Imagine this.
A donor heart becomes available.
Somewhere, several people desperately need a heart transplant.
Each of them has a story.
Each has people who love them.
Each wants more time.
So...
Who gets the heart?
And maybe the bigger question:
Who decides?
Before my own transplant, I certainly didn't understand everything happening behind the scenes.
I knew there was a waiting list.
I knew donated organs had to be matched with recipients.
But I didn't fully understand how a particular heart ultimately makes its way to a particular person.
And I think that's true for a lot of us.
Because from the outside, it's easy to imagine someone somewhere simply making a decision:
Give it to this person.
That's not how it works.
A Doctor Doesn't Simply Pick Someone
Organ allocation uses a structured system designed to match donated organs with appropriate transplant candidates.
For a heart, several factors can matter.
Medical urgency.
Blood type and other compatibility considerations.
Body size.
Geographic distance and timing.
Waiting time.
The exact process is more complicated than any short article can explain, but the important thing to understand is this:
A donated heart isn't awarded to whoever somebody believes deserves it most.
That means it isn't simply:
Who has the most money.
Who knows the right person.
Who has the best insurance.
Who has the most compelling story.
Who is the most important.
Or who a doctor happens to like.
There are established allocation policies and medical criteria governing how donated organs are offered and matched.
Why Matching Matters
A donated heart is extraordinarily scarce.
But scarcity isn't the only issue.
A heart also has to be medically appropriate for the person who may receive it.
You can't simply take the next available heart and give it to the next person waiting.
The system has to consider both the needs of potential recipients and whether that particular donated heart can appropriately be offered to a particular patient.
That's why the phrase “waiting list” can sometimes create the wrong mental picture.
It sounds like a line.
But transplantation is also about matching.
And that distinction became very personal for me.
I Didn't Win My Heart
In 2022, I spent seven weeks in the hospital waiting for a donor heart.
During those seven weeks, I had no control over what happened outside my hospital room.
And truthfully, barely any control over what happened inside it.
My days belonged to monitors, medications, tests, doctors, nurses and a body that was no longer taking instructions from me.
I couldn't find my own donor.
I couldn't move myself ahead.
I couldn't persuade anyone to choose me.
I couldn't make the right heart become available.
I could only wait.
Then, on July 4, the call came.
Somewhere, a donor heart had become available.
And through an extraordinarily complex process I couldn't see and couldn't control, that heart was offered and ultimately matched with me.
That realization still matters to me.
I didn't win it.
I wasn't chosen because my life mattered more than someone else's.
I wasn't more deserving of another tomorrow than the people who were still waiting.
I matched.
And on July 5, 2022, that donor heart became the heart now beating inside my chest.
Why Understanding the Process Matters
Organ allocation is complicated because what is at stake couldn't be more significant.
There are people waiting whose lives depend on receiving an organ.
There are donor families whose generosity has made transplantation possible.
And there is a donated organ that must be matched and transplanted within very real medical and logistical constraints.
Understanding that doesn't remove the heartbreak.
It doesn't make waiting easy.
And it certainly doesn't change the reality that there are people who will continue waiting after another person receives a transplant.
But understanding can replace one misconception:
Somebody simply decides who deserves the organ.
with something much closer to reality:
Organs are matched through an established allocation process.
I wasn't handed a prize.
I wasn't declared more valuable than someone else.
A heart became available.
And I matched.
Sometimes clarity begins by understanding something we never knew enough to ask about.
Know what's true.
Then make your decision.
——— ❤️ ———
AN ORGAN DONATION EDUCATIONAL MOMENT
One question. One fact. One story. One moment at a time.
Not pressure. Not persuasion. Just understanding.
Because education matters.
Wayne Adam Greer
Author • Heart Transplant Recipient
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