceased donor may help up to 10 recipients.

Organs that can be transplanted include the heart, lungs, liver, kidney, intestines and pancreas. Tissues that can be donated include heart valves, bone, tendons and parts of the eye. Gathering the organs – once the deceased donor’s family has agreed to go ahead with their wish to be a donor – is carried out by highly trained surgical teams with the utmost respect. 

How to become a donor

• To donate your organs after death, you must be over 16. Tick the box on your driver’s licence and enrol on the Australian Organ Donor Register, a government body that enables doctors all over Australia to check your donor decision status 24/7.
• You can register online via your MyGov account which you can link to your Medicare card. You can also fill out an online form or go to a Medicare service centre. It isn’t compulsory to link your organ donation decision with your Medicare account.
• You can choose which organs and/or tissues you’d like to donate and your wishes will be respected. Currently, your family has an opportunity to veto your donation decision (though this is rare) so it’s important to talk to your family about it upfront.
• In 2016, 267 Australians became living donors, mostly donating kidneys or partial livers to relatives and close friends in need. The Australian Paired Kidney Exchange Programme helps would-be donors who aren’t a match to their loved one by allowing people to exchange donors.

A donor’s journey

Matt Stewart’s father Charles died unexpectedly in January last year and though they’d never discussed it, Matt, who’s been a registered donor since he first got his driver’s licence, was in full support of Charles’ decision to donate his organs.

“You sit down with the [donation team] for about three hours of discussion,” says Matt. “Their duty of care was extraordinary and they really do make you feel like you’re doing the most worthwhile thing possible.”

Charles’ organs were donated to three people, two of whom survived (sadly, the third recipient died due to complications unrelated to the transplant). While organ donation is an anonymous process, Matt says he felt extremely involved and was kept fully informed at every step by Donate Life, the government body that handles organ donation.

“I was always kept in the loop and had a great point of contact. Donate Life gave me lots of information and that makes the decision easy.”

How recipients are found

Organs are allocated to transplant recipients via an equitable process that doesn’t take into account their race, religion, gender, social status, disability or age (unless age is relevant to the organ matching criteria).

When organs become available, transplant specialists first look for a recipient within the state and, if that isn’t feasible, they notify transplant teams around Australia. They consider how well the organs match the person, how long they've been on the waiting list, how urgent a transplant is and whether the organ can reach them in time.

The recipient experience

Jemma Neilson was born with biliary atresia (non-formation of the bile duct) and was just one when she had her first liver transplant; she had her second at age 10. Now, says her father Jeff, at the age of 11 “she’s going really well. She hadn’t been growing for a couple of years and now she’s growing a couple of centimetres a month".

"It’s hard to express how incredibly grateful we are to the donor, and their family, whose decision made this possible. It changed our lives forever and we now have a healthy little girl who is thriving – it’s been a complete turnaround. We’ve benefited so much while another family is grieving and it’s hard to explain what an incredible impact it’s had.”

Have the conversation

While many Australians have already made the decision to donate their organs, 44% have not – and 40% haven't discussed their decision with their family. Talking about your choice to donate with your family makes their decision to go ahead with donation much easier and enables them to give a wonderful gift to people in great need.

Being able to donate his father’s organs made “the process of death and grieving easier,” says Matt Stewart. “It put a positive spin on it and I knew that dad’s life had a real legacy.”