More than 80,000 people are waiting for organ transplants in the United States, and 16 die each day waiting for a match. For Kevin O'Connor of Needham, Mass., these statistics translate into job pressure. As director of organ donation services for the New England Organ Bank, he plays a critical role in finding organ donors and matching their hearts, kidneys, lungs, livers, pancreases, small bowels, blood vessels and other tissue to patients in need across the country.

O'Connor oversees day-to-day clinical operations of an organization that serves a population of 11 million people in six states, in cooperation with more than 170 donor hospitals and 12 transplant-performing hospitals. Working in the field for nearly 20 years, he has seen once-rare procedures, such as heart and lung transplants, become commonplace. But, as medical technology advances, the need for organ donation only increases. And while awareness of the need for organs is on the rise, the rate of consent by families of potential organ donors remains around 50 percent.

"The most important thing any individual can do if they wish to become an organ donor at the time of death is to make sure their family is well aware of their wishes," O'Connor explains. "The second is to register with their state or through their department of motor vehicles, so there is documentation of their intent to donate. As a rule, we still speak with the family, but if the family knows what their loved one wished, it makes their decision much easier and provides comfort to them."

O'Connor says that "organ bank" is a misnomer, because organs are procured and quickly transported to the patient in need, rather than being stored. In fact, time is always of the essence in the process of organ donation and transplant. As soon as a hospital identifies a potential donor, the organ bank sends staff out to meet with the family and offer the opportunity to consent to organ donation. If the family consents and the donor is found to be medically suitable, the information is fed into a national organ sharing database to obtain a customized donor match from the waiting list. The system uses various organ allocation factors, such as blood type and weight, to determine the best matches. As O'Connor explains, "You can't put a heart from a 200-pound man into a 9-day-old baby."

Organs are allocated preferentially to patients who are waiting in the same geographic area, except for kidneys, which can tolerate longer periods of cold preservation and therefore can be sent farther distances if there is a perfect match elsewhere. The final process of allocating one individual's donor organs often involves 12–16 hours of telephone conversations to ensure that patients receive them in order of priority.

For O'Connor and his staff, one of the biggest challenges is overcoming misconceptions and fears that people have about organ donation. "Some people express fears that if they agree to donate their organs, they won't be cared for in the same way as they otherwise would, which is completely false," he says. "Other people aren't familiar with religious policy on organ donation, although most major religions actively sanction it as a final act of generosity."

Such concerns are why family meetings are a key part of the organ donation process. It's not the right decision for everyone, O'Connor admits, but the vast majority of families are inclined to donate if given proper information. "We also know from extensive experience in following up with donor families that they derive tremendous and lasting comfort and solace in the knowledge that their loved one was able to provide others with the gift of life."

O'Connor says he is encouraged by the tremendous advances in organ transplant surgery, as well as the medications that increase survival rates of transplant patients. New therapies such as cell transplantation, which may replace the need for transplanting an entire organ in some cases, also are providing hope.

The biggest challenge remains that of increasing organ donation rates. "I take every opportunity I can to encourage people to seriously consider becoming an organ donor, and to communicate their intentions to their legal next of kin," O'Connor says.

Kevin and Joni O'Connor are the parents of Kathryn O'Connor, a UD sophomore majoring in criminal justice.