If your loved one is dying or has just died, someone from the hospital may raise organ donation. It can feel like too much to hear, at the worst possible time. You may also be wondering whether donation was something they wanted, or what it means for the funeral. This guide explains how donation works after a death, who has the authority to decide, what it costs your family, and where whole body donation fits. There is no right answer. The goal is to give you clear facts so you can decide with less pressure.

Quick answer
What happens with organ donation after someone dies?

The hospital notifies the local organ procurement organization (OPO), which decides whether donation is medically possible. If the person registered as a donor, that registration is legal consent. If not, the OPO may ask the next of kin. Your family does not pay for donation, and an open-casket funeral is still possible.

  • A registered adult's decision generally cannot be changed by the family.
  • Donation happens only after all lifesaving efforts have failed.
  • Whole body donation is a separate process with its own rules.

How Organ Donation Works After a Death

The federal Health Resources and Services Administration (HRSA) describes the steps. Donation is usually possible only when a person dies in a hospital while on artificial support.

  1. Doctors try to save the person. The medical team does everything possible to save a life. Donation does not become a possibility until all lifesaving methods have failed. The team caring for the patient and the transplant team are separate.
  2. Doctors test for brain death. Brain death means no brain activity, no ability to breathe without support, and no chance of recovery. Doctors confirm brain death and note the time of death. Then organ donation is possible.
  3. The hospital calls the OPO. Federal rules require hospitals to notify the OPO in a timely manner about patients whose death is imminent or who have died (42 CFR § 482.45). The OPO decides whether the person is a possible donor.
  4. The OPO confirms consent. It checks the state registry, and may check the driver's license or another legal form. If there is none, it may ask the next of kin for approval.
  5. Medical evaluation. The OPO collects a medical and social history, often from the family.
  6. Matching and surgery. A national system called the OPTN matches each organ to a patient. A surgical team removes the organs, then approved tissues such as corneas, bone, and skin, and closes the incisions.

Organs stay healthy for only a short time after removal, so the process moves quickly. The OPO is the best source of information on timing in your situation. For what else happens at the hospital, see what to do when someone dies in a hospital.

Who Decides

If your loved one registered

HRSA says an adult who signed up in their state's donor registry has legally given permission for donation, and no one can change that consent. Florida's law says the same thing in legal terms: a gift made by a qualified donor is irrevocable after death, and a family member, guardian, or health care surrogate may not modify, deny, or prevent it (Fla. Stat. § 765.512). Other states' laws are similar but not identical.

A donor card alone is not enough, according to HRSA. The registry is what hospitals check. A donor mark on a driver's license matters too. A will is a poor place to record the wish, because it may not be read until after the time for donation has passed. Washington's law says a gift made by will takes effect at death whether or not the will is probated, but the family may not know to look.

If your loved one did not register

The OPO may ask the next of kin. State laws set who counts as next of kin, and they follow a priority order. Under Washington's version of the Revised Uniform Anatomical Gift Act, the order is:

  1. An agent of the person at the time of death
  2. A spouse or registered domestic partner
  3. Adult children
  4. Parents
  5. Adult siblings
  6. Adult grandchildren
  7. Grandparents
  8. A guardian of the person
  9. Anyone else with authority to dispose of the body

The person must be reasonably available, and a person in a higher class who is available and objects takes precedence over those below. Your state's list may differ in order and detail, so ask the OPO who in your family has the authority.

If you do not know what they wanted

Think about what you know of their values and past comments. Look for an advance directive, since many include donation preferences. See what is a living will. You can also ask other relatives and close friends. If you are unsure, it is fine to ask for time to talk with family, though ask the care team how much time there is.

What It Costs Your Family

HRSA says the family does not pay for donation. Your family pays for medical care and funeral costs, but not to donate organs. Insurance or the people who receive the donation pay those costs. Federal law also makes it illegal to buy or sell organs (42 U.S.C. § 274e). The law allows reasonable payments for removal, transportation, and processing, which are not payments to the family.

If you receive a bill that mentions donation, ask the hospital and the OPO about it before paying. For funeral costs, see average funeral cost.

Donation and the Funeral

HRSA says donation does not prevent an open-casket funeral. The surgical team treats the body with care and respect and closes all incisions. If you plan a viewing, tell the funeral home that your loved one was a donor, and ask the OPO about when the body will be released.

Burial and cremation remain open to you. See how to plan a funeral and cremation vs. burial. For the paperwork that follows, see how to get a death certificate.

Whole Body Donation Is Different

Giving the whole body to a medical school or research program is separate from organ donation. It does not go through the OPO. The family contacts the program directly, and each program sets its own rules.

QuestionWhat programs say
Can someone do both?HRSA says total body donation is often not an option if you donate organs and tissue, though you may still donate eyes. The University of Minnesota says yes, and works with organ donor groups to allow both. UC Davis says organ recovery is completed before the donor arrives, but asks that donors avoid donating skin, bones, or vessels
What does it cost?The University of Minnesota says it typically has no cost to the next of kin. UC Davis says its program is entirely free and arranges transportation and cremation. A funeral before donation is the family's expense
How long does it take?The University of Minnesota says donation lasts 2 to 18 months, after which remains are cremated or buried
Are remains returned?It varies. UC Davis says remains cannot be returned to the family

If your loved one signed up with a program, call it as soon as you can after the death. Programs decide whether to accept a body, so have a backup plan for cremation or burial. See cremation vs. burial for choices.

Who Can Donate

Many families assume their loved one was too old or too ill. HRSA says there is no age limit to organ donation, and that people with an illness may still be donors. Doctors decide at the time of death whether donation is possible. HRSA also says people are matched with organs based on medical need, not citizenship.

Eligibility is the OPO's decision, not the family's. If your loved one cannot donate organs, ask whether eye or tissue donation is possible.

Questions to Ask the Care Team

  • Is my loved one registered as a donor?
  • How much time do we have to decide?
  • What organs or tissues are being considered?
  • Will this change our plans for a viewing or funeral?
  • Who is the main contact at the OPO?
  • Will we receive any bills related to donation?
  • Can we be with our loved one before and after?

Ask for a chaplain, social worker, or someone you trust to sit with you. Grief affects how well anyone takes in information, so write answers down.

Planning Ahead: Register and Tell Your Family

If you want to be a donor, you can register in your state registry or at your motor vehicle office. HRSA says you can also change your status at any time. The most helpful step is to tell your family, since they may be asked about your wishes. Add the decision to your advance directive and your emergency information list.

For how many people are in need, HRSA reported over 103,000 people on the transplant waiting list as of September 2024, and another person added about every 8 minutes.

Frequently Asked Questions

Can the family override a registered donor's decision?
Generally no. HRSA says that an adult registered in a state donor registry has legally given permission and that no one can change that consent. State laws such as Florida's also say a family member cannot modify, deny, or prevent a donor's gift after death.
Does the family pay for organ donation?
No. The family still pays for medical care and funeral costs, but not for donating organs. Insurance or the recipients pay those costs.
Can you still have an open-casket funeral?
Yes. HRSA says that donating organs, eyes, and tissues does not prevent an open-casket funeral.
Who decides if the person was not registered?
The organ procurement organization may ask the next of kin. State law sets the order. Washington's version of the uniform act, for example, lists an agent first, then a spouse, adult children, parents, adult siblings, adult grandchildren, grandparents, and guardians.
Can someone be an organ donor and donate their body to science?
Often not both fully. HRSA says total body donation is often not an option if you donate organs and tissue, though you may still donate eyes. Some programs, such as the University of Minnesota's, work with organ donor groups to allow both. Ask the program directly.
Will the doctors do less to save a registered donor?
No. HRSA says saving your life comes first, and donation becomes a possibility only after all lifesaving methods have failed. The medical team trying to save a life and the transplant team are separate.
Next step: Read what to do when a parent dies or what to do when a spouse dies for the steps that follow. Our complete guide covers every step after a death.
Reviewed October 6, 2026
Official and primary sources used for this guide

We reviewed this page against federal agency pages, federal law, and state statutes used as examples. Donation rules and the order of next of kin differ by state, and whole body donation programs set their own policies. Ask the organ procurement organization or the program about your situation.

Page last reviewed: October 6, 2026