March 24, 2026
Grant A. Redstone is the program manager for the Donor Care Unit (DCU) at Mayo Clinic Hospital, Saint Marys Campus, in Rochester, Minnesota.
Before his role at Mayo Clinic, he worked for an organ procurement organization (OPO).
Here, he explains how organ donation is managed for trauma patients with nonsurvivable injuries.
When and why did Mayo Clinic open a DCU in Minnesota?
In October 2023, Mayo Clinic in Minnesota opened its DCU. LifeSource, an OPO in the Upper Midwest, describes donor care units as "dedicated clinical facilities focused on providing optimal and efficient care of organ donors prior to organ donation as well as the most advanced organ recovery techniques, which can improve the opportunities for organs to be successfully transplanted into waiting recipients."
A 2022 National Academy of Sciences report identified DCUs as best practice for optimizing organs for transplantation and research. In response, the OPO for Minnesota and North and South Dakota issued a request for proposal for hospitals to host DCUs. The OPO selected Mayo Clinic in Minnesota for greater Minnesota, North Dakota and South Dakota, due to its critical care air transport capabilities. It selected a Minneapolis hospital for the metro area.
When did you begin working at Mayo Clinic in Minnesota's DCU, and what is your role?
I began in February 2025. My prior work with an OPO as a hospital partner liaison included helping establish the donor care unit at a Twin Cities hospital, which provided useful experience for Mayo's program development. I serve as the liaison between the OPO and Mayo Clinic, staying connected with clinical units involved in donor management and working closely with the unit's medical director, nursing and administrative leaders.
How does Mayo Clinic in Minnesota define organ donation eligibility?
Organ donation may be considered when patients:
- Are mechanically ventilated.
- Have nonsurvivable injuries, such as severe head trauma with loss of two or more brainstem reflexes.
- Complete maximal available medical therapy.
- Have family members who have made end‑of‑life decisions on their behalf.
Two donation pathways exist:
- Donation after brain death (DBD).
- Donation after circulatory death (DCD).
Mayo Clinic in Minnesota began performing DCD organ transplants in February 2025. DCD status applies when a patient is not brain‑dead but cannot survive without life support. In these situations, families must determine whether continued life‑sustaining treatment would align with patient wishes.
Patients with metastatic cancer are not eligible for organ donation due to transmission risk.
The OPO makes all determinations regarding donor potential.
What precedes a determination to donate a trauma patient's organs?
ICU staff must contact the OPO when a patient meets the following criteria:
- Cannot survive without life support and is brain-dead.
- Has lost two or more brainstem reflexes.
- Has warranted end-of-life discussions.
- Scores less than 5 on a Glasgow Coma Scale.
The other criterion that triggers contact between the ICU and the OPO is when the patient's family inquiries about or discusses donation.
Options for the patient's family typically include transitioning the patient to comfort care or meeting with the OPO to discuss organ donation. If the family elects withdrawal of life support, the attending physician may authorize the OPO to approach the family, regardless of the donor designation on the patient's driver's license. If the family chooses to proceed with donation, the OPO begins donor management, including organ function assessment and allocation planning.
Who has the legal authority to make decisions about organ donations?
First-person authorization, as designated on the patient's driver's license, is the first indicator of that individual's desire to donate. The Uniform Anatomical Gift Act, established in 1968 and revised and adopted by most states in 2006, states that a donor's decision cannot be retracted posthumously.
However, if the individual has not registered a desire to donate organs, the legal next of kin determines whether organ donation will occur following an end‑of‑life decision. U.S. law outlines a hierarchy of decision-makers, beginning with the patient's legally authorized representative and proceeding through immediate family members.
What organs and tissues may be donated?
Kidneys are the most frequently donated organs. Others include:
- Cornea.
- Heart.
- Liver.
- Lungs.
- Pancreas.
- Skin and other tissues used for grafting.
- Intestines (less common).
How many lives can one donor potentially save or improve?
A single donor can save or significantly improve the lives of up to 70 individuals through organ and tissue donation.
How does Mayo Clinic protect patients and families during donation discussions?
Mayo Clinic maintains strict boundaries to ensure ethical practice:
- The hospital does not control or influence donation decisions; the OPO independently manages the process.
- Mayo Clinic advises the OPO on appropriate timing for approaching families to prevent undue pressure during acute grief or crisis.
These safeguards ensure that discussions occur respectfully and without coercion.
How does Mayo Clinic honor donors?
If the family chooses, an honor walk is held as hospital staff transport the patient to the operating room, with other staff lining the hallway to acknowledge the donor's gift. The hospital also raises the Donate Life flag to honor the patient and family.
Where are donated organs sent?
Organs enter the national allocation system, which considers waitlist status, geography and organ match. Organs may be transported anywhere in the United States. For example, if a Wisconsin patient matches an organ donated at Mayo Clinic, the receiving transplant center sends a retrieval team to Minnesota.
Is the number of donors keeping pace with the national need for organs?
No. Approximately 110,000 patients in the United States are currently on the transplant waitlist, and 17 patients die each day awaiting transplant. Although donor numbers are increasing, the waitlist is growing faster.
Can donors' families and recipients meet?
Yes. Donor families and recipients may choose to meet, but Mayo Clinic does not coordinate these interactions. Requests must be made through the OPO, and both parties must consent before contact occurs.
For more information
Donor care units in Upper Midwest. LifeSource.
National Research Council. Realizing the Promise of Equity in the Organ Transplantation System.