Efficient organ donation touches donor families, recipients

"Nobody wants to think about their own death and nobody wants to think about their own mortality."Nick Shepherd, a senior external affairs coordinator of Tennessee Donor Services, has spent the last three years facilitating organ donation and educating the public. He said there are two sides to every story — a beautiful life gained and a heartbreaking, tragic loss."Many times when people go on and become organ donors, they weren't expected to die that day," he said.As an organ procurement organization, Tennessee Donor Services collaborates with transplant surgeons, recovery teams, organ donors, recipients and more to connect organ and tissue donations to people who need them. The nonprofit is headquartered in Nashville but services nearly the entire state with offices throughout the region.The state and the organization is efficient in terms of metrics. Tennessee has performed over 1,500 donations in the last year, with about 40% of those taking place in 2025. There were over 700 donors in the past year, with about a third of those donating this calendar year. And Tennessee ranks fourth in the nation for transplants performed per 10,000 people, although Shepherd noted that TDS is more focused on improving its own operations than comparing itself to others.Shepherd added that on most measurements, like the number of organs transplanted, the state is ahead of where it was at the same time last year. This is partly because of improved machinery and new techniques that allow organs to stay viable longer. Better technology also allows professionals to recover more organs from one donor.But even with improved processes — and even though TDS registered 170,000 people in 2024 as donors — the organization would like to see more registrations.Less than 1% of people become deceased organ donors, according to the Health Resources & Services Administration. This is because a person has to die under very specific circumstances in a hospital setting, usually while on a ventilator."It's similar to swimming underwater. You can only hold your breath for so long," Shepherd said. "If your organs are starved of oxygen and blood flow, then they die and they can't be put into anybody else."A larger registration pool could mean more donors for those waiting on organs. Currently, there are about 2,800 people on the waiting list for transplants in Tennessee. Although deceased organ donors have increased over time nationwide, about 13 people still die every day while waiting for an organ.Registering to donate can also be a gift for donor families and recipients, especially as they face complex emotions and grief.Donor families find peaceIn 2023, Hudson Lee passed away at 13 on a hike. Although he wasn't able to donate organs, he became a tissue donor. Amber Floyd Lee of Johnson City, his mother and a two-year TDS volunteer, said his donations helped about 15 people. A couple of recipients were even able to regain their vision.Lee said she coincidentally had a conversation about donation with her son a couple of months before his death. Those conversations are important to have with family, she said, even if it's just in the car on the way to a ball game."Even kids can tell their parents and their family what they want to happen," she said. "Giving somebody an understanding of what you would like to happen upon your death is a real gift."It's a sentiment echoed by David Lively of Kingsport, a TDS volunteer for nearly three decades. His son Adam was a senior at ETSU when a car accident his parents with the decision of donation."It was easier because Adam told his mom what he wanted to have happen," Lively said. "We had no control over what happened [with] Adam, but we could have control over what happened afterwards."A number of people received Adam's pancreas, liver, eye tissue and heart. The family has also met some of the recipients."It's quite a deal to be able to put my hand on Ken's chest and feel Adam's heartbeat," Lively said.Along with gaining peace from knowing Adam's decision, Lively feels closure from knowing his loss came with a good outcome from others."I am convinced that at the hardest moments in your life, that if you can do something to benefit someone else, that's the opportunity you need to take," Lively said.Recipients feel gratitude, guiltThat opportunity comes with an immense deal of gratitude for recipients. It is also partnered with a sense of guilt.At one point, Joe Carder thought he would never see the hills of East Tennessee again. Heart medication decimated his liver, leaving him in need of a transplant in 2014. When he finally received a transplant at the age of 61, Carder felt guilty after learning his donor was a 26-year-old."I'd already lived a long life," he said. "Here he was, 26, just starting out."Carder added that he thinks all transplant recipients go through these feelings. But he also believes that organ transplants change recipients for the better. Since getting his "11 bonus years," Carder has volunteered with TDS, travelled to almost every U.S. state, competed in competitive games for recipients and spent valuable time with his grandchildren."[Recipients] want to live the rest of their lives in a way that would make their donor proud," he said. "You can't express it in words how much you do appreciate that gift… not many people get a second chance at life."Tennessee residents can register as an organ donor at their local Department of Motor Vehicles or online at https://donatelifetn.org/donor/create.