Why so many donated organs never get transplanted

ATLANTA, Ga. (Atlanta News First) — An average of 13 people die every day waiting for an organ transplant, but an Atlanta News First investigation uncovered that in Georgia alone in 2024, one in six organs were never transplanted.

“He loved this park,” Kristina Hernandez said. “I feel closer to him, I feel like he’s here.”

As Kristina Hernandez and her daughter Hannah Wood walk through East Roswell Park, they have a specific destination in mind: disc golf hole seven. It’s the area dedicated to Cesar Hernandez, with a special marker that memorializes the beloved father and husband.

A life of giving continues after death

Aside from his love of family and disc golf, Cesar Hernandez thoroughly enjoyed lip syncing contests.

“[He was] so full of life. Cesar loved to have fun,” Hernandez recalled.

Just like with singing, he gave everything his all in life. So it comes as no surprise that even in death, he’s given his all, too. The 51-year-old was an organ donor.

“Some days it feels longer days, it feels longer than two years. Some days it feels like a lifetime that he’s been gone,” she said.

In 2023, Cesar Hernandez died from an aortic rupture, a tear in the wall of a major artery.

“Fully processing the loss, I don’t think has yet occurred, because I’ve been in survival,” Kristina Hernandez said.

After Cesar Hernandez’s death, his family learned not only was he an organ donor but that he also agreed to a full body harvest, which includes donating skin, eyes, and tissue.

“So, that was really exciting because that is the epitome of Cesar. Give everything, and leave nothing on the table,” Kristina Hernandez explained.

His organ donations transformed and saved lives.

Staggering waste revealed

Atlanta News First Investigates found that saving lives is not always the case with organ donations. The analysis uncovered that in Georgia alone in 2024, one in six organs were discarded. Despite doctors recovering the organ from a deceased person, 17% of the time the organ was not used at all to save a life.

The gap is even bigger for specific organs like kidneys. The statewide analysis shows one in four kidneys were never transplanted.

The numbers matter to people like Clyde Williams, whose severe flu eventually caused acute kidney failure. Williams now does dialysis three times a week while waiting for a kidney.

“They say eventually you’ll get used to it,” he said. “I don’t want to get used to it. I’d rather have a new kidney.”

Williams’ health began deteriorating, leading to a leg amputation. At 42 years old with two active sons, the father misses being able to run around with them.

“I’m in this chair [and] hardly leave the house unless I’m going to dialysis,” Williams said.

When organs go unused, it not only costs patients like Williams time but also money. His older sister created an online fundraiser for all the mounting medical fees.

“I was just watching him, and I thought about how good of a person he is,” Terrail Williams said, “and what he means to me and the kids and so many things as my baby.”

National crisis acknowledged

The Association of Organ Procurement Organizations (AOPO) says the rate at which organs go discarded underscores a “mounting national crisis.” Across the U.S., 20% of all organs are never transplanted. AOPO is a nonprofit trade association representing 46 of the nation’s 54 organ procurement organizations (OPOs), which are the nonprofits saving and healing lives by coordinating deceased organ donations, supporting the families of donors, transporting donated organs to transplant centers, and providing public education about donation.

“We are as concerned as everyone else,” said Jeffrey Trageser, AOPO president. “We don’t like that when an individual or their family has chosen to share that precious gift, for it to not be used.

“It can be heartbreaking for the family.”

Atlanta News First Investigates found the main factors an organ goes unused include the quality or condition, such as a liver too damaged from alcohol use; logistics, including the commute time needed to deliver the organ, which can only be out of the body for so long before it becomes unusable; and potential patient outcomes, where doctors may decide against transplanting if they believe it could have negative outcomes.

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The AOPO said the patient outcomes factor is likely the leading cause of the discarded rate phenomenon, calling it a “misalignment of metrics.”

The organization suggests because transplant centers at hospitals must be mindful of negative success rates, they have been historically disincentivized from accepting more complex organs.

“It’s tragic because the families really want to really help as many people as possible,” Trageser said. “The goal is that everybody gets a transplant, and we know that right now nationally that 13 people pass away waiting for an organ, so the goal is to stop that.”

A recent Congressional commissioned study outlined recommendations to address the issue, including changing policies and algorithms that lead transplant centers to decline organs in the first place.

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