Generally, organs are not removed when a person dies, as most post-mortem procedures do not involve surgical extraction. For the vast majority of deaths, the body remains whole as it is prepared for final disposition, whether burial or cremation. Organ removal only occurs in two specific circumstances: when the deceased consented to organ and tissue donation, or when a medical or forensic examination known as an autopsy is required. These procedures are highly regulated and performed only under strict medical and legal guidelines.
Routine Handling of Organs After Death
When preparing a body for a funeral, internal organs are left in place within the thoracic and abdominal cavities. If a viewing is planned, the body is preserved through embalming to slow decomposition. Embalming involves injecting a chemical solution, typically formaldehyde-based, into the arterial system to preserve tissues.
Internal organs, which hold significant fluid, are preserved through cavity embalming. This process uses a surgical instrument called a trocar, inserted through a small incision near the navel. The trocar is used to drain fluids and gases from hollow organs, such as the stomach and intestines.
After draining, a highly concentrated preservative chemical is injected into the cavities to treat the remaining visceral organs. The organs are not removed but are chemically preserved in place. This procedure ensures the torso is properly prepared for viewing without compromising the body’s external appearance.
Organ and Tissue Donation Procedures
Organ removal for donation is a precise surgical procedure that occurs under two distinct medical pathways.
The first is Donation after Brain Death (DBD), which happens when a person has suffered an irreversible cessation of all brain function. Although a ventilator keeps the heart beating and blood circulating, death is legally declared. Maintaining circulation is necessary to keep the organs viable, and recovery surgery takes place in a sterile operating room.
The second pathway is Donation after Circulatory Death (DCD). This applies when a patient has a non-survivable injury but does not meet the criteria for brain death. In DCD cases, life support is withdrawn, and death is declared after the heart has stopped beating for a specified period, typically five minutes.
Following either pathway, a specialized surgical team recovers the organs (heart, lungs, liver, and kidneys), focusing on speed and sterile technique for successful transplantation. Only about 1% to 2% of all deaths meet the clinical conditions for whole organ donation. Tissue donation, including corneas, skin, bone, and heart valves, is a separate process that can occur up to 24 hours after circulatory death. These tissues do not require continuous circulation and are recovered while maintaining the donor’s appearance for viewing.
Organ Removal for Medical Examination
Organ removal takes place during an autopsy, a detailed medical examination performed to determine the cause of death or study disease progression. During this procedure, a pathologist makes incisions to access the internal cavities and systematically removes the organs. The organs are temporarily taken out to be weighed, measured, and examined for signs of injury or disease.
Small tissue samples are typically taken for microscopic examination, providing cellular-level detail regarding the cause of death. After the examination, the organs are treated and generally returned to the body cavity, often placed inside a plastic bag called a viscera bag. The body is then reconstructed, and incisions are carefully sutured before release to the funeral home.
In rare cases, specific organs or tissue samples may be retained for an extended period if further legal or medical study is required. Retention must be legally authorized, and the funeral home is informed if parts are not returned. This process is distinct from donation, as the purpose is diagnostic, not transplantation.
Legal Authorization for Organ Removal
The removal of organs, whether for donation or autopsy, is strictly governed by law and requires specific authorization.
For organ and tissue donation, the Uniform Anatomical Gift Act (UAGA) establishes first-person authorization in the United States. A person’s decision to register as a donor, often indicated on a driver’s license or state registry, is a legally binding gift that family members cannot revoke after death. If the deceased did not register, the legal next-of-kin may be asked to provide consent.
For an autopsy, the need for authorization depends on the type of examination. A hospital-requested or medical autopsy requires consent from the next-of-kin, allowing them to limit the scope of the examination. Conversely, a forensic or medicolegal autopsy is mandated by a coroner or medical examiner when a death is sudden, suspicious, or unnatural. This legal authority overrides the need for family consent.