We asked David Fleming, the president and chief executive of Donate Life America, to sound off on the changing landscape of organ transplantation.

Mediaplanet: What is the importance of designating yourself as a donor?

David Fleming: Most Americans believe that organ donation is the “right thing to do.” However, many are uncertain how to make sure their wish to be a donor will be honored. The most important thing to do is to register as an organ, eye and tissue donor. This can be done on the national Donate Life registry by visiting RegisterMe.org. It is also important to communicate this decision to family members and loved ones so they will be aware of your legally binding decision.

MP: What are the advantages of first-person authorization?

DF: First-person authorization recognizes the individual’s right to be an organ, eye and tissue donor, even if family members disagree. This is a very “American” concept in that the individual’s wishes will be honored over and above those who succeed them. Family members typically want to honor the wishes of loved ones, making sure they know you want to be an organ, eye and tissue donor is a gift to your family, a decision they can honor and do not have to make on your behalf.

MP: Who is responsible for managing the organ donation process?

DF: Federally designated non-profit organizations called Organ Procurement Organizations and partner hospitals manage the donation process.  The National Organ Transplant Act of 1984 was enacted to make sure the process is carried out in a fair and efficient way.

"A surprise to many is the vast number of people that can be saved or healed through donation and transplantation. Donation is not just about organs."

MP: How do they determine who will receive the organ and can you specify who receives your donation?

DF: The national “matching system,” operated by the United Network for Organ Sharing, uses detailed medical information from both the donor and the potential recipient to determine the best match for organs that are available for transplant. Factors used during the matching process include blood type, degree of medical urgency, tissue typing, location, length of time waiting and many more.

In general, individuals cannot specify who receives their organs. While uncommon, family members of a donor may request that a donation be “directed” to a specifically named person who is waiting for a transplant. If the person named is a match and the organ is medically suitable in the judgment of the healthcare team, then the system will honor the request as long as there are no prohibitive logistical barriers.

MP: What’s one thing that people don’t necessarily know about organ transplants and donation?

DF: A surprise to many is the vast number of people that can be saved or healed through donation and transplantation. Donation is not just about organs. More than 100 lives can be saved or healed by the generous gifts of one donor. Such gifts might include tendons for ACL reconstruction, heart valves for replacement surgery or corneas to restore sight.

MP: What types of changes do you see being made in the future so that no one has to lose their life while waiting for an organ?

DF: I believe we will see amazing changes in the years to come. Incredible advances are being made in artificially constructed organs, there is increasing emphasis on increasing living donation and advances continue to be made in maximizing the number of lives saved by deceased donors. We will also continue to see support for those waiting from generous Americans who provide hope by registering to be donors

MP: Why is it more common for minority populations to be in need of a transplant?

DF: The need for organ transplants for some ethnicities is disproportionately high due to high incidence of medical conditions like diabetes or high blood pressure. An important fact related to this question is that people of the same race are often matches for each other so the need for registered minority donors is a vital element of the solution.