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Recycle Yourself

Save lives through organ, eye, and tissue donation!

Introduce yourself!

Who are you? What’s your job? Why are you here?

If your job is related to donation/transplantation, how did you choose your job?

If you are a volunteer, what motivates you to educate people about donation? (don’t tell your whole story yet)

As I go through my presentation, raise your hand if you have a question! I’ll do my best to answer (but I am not a health professional).

Today we will be talking about organ, eye, and tissue donation, how the process works, some of the science behind it, and the impact it can have.

It is important get all the facts and be able to ask any questions you have on this topic so you can make an informed decision on whether you want to become a registered donor or not.

We are not here to register you as an organ donor. This is your choice to make and share with your family.

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This presentation contains sensitive content regarding the discussion of death, grief, illness, and the showing of medical images.

Be mindful and respectful of everyone’s experiences, feelings, and attitudes regarding the topic of organ, eye, and tissue donation.

Please care for yourself and reach out for support if needed.

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Outreach & Education

Organ Procurement

Eye Bank

Tissue Bank

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Questions or connections?

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What is organ, eye, and tissue donation?

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The opportunity to donate organs, eyes, and/or tissues after death to save or heal the lives of people who need them.

Organ, eye, and tissue donation is . . .

One organ donor can save up to 8 lives &

One cornea and tissue donor can save or enhance 125 lives.

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Have you been to the DMV to get your driver’s permit, license, or ID?

D

Saying yes to being an organ donor means; After I die, I wish to donate organs, eyes, and/or tissue to save someone’s life, restore someone’s vision, and/or restore someone’s mobility.

A lot of student’s first experience with organ, eye, and tissue donation comes when they visit the DMV.

Ask for a raise of hands. How many of you that have a license, permit, or ID already or you will be getting it soon? For those of you who have been to the DMV anyone said yes and have a “D” or a heart on your permit or license?

If you have not been to the DMV yet, know that when you go to get your permit, license, or ID, they will ask you “Do you wish to register as an organ, eye and tissue donor?”

Saying yes means you are joining the Oregon Organ Donor Registry, and confirming that (click text)

After I die, I wish to donate…

When you register at the DMV, you are agreeing that you want to donate organs, corneas, and tissue. If you would like the option to choose what you feel comfortable donating, you can register online, where there is a checklist of options for donation.

Alternatively, if you do not want your name in the donor registry data base or do not want to have the D or heart on your license, but still want to be a registered donor, you can register online. In fact, online you can get a username and password and can change your status at any time.

To change your status through the DMV it involves getting a new license which costs $$.

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Why is there a need for organ, eye, and tissue donors?

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The Need for Organ Donors

Every 8 minutes someone is added to the waiting list

On average 13 people die each day while waiting for a transplant.

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How many people are currently waiting?

Currently, there are over 109,000 people in the US on the transplant waiting list.

That number of people can fill:

Reser Stadium

Autzen Stadium

Moda Center

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How do patients get on the waitlist?

Doctors refer sick patient to a transplant center.�
A committee of doctors, surgeons, and hospital staff decide whether a patient is a candidate for transplant.�
A transplant candidate is added to the national waiting list.�
People stay on the national waiting list for days, months, or even years.

The Waiting List

Alysia’s Story

Discussion prompt:

How do you imagine it must feel, waiting and hoping you’ll get your lifesaving transplant? Ask students for adjectives (scary, nerve-wracking, etc.)

Playing the “Alysia’s story” video is optional; it is 1 minute, and 32 seconds long.

Being placed on the waiting list is not automatic. Because there are so few organs available, professionals must be sure that an individual is stable – emotionally, physically, and financially – in order to ensure that they can take care of their new organ for the rest of their life.

Playing the “How the National Organ Transplant Waiting List Works” video is optional, it is 1 minute, and 35 seconds long.

Frequently Asked Questions

What determines whether people get on the list?

This decision is based on the status of the patient’s health, his or her medical and social history, and the expectation of their stability after the transplant takes place.

How long do people stay on the waiting list?

Those on the national waiting list may wait days, months, or even years. Many medical and logistical criteria impact the time an individual spends on the waiting list, including: • Blood type and size of organ needed • Distance between donor and recipient • Medical urgency • Immune-system matching

UNOS provides detailed statistics on the waiting list.

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Kidney Transplants

Heart Transplants

Kidney and liver

Transplants

Kidney, liver, and heart

Transplants

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How does someone become a donor?

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Needs constant blood flow and oxygen

Stays viable longer w/o blood and oxygen & can be stored

Must pass away in a hospital

Can pass away outside of a hospital

Be connected to a ventilator

Does not need to be connected to a ventilator

Eye/Tissue Donors

Organ Donors

Limited to 6 transplantable

organs

So much tissue possible to donate

There is different criteria that determines if someone can be an organ or tissue donor.

· Organ donation has very strict medical criteria that must be met in order for the process to work and organs to stay viable.

· Eye/tissue donation does not have such strict medical criteria.

· For example (refer to slide):

Organ donation → must pass away in the hospital.
Eye/tissue → can pass away outside of a hospital.

Organ donation → needs to be connected to a ventilator (breathing machine found in a hospital). This forces the patient to breathe because they no longer can on their own due to severe injury. Breathing supplies oxygen to the organs.
Eye/tissue → does not need to be connected to a ventilator.

Organ donation → needs constant blood flow and oxygen. Organs will no longer be viable (healthy and functional) for transplant if they go too long without blood and oxygen.
Eye/tissue → stays viable for much longer without blood and oxygen.

Organ donation → limited to 6 transplantable organs.
Eye/tissue → incredible amount of tissue that can be transplanted, lots to choose from.

It is rare to become an organ donor and the need is extremely high. About 1% of all deaths lead to organ donation. Eye/tissue donation is much more common and gives the majority of people the opportunity to donate.

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Heart

2 Lungs

Liver

2 Kidneys

Pancreas

Intestine

How does one organ donor save up to 8 lives?

There are 6 recoverable organs for transplant.

Can you guess them?

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Organ Donation Compatibility

Making the match

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The Science of Self: What Makes You, You

We are all made up of inherited proteins, cells, genes and DNA.

We all have these in common, but they work together to make us unique individuals.

Some genes are expressed outwardly in features like hair and eye color.

Some are expressed internally in features we can’t see like blood type and tissue proteins.

These inherited proteins, called antigens, are markers on the surface of the blood and

tissue cells that identify you as “self” and play a crucial part in organ transplantation.

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The Body’s Defense & Transplant Challenges

When “non-self” antigens are detected in our bodies antibodies are activated by our immune system to attack and destroy.

This keep our bodies healthy against bacteria and viruses but attacks a transplanted organ even if someone needs one to survive.

A successful transplant relies on many different factors of compatibility along with the recipient’s

lifelong management of immunosuppressant medication.

When “non-self” antigens are detected in our bodies (e.g. from bacteria, a virus, and transplanted organs) antibodies are activated to attack.

Antibodies are small proteins that circulate in the body and are used by the immune system to identify and destroy foreign objects or things that are identified at “non-self”.

Antibodies are great in keeping the body healthy, but work against transplanted organs even if someone needs one to survive.

Placing a transplanted organ with mismatched antigens tells the antibodies to attack and kill this non-self invader. This leads to organ rejection. Even under compatible matches, recipients almost always need life long immunosuppressant drugs to combat organ rejection.

A successful organ transplant relies on many different factors of compatibility.

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Matching

Matching an organ donor with a recipient depends on several factors:

How long a person has

been on the waitlist

Geography

Body size

Blood type

Tissue type

Medical urgency

Matching an organ depends on several factors like how sick someone is, how long that person has been sick, how far away they are from the donor/transplant hospital, body size, blood type, and tissue type; some of these have more weight than others.

We know recipients are not matched based on race and ethnicity, but it is important to have as many people registered as possible because when we have a diverse pool of donors it increases the chance of someone finding their perfect match. Additionally, if people match and happen to be from the same racial/ethnic background, there is a higher chance for a successful transplant!

Geography is important because organs are only viable outside the body for a short time. (Perfusion technology being developed to increase time donate organs can remain viable for transplant). We’ll look at this in more detail in a few minutes.

For now we’ll focus more on these last two points.

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Testing Organ Compatibility

ABO Compatibility

(matching blood type)

Human Leukocyte Antigens or HLA

(matching tissue)

Cross Matching

To successfully match organ donors with recipients, 3 crucial tests need to happen.

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ABO Compatibility

What are the 4 blood types?

A

Contains A antigens

B

Contains B antigens

AB

Contains both

A & B antigens

O

Contains neither

A or B antigens

Organ Recipient Blood Type	Compatible Organ Donor Blood Type
O	O
A	A , O
B	B, O
AB	A, B, AB, O

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Human Leukocyte Antigens (HLA)

Each color represents

3 antigens

Biological parents

Biological children

HLA is a genetic marker inherited from our parents that occurs on the surface of almost all cells in the body except red blood cells.

You are always a half match with your biological parent as you get 50% of your genetic make up from each. Only identical twins have identical HLA. (Since identical twins have matching genetic make up, if one twin is an organ donor to their identical twin, this often allows the recipient of the organ to avoid lifetime anti rejection medications. The immune system in the recipient doesn’t see the transplanted organ as an invader, but as self.)

For organ transplant 6 markers/antigens have been identified as most important for transplant and are tested for in both the donor and the recipient (There are 150 identified HLA markers in the human population.)

It’s not necessary to share HLA antigens, but studies have shown that some matching of these lead to longer lasting organ transplants. It is unusual for people who are not blood relatives to share more that one or two HLA antigens in common.

You can share 0, 3, or 6 antigens in common with a sibling.

Today an HLA match is less important than in the past as there have been many advancements in immunosuppressant drugs.

A transplant could even happen with a mismatch of HLA antigens as long as blood type and the cross match is compatible.

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Cross Match

+ Positive Cross Match	Antibodies in the recipient are ready to attack	No transplant
- Negative Cross match	No reaction	Transplant happens

Cross matching happen when cells taken from the donor are mixed with serum from the recipient’s blood.

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Organ Viability

Heart = 4 to 6 hours

Lungs = 4 to 6 hours

Liver = 8 to 12 hours

Intestines = 8 to 16 hours

Pancreas = 12 to 18 hours

Kidney = 24 to 36 hours

Cornea up to 18 hours

Tissue up to 24 hours

Machine perfusion

Once a match is found the clock begins to get the recovered organ to the awaiting recipient. Organs are only viable or healthy for transplant for a very short amount of time.

To help aid in extending viability times machine perfusion is an area of continued research.

The most common types of perfusion used to preserve organ recovered from deceased donors are Hypothermic Machine Perfusion (HMP) and Normothermic Perfusion (NMP).

Hypothermic Machine Perfusion (HMP) in the first picture on the slide cools the organ below normal body temperature while pumping a oxygen rich solution. This slows down the organ’s needs and protects cells from injury during transport. It is manly used for abdominal organs like the kidneys, liver, and pancreas, but can be used for other organs.

Normothermic Perfusion (NMP) keeps organs at a normal body temperature (98.6 degrees F) with warm oxygenated blood to let organ function normally. This allows doctors to test performance of an organ and even repair damage prior to transplant. It is mainly used for hearts and livers but can be used for other organs. This is the second image on the slide.

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Transplant is not a cure.

It is a treatment.

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Name that Organ

The following slides contain graphic medical images of organs you’ve been warned!

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What organ is this?

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What organ is this?

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What organ is this?

(Click) This is a diseased liver with cirrhosis. About 40% of those needed a liver transplant suffer from alcohol related cirrhosis. About 20% of liver transplant patients suffer from Hepatitis C and about another 20% suffer from MASH (formerly fatty liver disease”). **It is important to note that people who suffer from alcoholism must meet stringent requirements before they can ever be placed on the waiting list to receive a new liver.**

(Click) On the right we have a healthy liver. The liver is like a chemical factory that destroys toxic substances in the blood such as drugs and alcohol. It also processes nutrients and breaks down proteins, fats, carbohydrates and stores energy for later use.

People who are in liver failure may experience an accumulation of fluids in the belly and the extremities, Jaundice (which causes a yellowing of the skin and whites of the eyes as well as itching), and mental disorientation or confusion.

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What organ is this?

(Click) On the left we have two polycystic kidneys. This is an inherited condition that causes the kidneys to fail when many fluid filled sacs engorge the kidneys.

(Click) One the right we have a picture of healthy kidneys. The kidneys are responsible for filtering the blood. The kidneys are retrieved together and then separated for transplantation. Kidney donors can be the source of two transplants because humans only need one kidney to survive.

People suffering from kidney failure can experience swelling (edema) in their ankles, feet and hands due to the body holding excess fluid. They can feel fatigue, shortness of breath, and itchy skin due to the waste imbalances in the blood. They can experience muscle cramps, loss of appetite, nausea and vomiting, and experience changes in urination.

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Cornea & Tissue Donation & Transplantation

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One tissue and eye donor

can save or enhance over 125 lives.

Reminder: 1 organ donor can save up to 8 lives, 1 eye/tissue donor can save/enhance up to 125 lives!

Why is it so much more? Have students brainstorm and share why they think so.

This number is an average for the Pacific Northwest. One eye donor can save or enhance up to 2 lives, while one tissue donor can save or enhance an average of 125 lives. The actual number could be less or more.

Nationally the average is 75.

Solvita works closely with the potential donor’s next-of-kin and doctors to do a thorough evaluation. A full medical and social history is conducted (several times in fact) to ensure that the donor’s tissues are safe for transplant.

Once tissue is recovered, it can be preserved and stored for up to 5 years (Cornea for 3 years). It can be transported to recipients in our local area, around the US, or even internationally. There is no waitlist for cornea and tissue.

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nerves

skin

tendons

ligaments

cornea/sclera

bone

arteries/veins

heart valves

connective tissue

cartilage

What types of tissue can be donated?

What kinds of tissue can be donated?

(connective tissue, corneas/sclera, skin, nerves, tendons, bone, ligaments, arteries, veins, heart valves, cartilage)

Ligaments and tendons may be used for reconstruction of rotator cuff, knee ligaments, and Achilles Tendon repair. Ligaments and tendons also don’t have to be one for one transplants. For example, an ACL can replace other ligaments in the body

Cartilage (also pictured) can be donated and used to help repair joints for people with arthritis. Cartilage does not repair itself like bone, what we are born with is all we have.

Veins/Arteries: repair of veins and arteries to improve circulation if there is disease, injury, or blockage

Nerves: Provides a pathway for nerves to reconnect due to injury or surgery. Restores peripheral nerve, muscle, and organ function. Restores sensory feeling!

Skin: donated skin (taken unobtrusively from a donor, only the thickness of a piece of paper) is used as a biological bandage primarily for burn patients, but also can be used for slow or non-healing wounds like diabetic ulcers. Donated skin prevents infection and allows patients to heal until their own skin can grow back. Donated skin is removed from areas usually hidden by clothing (back, back/front of legs, buttocks, and tops of thighs; sometimes the front of the trunk and the back of the arms). Donation of the skin does NOT interfere with funeral viewing arrangements.

These are just a sample of what type of tissue can be recovered. The list of bone, cardiovascular (valves, arteries, and aorta tissue), skin, tendons, connective tissue, ligaments, nerves, as well as fresh allografts is quite extensive and available on the next slide.

Nationally, more than 2.5 million tissue transplants heal lives each year. In 2023 Solvita distributed 22,079 square feet of skin.

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Extended list of recoverable tissue

Bone

Proximal/ Distal Femur

Whole Femur

Proximal/ Distal Tibia

Whole Tibia

Proximal/ Distal Fibula

Hemi-Pelvis

Humerus

Radius

Ulna

Costal Cartilage w/ Sternum

Cardiovascular Heart

Valves (tricuspid, bicuspid)

Aorta

Pulmonary Valves

Descending Thoracic Aorta � Saphenous Vein

Femoral Vein/ Artery

Aortoiliac Artery

Tendons

Achilles

Semitendinosus

Anterior Tibialis

Posterior Tibialis

Peroneus Longus

Plantaris

Achilles

Semitendinosus

Gracilis

Connective Tissue

Fascia

Pericardium

Ligaments

Patellar Tendon w/ Ligament

Skin

Full-thickness

Split-thickness

Nerves

Deep Peroneal Nerve

Tibial Nerve

Sciatic Nerve

Musculocutaneous Nerve

Median Nerve

AIN (Anterior Interosseous)

PIN (Posterior Interosseous)

Ulnar Nerve

Radial Nerve

Femoral Nerve bundle & branches

Superficial Peroneal Nerve

Common Peroneal Nerve

Sural Nerve

Lateral Sural Nerve

Plantar Nerve

Fresh Allografts

Knee Block

Ankle Block

Arm Block

Shoulder Block

Elbow Block

Bilateral Cartilage

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IMAGE WARNING

The following images are of a eyes and tissue. You do not have to look.

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Life Saving Skin

Saves the lives of people with severe burns
Graft placed over the wound
Prevents infection, regulates body temperature, replaces/repairs lost skin

Jan’s Story

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Ligaments

(bone-to-bone)

Tendons

(muscle-to-bone)

Common: tearing an Achilles Tendon or ACL
Athletes are susceptible, but can happen to anyone!
Transplant may be the only option for a full recovery
Restores mobility, eases pain, scaffolds healing

THE IMPACT OF TENDON & LIGAMENT REPAIRS

Keep. The impact of tendon and ligament repairs:

Achilles tendon or ACL tears are common. You may hear about them among athletes, or you may know someone who has personally tore a tendon or ligament.

Many individuals may need a transplant to get back to peak performance, sometimes it is their only option for a full recovery.

Something cool about tendon/ligament repairs is that they are so versatile. They do not have to replace the same body part one-for-one. For example, a recovered Achilles tendon can repair someone else’s Achilles tendon, BUT it can also repair other tendons in the body. So, the transplanted tissue does not have to be from the exact same body part as the injury. (However, still must be the same type of tissue. Tendon cannot repair a ligament).

Tendon/ligament transplants can restore mobility, ease pain, and scaffold healing

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Rib Cartilage ⟶ Outer Ear Structure

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What is the cornea?

John’s Story

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Chemical Burn

The Impact Of Cornea Transplant

Keratoconus

Vision with Fuchs Dystrophy, untreated and post-transplant Vision in the same patient.

JAMA Ophthalmol. 2015;133(4):e145353.

Transplant Procedure

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A kidney, a portion of your liver, or a small lobe of the lung.

Most people are familiar with donating blood or bone marrow

Not the same as deceased organ donation, has nothing to do with the donor registry or registering at the DMV or online.

Generally must be at least 21 years old to participate.

What can you donate while living?

Please note that this presentation is designed for a high school audience. The goal is simply to raise awareness of LKD, not promote it. Most high school students are too young to be considered a living donor. Most transplant hospitals was living donors to be 21 before making the decision.

If you’d like to learn more about living kidney donation, see the Recycle Yourself: A Guide to Organ, Eye and Tissue Donation curriculum.

In 2025, about 15% of the organs transplanted came from living donors.

Pictured top is Cam Dixon, a former Portland State University soccer player who donated a portion of her liver to her mom, Jamie Ellman, in 2023. Cam’s Op Ed in the NCAA News: https://www.ncaa.com/news/soccer-women/article/2023-12-15/op-ed-portland-states-cameron-dixon-sacrifices-senior-season-save-moms-life

Pictured below is Gloria Little, a kidney recipient, and living donor, Allison Wiley. While Gloria and Allison weren’t a compatible match for direct donation, through paired donation Allison was able to donate her kidney to someone in need. This in turn moved Gloria up on the waiting list. Gloria’s Story of Hope:

https://www.donatelifenw.org/stories-of-hope/gloria-little

In 2025, Jesse Eisenberg, a notable actor, donated a kidney altruistically to a stranger.

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Donor Families

The gift of more life is invaluable to those who receive a donated organ or tissue, and donor families, like Hayden’s, are also impacted by the gift their loved one has given to others.

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You can register:

at the DMV
online at our website www.gorecycleyourself.com
through the iPhone health app when you are 18.

How can I register to be a donor?

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Although you can register your intent online at 13 in Oregon and 15.5 in Washington, your next of kin has the final say on organ, eye, and tissue donation until you are 18.

Talk to with your family.

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WHY PEOPLE SAY “NO” TO DONATION

Can you guess?

?

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Don’t think they are eligible

Inaccurate tv/media portrayal

Funeral arrangements

Illegal organ trade

Religious beliefs

Worry of additional cost

Compromised medical care

WHY PEOPLE SAY “NO” TO DONATION

There are various reasons why people may opt out of organ donation. A lot of them are valid, however many are rooted in misinformation. Let’s go over some of these answers and talk about why these common myths are inaccurate.

· Compromised medical care

o Myth: The doctor will let me die if they know I am a registered organ donor, they just want my organs.

o Fact: In an emergency, the doctors’ #1 priority is to save your life. They went into the field for a reason; they took an oath. Also, the medical team and organ donation team are completely separate. The doctor does not know your donation status or have access to the donor registry.

· Religious beliefs

o Myth: My religion does not support organ donation.

o Fact: All major religions support organ donation, however if you are unsure, please talk to your spiritual/faith leader. Even if you think the answer is no, you might be surprised!

Inaccurate tv/media portrayals of donation and transplant

Myth: What I see on tv and in media must be true.

Fact: TV and media often have inaccurate portrayals of donation and transplant for entertainment value or only give part of the information. Always consider your source.

· Illegal organ trade

o Myth: There is a corrupt system in the US where organs will be sold for money

o Fact: It is illegal to sell human organs in the United States, and the organ donation system is heavily regulated by the government with multiple safeguards in place. The OPO carefully tracks and reports organs recovered under strict metrics that must be met to remain operational.

· Worry of additional cost

o Myth: Organ donation is extremely expensive.

o Fact: Organ donation is completely free for the donor's family. It is a selfless gift. However, all life-saving efforts by the hospital prior to the donation/recovery process do cost money (ex: procedures, scans, medication, hospital stay, etc.)

Funeral arrangement

Myth: I can’t have an open casket or viewing if I am an organ donor. I can’t be cremated if I am an organ donor.

Fact: All these final wishes can happen along with organ donation. Recovery is done in a respectful way. Recovered organs and tissue are replaced with prosthetics and all incisions are closed. Skin is taken from the backside of a donor or an area that will be covered by clothing.

Don’t think they are eligible

Myth: I’m too sick/old to donate my organs.

Fact: ANYONE can register to be a donor regardless of health, medical condition, age, gender, or sexual orientation. It is determined by a doctor at the time of someone’s passing if they are eligible to be a donor.

There are many reasons people choose not to become organ donors, but we want to make sure everyone has the facts so they can make informed decisions, not ones based on misconceptions or fear. If you have ever heard any of these myths and they make you pause, please consider reflecting on some of the things you learned today before making a decision.

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True or false:

Grandparents can be donors.

True. No one should rule themselves out due to age, health, medical conditions, physical ability, gender, or sexual orientation! Additionally, the criteria required for organ donation do not apply to tissue and eye donation.

Answer: True! Every day, Donate Life Northwest receives calls from elderly people who no longer want to be donors, because they say, “I’m too old… nobody would want my kidneys!” 2026 data from Donate Life America states that 1 out of 3 deceased organ donors is over the age of 50.

First, there is no way of knowing if someone may die in the right circumstances to become a donor, and if so, they will be evaluated on a case-by-case basis as to whether or not they can be an organ donor. Additionally, they can likely still save lives through TISSUE or EYE donation.

Why is this?

Essentially, the criteria required for organ donation do not apply to tissue and eye donation.

The person does not have to pass away in a hospital – could be hospice, home, hospital, etc.
The person can pass away from natural causes.
Even having certain diseases – cancer, Lyme disease, etc. – may not prevent you from being able to donate tissue or eyes! Many tissues (cornea, cartilage, etc.) are avascular, meaning no blood runs through them, so they are not impacted by some diseases.
Organ donation is not ruled by the FDA, like eye and tissue donation. Potentially, organs from a drug overdose or even an IV drug user who has passed could be recovered if that organ is healthy enough. In a case like this, the organ bank would have the recipient sign a high-risk waiver because the organ is considered life-saving, as opposed to eye or tissue, where it is life-enhancing and under stricter guidelines.

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What are some careers related to donation and transplant?

Transplant Surgeon	Case Manager	Referral Response Coordinator	Community & Outreach Education
Speciality Physician	Speciality Pharmacist	Organ Preservationist	Dialysis Clinician
Transplant Coordinator	Social Worker	Hospital Development	Therapist
Nurse Practitioner	Dietician/Nutritionist	After Care Coordinator	Phlebotomist
Operating Room Nurse	Physical Therapist	Donor Family Referral Call Staff	Immunologist
Intensive Care Nurse	Laboratory Technician	Donor Family Advocate	. . . . and more