In 1984, the U.S. Congress passed the National Organ Transplant Act, which established the Organ Procurement and Transplant Network, a national registry for organ matching.¹ This act was created to address the critical shortage of organ donations and to improve the organ matching and placement process. With passage of this act, it’s now a federal requirement to identify potential organ donors.

In addition to requirements of the National Organ Transplant Act, the U.S. Department of Health and Human Services requires U.S. hospitals to report every death or imminent death to the Organ Procurement Organization (OPO) as part of the hospital’s condition of participation and eligibility to receive Medicare funds. The Joint Commission has also addressed organ donation in its accreditation requirements. As part of the process of identifying a potential organ donor, the doctor should make the family aware early on that organ donation should be considered to help elicit a more positive response from family members. The death pronouncement and the request to consider organ
donation should never occur at the same time.² Ideally, referral to the OPO should occur when a patient scores less than 5 on the Glasgow Coma Scale or when two or more brain stem reflexes are absent.²