American Association of Healthcare Executives

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Approved by the Board of Governors Dec. 9, 2024.

Statement of the Issue

Medical advances have provided a tremendous opportunity to save and heal lives through organ, eye, tissue, blood and blood stem cells (marrow, peripheral blood and umbilical cord blood) transplantation. Each year, more than 46,000 lives are saved through transplantation and 2.5 million are healed through tissue transplantation. Despite significant improvements in the donation process in hospitals across the country, the national transplant waiting list continues to outpace the number of organs available.

Significant opportunities exist to increase both the proportion of eligible donors and the number of organs and tissues transplanted per donor. According to Donate Live America, at any given time, more than 100,000 people in the United States are waiting for a lifesaving organ.

To increase donation and transplantation:

• Ensure specific hospital procedures are developed in collaboration with affiliated organ and tissue procurement organizations to work with patients and families in honoring patient wishes to become a donor. Successful recovery of organs requires a coordinated approach to discuss donation with family members and significant others.
• Provide information to enable the organ procurement organization or referral center to access donor registries and support patient authorization for donation as documented in the registries.
• Heighten public and professional awareness of the need for registered organ, eye and tissue donors, and distribute informational resources.

Though governments, medical professionals, hospitals, organ procurement organizations and insurance companies can provide resources that support donation, only individuals and their families have the ultimate power to offer the gift of life.

Policy Position

The American College of Healthcare Executives believes all healthcare executives should work to increase the number of available organs, eyes, tissues, blood and blood stem cells (marrow, peripheral blood and umbilical cord blood) for transplantation. ACHE recognizes donation as a critical component of lifesaving technology and end-of-life decision making and supports voluntary efforts to increase organ, eye, tissue, blood and blood stem cells availability (see related Ethical Policy Statement: “Decisions Near the End of Life”).

As business and community leaders, healthcare executives have the influence and credibility to motivate individuals and families to consider the donation of organs, eyes, tissues, blood and blood stem cells. As healthcare professionals, it is part of their responsibility to do everything possible to honor someone’s wishes to be a donor. ACHE encourages its members to actively pursue the following:

Establish Protocols and Information Programs

• Establish effective and compassionate protocols in collaboration with their affiliated organ and tissue procurement organization for working with patients and their families. Families of dying patients who have not registered as donors should be provided with the information and option to donate.
• Provide families of registered donors with information and support. Many appreciate the opportunity to ease their personal loss with a selfless, giving act and to help their loved ones carry out a lifesaving gift.
• Collaborate with stakeholders to develop new and ongoing public information and education programs to help people understand opportunities for deceased and living donation, the advantages of registering with their state or national donor registry and the importance of sharing with their families the decision they have reached.
• Educate and train the public on the expanded U.S. Food and Drug Administration blood donor eligibility screening process, which eliminates questions based on sexual orientation and highlights opportunities for individuals who are HIV, HCV, and/or HBV positive to become organ donations.
• Support existing blood donation nongovernmental organizations in the development of new and ongoing public information and education programs that help people understand the process of blood donation and how to become a potential marrow, peripheral blood stem cells or umbilical cord blood donor.
• Require protocols to ensure timely referrals to organ procurement organizations of patients who meet the clinical criteria and are potential candidates for organ donation. Early notification allows for more time to facilitate the donation process, which enhances the chances of a successful donation outcome.
• Support efforts to provide access to state and national donor registries by people in the hospital community.
• Support policies and procedures that enhance equitable access to donation and transplantation opportunities, particularly for individuals from underserved communities who have historically been excluded.

Encourage Donation

• Encourage members of the medical community, particularly physicians and clinicians in the critical care setting, to develop protocols reflecting the best practices in the field to maximize organ, tissue, blood and blood stem cells donation and transplantation.
• Consider serving as a role model by publicizing your own personal decision to register as an organ and tissue donor and participate in blood drives or join the marrow registry. Healthcare executives can demonstrate leadership in addressing the resolution of this important social need by encouraging their staff to register and engage in education efforts.
• Participate in national, state and local government and private-sector initiatives to promote organ, eye, tissue, blood and blood stem cells donation.

Organ, eye, tissue, blood and blood stem cells donation and transplantation saves and heals lives. Healthcare leaders are the first system stakeholder to preserve the option of donation for all patients and families, ensuring the decision to donate is honored and provides hope for the many waiting for a transplant. ACHE encourages its members to develop an environment that fosters this opportunity.

Policy created: November 1986
Policy updated: December 2024