Understanding the Donor Registry: Your Decision Matters

February 18, 2026

The Law Behind Donation: What Is the UAGA?

Organ, eye, and tissue donation in the United States is guided by the Uniform Anatomical Gift Act (UAGA).

It may sound technical, but its purpose is simple.

  • Provides the legal framework for donation in all 50 states
  • Ensures your decision can be documented and respected
  • Gives you the choice to register as a donor or leave the decision to your next-of-kin

This law has been in place for decades and continues to guide how donation works today.


The U.S. System Is “Opt-In” – What That Means

In the United States, donation is not automatic. You are only included in a donor registry if you choose to be.

  • Saying “yes” at the driver’s license office, through KOG, MyChart, Apple, online, or another pathway adds you to the registry
  • If you have not registered, it simply means no decision is documented. It is not considered a refusal
  • No one is ever added to the registry without taking action

The decision is always yours.


Two Ways a Donation Decision Can Be Made

1. You make the decision during your lifetime
Registering as a donor creates a legally documented decision under the UAGA.

2. Your family makes the decision at the time of death
If no decision is recorded, your next-of-kin will be asked to decide (only if donation is clinically possible)

Donor registries exist to ensure that if you make a decision, it is clearly documented and accessible when needed.

At the same time, the system respects those who choose to leave that decision to their loved ones.


You Can Change Your Mind at Any Time

Your decision is yours to make

  • You can update your information
  • You can remove yourself from the registry

The registry is designed to reflect your most current choice.


First Person Authorization: Making Your Own Decision

In Kentucky, an important part of the law is called first person authorization.

This means that as a registered donor and are over 18, you are making a legal decision during your lifetime to donate after your death.

  • Your decision is documented in the donor registry
  • It can be accessed at the time of death by trained personnel
  • It is honored as your personal decision, like a will

Donor registries were created to give individuals a clear and legally recognized way to make their own decision.

Kentucky law also respects those who choose not to register and prefer for their next-of-kin to decide.

You are encouraged to talk to your loved ones about your decision.