Organ donation growing in Iowa as donor network seeks to expand education

Organ donation saves hundreds of lives every year across the United States, and the Iowa Donor Network — the nonprofit that organizes organ donation in Iowa — is working to increase that number.

The Gazette talked with Natalie Oakes, a partner relations coordinator at the Iowa Donor Network, about the status of organ donations in Iowa, and the work the network is doing to educate more people about donation options.

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Q: How many organ donations does Iowa see each year?

A: Last year, in 2024, we had 130 total organ donors in the state of Iowa, which resulted in 387 total organs transplanted. Then we had … 1,114 tissue donors. Each tissue donor impacts anywhere from 50 up to 300 people's lives. Tissue can be used in the United States, but also our tissue can be sent internationally to help other countries that don't have tissue readily available to them.

Q: Do most Iowan organ donations stay in Iowa, or do they get sent to other states?

A: With organ donation, it can stay in Iowa, but it can also be sent to other states.

Q: What misconceptions do Iowans have about organ donation?

A: The first misconception is that we can only donate heart, lungs, liver, kidney, pancreas and intestines, when there’s so much more. There's organ donation and there's tissue.

Some other misconceptions that we see a lot is that there's a cost for donation. As an organ procurement organization, we do not charge the families for donation. And then the other one would be that you can't have an open casket viewing or a traditional funeral service. You absolutely can have that. It does not impact traditional funeral services whatsoever, and does not delay that process.

Q: If someone dies outside the hospital, are they still able to donate?

A: The important part with anybody being a donor is ensuring that we are notified of that death. We have to be notified of a death in order for organ and or tissue donation to occur and to offer that opportunity to the family.

For those that are passing away outside of the hospital, we're not always getting notified about that death in order to provide that opportunity to that family. We have about 30,000 deaths in the state of Iowa per year. We only receive about 12,000 total referral calls a year, or a little bit more, and that includes hospital and out-of-hospital. We're seeing about 22 percent of our overall referral calls come from out-of-hospital agencies.

Absolutely, yes. Deaths that occur outside the hospital, or in the hospital, they absolutely can be donors. The most important part is, in order for them to be a donor, Iowa Donor Network has to be notified that death has occurred.

Q: What other things determine whether someone can be a donor?

A: The donation outcome is driven by someone's medical suitability, so it's a screening done to determine their social and medical history, and then from there they can determine if someone can be a donor. As long as we're notified, then we go through a screening to determine if those individuals are medically suitable. The screening we do for out-of-hospital deaths or deaths that are in the hospital is the same.

Q: What work has Iowa Donor Network been doing to increase education and understanding surrounding organ donation?

A: My role, and my colleagues’ role as partner relations coordinators, our main responsibility is education. … Our main audience would be nurses, social workers, EMTs, paramedics, medical examiners and medical examiner investigators. Really, anyone that works in the medical profession that could be involved in a death. Our goal is to educate as many people as possible on their role in that process, so that way we ensure that upon every death, we receive a referral call. Our punch line is, “Every death, every time,” especially with those out-of-hospital agencies.

Q: How long have you been focusing on educating out-of-hospital agencies?

A: We’ve done it for many years, but over the last two years, I would say, we've really built projects up within our daily work to ensure we're really getting into those out-of-hospital agencies more and more, to see how we can increase those referring calls from our out of hospital agencies.

The work that we're doing definitely shows in numbers. … Two years ago, we reached a benchmark of over 1,000 tissue donors, and we've never had that in the state of Iowa before. Then this year, it increased again. … Every year we're seeing that increase, and part of that reason for that increase is because we're having more and more referrals, and more and more even out-of-hospital referrals.

Q: How can someone ensure that they can be an organ donor after they die?

A: I don't want to say that you're going to be guaranteed to be a donor, even if you're registered, because it's all going to depend on things at your time of death. Is the death noted to the Iowa Donor Network, and are you medically suitable?

You can be a donor, whether you're a registered or not registered donor. … As long as we do have somebody medically suitable, we can approach those families and offer that. However … if you register as a donor, or you donor-designate yourself to be a donor at your time of death, once you reach the age of 18 and older, your legal next of kin cannot change that decision postmortem.

So, registering to be a donor is incredibly important, because it does tell your family, “this is what I wanted to do.” It doesn't leave an open-ended area for the family to have to decide. If you're not registered, it is the family's decision: Do they donate? Do they not? Either way, we're going to talk with the family. We're going to let them know this is an option, and then get the next steps in moving forward. If we're registered, our families know what it is that we wanted, and it’s a lot the time a lot easier for them, those families, to move forward, because they know that's what we wanted.

Q: How can people register as donors?

A: You can register through your driver's license. That's the most common. There are a couple other ways. In Iowa, we always have the state registry online. So, if you go to our website, iowadonornetwork.org, there's a spot right on the main page that says register. You can register yourself there.

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“Also, very unique to Iowa is something called Logan's Law. Logan's Law was established after a 15-year-old boy from Charles City, Iowa, by the name of Logan Luft, he passed away in an ATV accident going into his freshman year of high school. Unfortunately, did not survive his injuries, but was able to be a donor. His family, about a year after his death, met with legislators in Iowa to get it passed to allow you to register as a donor when you get your hunting, fishing or fur trapping license. Since that law was established in the fall of 2019, we've had over 6,000 new registered donors added to our state registry.

It’s really cool in Iowa that we have all those ways to register, and the nice thing about is you only have to register one of those ways.

Q: What would be the process to ensure you won’t be a donor after you die if that’s what you want?

A: There’s no way in Iowa to mark no for registration. You're just not registered, which leaves it open-ended, which just leaves it open to your family to decide. So, it's just a conversation to have with your family that you don't want to be a donor at your time of death. … So, it's important either way, whether we're registered donors or not, just like so many other things, to have those conversations. If you're not registered, it is ultimately up to your legal next of kin to make that decision.

Comments: (319) 398-8328; emily.andersen@thegazette.com