You Don't Have to Be Dead to Donate Organs Anymore

America’s transplant system: now with 73% more horror

You know that old saying, “They’ll rob you blind”? Well, in 2025, the American healthcare system took it to a whole new level: They’ll also harvest your kidneys while you’re still blinking.

This week, the U.S. Department of Health and Human Services—the agency that’s historically been as successful at “regulating” healthcare as a mall cop might be at “securing” the Pentagon—announced a bold new reform of the nation’s organ transplant system. The reason? Oh, just a teeny-tiny scandal involving a federally funded organ procurement organization that got caught trying to excavate vital parts from patients who weren’t actually dead.

Yes. You read that correctly.

They were “not deceased at the time organ collection was initiated.”

Even though it’s a statement so dystopian it sounds like it was stolen from a Black Mirror script, sadly, you’re probably not even surprised.

HHS’s Health Resources and Services Administration (HRSA) recently reviewed 351 cases where organ donation was “authorized but not completed” (because the ‘deceased’ wasn’t actually deceased, oh how I wish I were making that up). In 73 of those instances, patients still had brain activity “incompatible with being a donor” (meaning they had some), and in at least 28, doctors were basically standing over the bed with a scalpel while the “donor” was exhibiting visible, measurable signs of life.

This isn’t a minor design flaw or a bad business plan. It’s a horror movie with a billing department.

The worst part: we’re not talking about some back-alley body-part operation run out of a van here. This was Network for Hope, an independent, nonprofit organ procurement organization (the 16th largest in the US, they’re proud to note!) serving Indiana, Kentucky, Ohio, and West Virginia. You know, the heartland. Where you’re supposed to die peacefully in a rocking chair, not get fast-tracked to the morgue because your organs look especially fresh.

The organization’s response to the investigation was shame, remorse, and a plea for judicial mercy.

Just kidding.

CEO Barry Massa told Reuters that Network for Hope is excited to work collaboratively with the very agency that’s threatening to decertify them, and he “encourages the development of policies” to support the system.

Ah yes, policies. Because that’s what’s been missing this whole time! Not ethics. Not oversight. Not common cotton-pickin’ sense. Policies.

(Network for Hope is also big into DEIB—they added B for belonging, just to be extra-extra—you will not be surprised to learn.)

Meanwhile, HRSA confirmed that similar patterns of high-risk retrieval practices are happening at other organ procurement organizations (known as OPOs, for those following along with the acronym soup of doom). In other words, this isn’t one rogue outfit. It’s the system.

Let’s not kid ourselves. Organ donation isn’t just a noble life-saving endeavor, it’s also a jaw-droppingly profitable industry. The global transplant market is worth over $16 billion annually and climbing exponentially, with individual organs fetching tidy sums: a single kidney can be valued at upwards of $440,000 when you add up procurement, transplant surgery, and follow-up care. Nonprofits like the OPOs aren’t technically selling organs, of course—that would be ghoulish—they just facilitate the process and bill Medicare and insurers for the logistics, the procedure, the preservation, the transport, and possibly the snacks.

So while hospitals and independent surgical scavengers may not be auctioning kidneys off on eBay [*that we know of*], they are most definitely getting rich off the “gift of life.” Which makes the rush to declare someone brain-dead just a tiny bit suspicious, don’t you think?

Here’s just one gruesome example: In 2021, TJ Hoover, a 33-year-old Kentuckian, was hospitalized after an overdose. Doctors declared him brain-dead. Later that day, he woke up in the OR as staff shaved his chest and discussed which organs to take. (Seriously.) He was responsive, making eye contact, and shaking his head—but the transplant team had already begun prepping his body for removal.

The only reason TJ is still alive is that a surgeon noticed his reaction to stimuli and stopped the procedure.

Let that sink in: he wasn’t saved by the system. He was saved by a lucky flinch.

Former staff involved in the case insisted they raised concerns at the time, but according to the federal investigation, those warnings were ignored. The organization later told CNN it had reviewed the case and remained “confident that accepted practices and approved protocols were followed.”

It’s a legitimate—and vital—question.

To recap:

• 28 people—that we know of, from one OPO—may have had organs harvested while still alive

• 73 showed neurological activity that should have disqualified them from donation but were being processed anyway

• No one was arrested

• No major network covered this scandal for more than five seconds

• We’re all just supposed to keep signing our driver’s license donor cards like this isn’t turning into Soylent Green: The Sequel.

One has to wonder: how are hospitals not recognizing that a patient is “incompatible with donation”? This is basic biology. You’re either brain-dead (the key requirement for legally and ethically harvesting organs) or you’re not. We’re not talking kinda comatose, or a little bit vegetative. Donors must have irreversible loss of all brain functions.

Not sure? Fair. It’s a complex diagnosis! Take your time. Conduct a rigorous exam. Order some confirmatory tests. Call in some colleagues for a second—or twenty-second—opinion. WAIT A DAY OR TWO so that there’s zero ambiguity. I know you want that liver—cha-ching!—but this isn’t really a judgment call you should make between afternoon rounds and happy hour.

And where are the watchdogs? Oh, right. They’re at brunch with Pharma lobbyists, sipping bottomless mimosas and discussing language for the next “trust the science” campaign.

In response to the findings, HHS has graciously instructed the OPO in question to implement a procedure allowing any staff member to stop a donation in case of “patient safety concerns.” (Apparently before this, if Janet in billing noticed the donor was humming “Sweet Caroline,” there wasn’t a process to yell “WAIT!”)

The tragic part is, this information will undoubtedly make people hesitant to donate organs. And frankly, it should. When I’m unequivocally dead-and-gone, with negative-eleven chance of resuscitation, I hope and pray that the working bits of my remains can save a life or seven. (Right now, there are 103,223 men, women and children on the national transplant waiting list; thirteen of them die every day waiting for upgraded body parts.) As long as I don’t need ‘em, knock yourselves out. But if there’s even a sliver of a chance that a hospital’s going to finish me off—or even be a tiny bit slow to respond to distress signals—so they can make a swift and ridiculous profit, I’m ripping that ORGAN DONOR sticker off my license and calling it a day.

I’m all for saving lives, but honestly, not at the cost of my own (*unless it’s for my family, then you can run me over twice and harvest anything you’d like). LMK what you think in the comments. :)

You cannot have my spleen, but you CAN have my signature on this book. Win!