Kentucky Transplant Probe Sparks Local Organ Network Fallout

The Honor Walk: A Tradition of Compassion and Sacrifice

At OneLegacy, a nonprofit organization dedicated to organ donation in Southern California, every organ donor is honored with an "honor walk." This solemn tradition involves hospital staff and the donor's loved ones walking alongside the donor in a quiet, respectful procession. It serves as a tribute to the donor’s final act of generosity—saving another person’s life through organ donation.

This walk begins with loss, but it also represents hope. “We have 9,000 recipients waiting on the waitlist, and if it wasn’t for our donor families, that would not be possible,” said Dr. Prasad Garimella, CEO of OneLegacy. “They are saving lives.”

OneLegacy is a federally designated organ procurement organization that operates across seven counties in Southern California. The nonprofit collaborates with 215 hospitals to coordinate the donation of organs, tissue, and corneas when a patient’s life has ended or is nearing its end. By law, hospitals in California are required to identify potential donors, and if a patient meets the clinical criteria, they are referred to OneLegacy for further assessment.

Most donations occur after a patient is declared brain dead. However, there is a growing trend involving donations after circulatory death (DCD), where a patient has suffered irreversible loss of heart or lung function and is on life support. The family must decide whether to withdraw life support.

“That decision is a combination between the attending physician and the family,” said Garimella. “That’s the process that is probably the most difficult.”

Despite the challenges, DCD has become increasingly common. Last year, over 44% of all donations were from patients who had undergone DCD. Approximately 20,000 recipients received lifesaving organs from these cases.

However, the DCD process has recently come under scrutiny. A Department of Health and Human Services investigation into a Kentucky-based organ procurement organization found “concerning patterns of risk” in the initial planning of organ recovery, particularly in smaller or rural hospitals. The investigation revealed instances where potential donors were prepared for organ retrieval while still showing signs of life or improvement.

“Transparency is key to improving the system and repairing the public trust,” said Rep. John Joyce (R-Pa). “This committee has and will continue to follow the facts so that we can restore trust and accountability within the system.”

In response to the findings, new safeguards are being implemented nationwide to protect donor patients. The Health Resources and Services Administration, one of two federal agencies overseeing organ donation, has directed the national transplant network to develop policies that halt a donation any time a family member, hospital staff, or organ recovery staff expresses concern about a patient's eligibility.

The investigation has sparked public concern. Donate Life California, which oversees the donor register, reported a significant increase in people removing themselves from the registry. In one day alone, 841 individuals opted out.

“I think with the rapid growth in donation after circulatory death, I think it is the right time to highlight it and start looking at process change,” said Garimella.

While California already has a robust and safe organ donation system, additional safety measures help ensure that a donor’s final act remains one of compassion rather than controversy. The honor walk, a symbol of respect and gratitude, continues to remind everyone involved of the profound impact of organ donation.