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State Legislature Feature

The Alliance Launches Expanded Reference Guide for State-by-State Anatomical Gift, Determination of Death & FPA Legislation 


This week, The Alliance launched an expanded online reference guide for healthcare professionals at hospitals, organ procurement organizations (OPOs) and transplant centers to navigate the complexity of legislation and laws related to organ donation and transplantation. The reference guide is available here.

The need for an expanded reference guide was identified by the workgroup that created The Alliance’s DCD (Donation after Circulatory Death) Educational Resource Guide earlier this year. “During the work on the creation of the DCD guide, the workgroup saw there was a need for clear and precise language regarding legislation and laws,” said Karri Hobson-Pape, Executive Director of The Alliance. 

Curating state-by-state legislation

The Alliance’s new reference guide compiles anatomical gift laws and legislation for each state in the U.S. and links out to the relevant state code for the Uniform Determination of Death Act (UDDA) and the Uniform Anatomical Gift Act (UAGA), which includes the legislative requirements surrounding First Person Authorization (FPA), or donor registration.

Coordination of this work was initially led by Alliance Program Consultant Glenn Matsuki, and was later continued by Hedi Aguiar. The workgroup developed this expanded reference tool to support infrastructure to support the donation process. It will eventually be part of The Alliance’s Community Hospital Resource Guide and forthcoming DCD Educational Resource Guide.

“Our hope is that by providing this legislative resource, professionals working in the hospitals, OPOs, and transplant programs are able to locate the critical information needed more quickly and easily,” said Aguiar. “Future additions are anticipated and every effort will be made to keep this resource current.” 

Healthcare is managed state by state

Each state has their own version of the Uniform Anatomical Gift Act (UAGA), which outlines all of the rules around the gift of giving of organs, eyes and tissues, as well as their own version of the Uniform Determination (or Declaration) of Death Act (UDDA).

A majority of states have adopted the Revised UAGA, which emphasizes the legal binding nature of First Person Authorization (FPA) for donation. In most states, FPA takes effect after the death of a person, at which point the decision cannot be revoked or amended. One must then review how that state determines a person to be dead, according to that state’s UDDA. The only exception are minors, in which case the parents can usually amend the minor’s decision.

The Alliance’s revised legislative map curates links to the state laws and associated navigation steps, where needed. The relevant section numbers have been provided for reference of when FPA takes effect as well as the legally binding nature of the FPA.

The Alliance has made efforts to to highlight some of the nuances within a state’s UAGA and UDDA; however, it is not all inclusive. It is highly advised to read each state’s UAGA and UDDA thoroughly for clarity.

This legislative reference guide is not intended to serve in place of expert legal advice. For further detailed questions, please contact your local OPO and ensure that local policies are followed. To provide feedback or updates to this resource, please contact The Alliance at [email protected].


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