Regulatory
What is the Donor Registry?
- Legal authorization to donate all eligible organs and tissues upon the individual’s death for transplantation.
- Donor Alliance checks in and out of state registries for every potential organ/tissue donor.
- A Donor Alliance Family Services staff member will go over the registry and disclosures as well as provide a copy to the family.
- If the individual is not registered, legal next of kin (as outlined in the UAGA) will be asked to authorize for donation on their behalf. A lack of a registry is not a formal decline of donation, it is the lack of a decision, this allows for authorization on the patient’s behalf.
The Uniform Anatomical Gift Act (UAGA)
- The Uniform Anatomical Gift Act is the law that governs deceased donation
- Link to WY and CO UAGA
- The UAGA is based on gift law not informed consent, it is a legally binding, uncompensated transfer from one individual to another.
- The law firmly states that a donor’s autonomous decision to make an anatomical gift is not subject to change by others.
- First Person Authorization
- Colorado statues C.R.S, 12-34-104. Who may make anatomical gift before donor’s death (a) Subject to section 12-34-108, an anatomical gift of a donor’s body or part may be made during the life of the donor for the purpose of transplantation , therapy, research or education in the manner provided in W.S. 35-5-205 bu” (i) the donor if the donor is an adult or if the donor is a minor and is emancipated or authorized under state law to apple for a driver’s license because the donor is at least sixteen (16) years of age.
- Wyoming statues W.S. 35-5-204. Who may make anatomical gift before donor’s death (a) Subject to W.S.35-5-208, an anatomical gift of a donor’s body or part may be made during the life of the donor for the purpose of transplantation , therapy, research or education in the manner provided in W.S. 35-5-205 bu” (i) the donor if the donor is an adult or if the donor is a minor and is emancipated or authorized under state law to apple for a driver’s license because the donor is at least sixteen (16) years of age.
- The UAGA also outlines who is the legal next of kin who may make an anatomical gift on the decedent’s behalf
- MPOA
- Spouse
- Adult Child
- Adult Sibling
- Adult Grandchildren
- Grandparents
- Adult exhibiting special care and concern
- Legal guardian
- Person having the authority to dispose of the decedent’s body
CMS Rules and Guidelines
- CMS Conditions of Participation {42 CFR §482.45(a)(5)} require that “hospitals work cooperatively with the OPO while necessary testing and placement of donated organs, tissues, and eyes takes place.”
- Colorado statues C.R.S. 12-347-114 (c): “When a hospital refers an individual at or near death to a procurement organization, the organization may conduct any reasonable examination necessary to ensure the medical suitability of a part that is or could be the subject of an anatomical gift for transplantation, therapy, research, or education from a donor or a prospective donor. During the examination period, measures necessary to ensure the medical suitability of the part may not be withdrawn unless the hospital or procurement organization knows that the individual expressed a contrary intent.”
- Wyoming statutes W.R.S. 35-5-213 (c): When a hospital refers an individual at or near death to a procurement organization, the organization may conduct any reasonable examination necessary to ensure the medical suitability of a part that is or could be the subject of an anatomical gift for transplantation, therapy, research, or education from a donor or a prospective donor. During the examination period, measures necessary to ensure the medical suitability of the part may not be withdrawn unless the hospital or procurement organization knows that the individual expressed a contrary intent.”
Frequently Asked Questions
Legally, a family does not have the right to overturn their loved one’s donation decision. The law governing donation decisions is gift law—like a person’s will, the surviving family members do not have the right to overturn this decision. Sometimes, a family member may have concerns that a person on the registry did not fully understand what donation entails; however, donor designation is not based on principles of informed consent.
The key components of honoring all donation decisions are collaboration with all levels of the hospital, frequent and broad communication, providing the patient hemodynamic support, and allowing the family adequate time. Donor Alliance has proceeded on several cases where the family has been opposed to someone’s donation decision. We have standard communication protocols to ensure involvement from both Donor Alliance and the hospital.
The DMV provides: “What it Means to Sign Up as an Organ, Eye and Tissue Donor: Signing up as an organ, eye and tissue donor means you have made the decision to donate your organs, eyes and tissues at the time of your death. Your decision to be a donor takes priority over your family’s preferences so it’s important to discuss donation with your loved ones.”
No, the UAGA does not work differently for DCD cases. Donation should still move forward in a DCD scenario, as the UAGA does not address how a donor dies or pathways to donation. Following a referral, the UAGA requires the hospital maintain necessary measures to ensure a registered potential donor is medically suitable, so that the organ procurement organization (OPO) can complete examinations to ensure organs are medically viable for donation.