When it comes to organ donation, there’s a natural tendency to focus on the good. But investigations and whistleblowers have exposed a darker reality: donors rushed toward organ removal too soon. When a transplant involves so much money, are some in the chain too eager to declare a life lost? Today, shocking cases where people appeared to wake up or show brain activity right before or even during surgery to remove their organs. Federal reviews show it’s surprisingly common. Now there’s a focus on fixing the system without without losing the lifesaving gift so many still need.

The following is a transcript of a report from “Full Measure with Sharyl Attkisson.”
Watch the video by clicking the link at the end of the page.

After tragedy, the Honor Walk ceremony offers a powerful tribute to organ donors this one last October in Alabama for 18-year-old Kimber Mills. She’d been shot in the head and was taken off life support three days later, her heart and lungs given to save lives.

Since 1988, more than half a million US organ donors have made 1.1 million transplants possible. 170 million Americans are registered donors, yet more than 100,000 people still wait. Organ Procurement Organizations, OPOs, are nonprofits tasked with managing, removal, and transfer.

But major investigations have exposed disturbing cases involving the “gift of life.”

Nycki Martin: There are some people that will take advantage of a living person and maybe see them more valuable, dead than alive.

As an industry insider, Nycki Martin became a whistleblower. She’s a former surgical preservation coordinator for Kentucky Organ Donor Affiliates or KODA.

Martin: I just wanted to be a part of something that was a way to take something tragic and turn it into something beautiful. Quickly found out as soon as I got involved, that was not really the case of what was going on. There are good parts to organ donation, but there’s also a very dark side of it.

“The dark side,” she says, starts with Organ Procurement Organizations, OPOs, targeting potential donors from the moment they arrive at a hospital.

Martin: They have access to your medical charts. They follow you. Every shift change really to kind of watch and see what your prognosis is gonna be and where you’re at, which I think is deceptive from the beginning because your personal information is being viewed by someone who you do not give permission to, because you’re unresponsive. So that’s kind of the first step of deception.

But it’s the alarming case of TJ Hoover that she says really opened her eyes. In 2021, Hoover was declared brain-dead after a drug overdose. He was prepped for organ donation, even when he repeatedly showed signs of life.

Martin: TJ was taken to have a cardiac catheterization done to look at the quality of his heart as he was becoming an organ donor. His family had consented to that. TJ was registered. So during that process, TJ woke up for the very first time in seven days. He was paralyzed and sedated, taken back to the ICU. The family was never told what happened, was never told that he woke up.

TJ Hoover was still pushed toward organ removal, overseen by Martin’s then-employer, Kentucky Organ Donor Affiliates, again KODA for short.

Martin: During his honor walk, he woke up even more, was more responsive, was tracking with his eyes, looking around. The family was told by the KODA coordinator that that was just reflexes, and that’s not true. He was waking up. So when we got him to the OR, TJ was pulling his knees up to his chest crying, trying to pull out his, you know, endotracheal tube, you know, visibly upset, you know, aware what was going on. And then TJ was administered six milligrams of morphine during that time to calm him down, which was unnecessary. We should have reevaluated over and over and over. And there were so many opportunities to do the right thing, and they just failed TJ and his family.

The procedure to take Hoover’s organs was finally halted— when doctors refused.

Martin: As soon as the doctors walked out of the room and said that they weren’t gonna do this case, our KODA coordinator called KODA’s admin and told them, you know, “What, what do we do? What, what are we gonna do now?” And KODA’s admin said, “find another doctor who will pursue the case. ’cause we’re going to finish the case.” So that was very alarming.

No doctor did “finish the case.” Hoover survived and recovered, though he remains disabled. More than four years later, he lives with his sister.

KODA, now “Network for Hope,” insists all protocols were followed, and says the accounts “greatly misrepresent” the case. But it has announced reforms and said it’s committed to transparency and rebuilding trust.

Federal investigations concluded the group acted improperly. They also flagged broader issues: inadequate assessments, poor communication, and other problematic cases.

An equally startling case in Texas made headlines in 2015. George Pickering, pulled a gun and locked down an hospital to stop doctors from removing life support from his 27 year old son— an organ donor declared brain dead. During the standoff, the son repeatedly squeezed his father’s hand upon request. Organ removal was halted and the son recovered. Pickering served a year in prison, but had saved his son’s life.

A shocking review by the federal government found in one in three cases, donors showed signs of life after organ removal began, such as response to pain, crying, or gasping— causing the procedures to be aborted.

Martin says pressure to meet metrics can lead doctors to give high doses of opiates.

Martin: We were pursuing organ donors with a really high GCS, which means that they’re, you know, they’re awake, they’re just not verbal or, you know, they’re sick, but they’re not catastrophically ill. They’re given opiates most of the time. It’s, you know, morphine, dilaudid, things like that. But, subsequently these medications suppress your respiratory drive and then your heart stops. So basically guaranteeing an organ donor, and that’s the scary part.

Critics say Organ Procurement Organizations or OPOs face heavy pressure to meet metrics set by Medicare and Medicaid, where they get most of their money.

But something worrisome happened after a federal rule in 2020. To encourage important pancreas research, the rule lets OPOs count pancreases removed for research — not actual transplants — toward performance scores. That led to an unusual spike. For example in Kentucky, where TJ Hoover was hospitalized, pancreas removals jumped from 83 in 2021 to 441 in 2022.

Senator Ron Wyden spotlighted that issue in a bipartisan investigation. He notes that pancreas removals for research have quadrupled, inflating transplant metrics for some Organ Procurement Organizations.

Senator Ron Wyden: For example, we’ve seen something called the pancreata loophole and this was based on trying to find a way to address the rating system and show that you are giving good quality. And basically all it has done is create, skepticism and cynicism because it’s made the system less functional.

Sharyl: There have been some whistleblowers and investigations looking into the possibility, as some claim, that sometimes people’s organs are harvested before their time. Are you concerned about those stories and what have you learned?

Wyden: Very much so. And even one of those incidents is too many. And we’re looking at how we might include a way to have more enforcement against those kinds of practices.

Sharyl: When you first heard about a story like that, even if it’s just one or it could be more, what were your thoughts?

Wyden: This was slap your forehead kind of stuff. I mean, you say to yourself, “How can it be?” Because most of the people who work in this field are good and caring, but there are some bad apples. There hasn’t been enough enforcement and there has been certainly in these kinds of situations, you describe a lack of training and safety.

Sharyl: Who’s making money on this?

Wyden: It seems that everybody sees it as a profit center in theory, but then they create incentives that just do so much damage that everybody, you know, loses out.

The system is highly profitable even though organs aren’t technically sold: A single patient can generate hundreds of thousands of dollars in tissue, with total value per body sometimes exceeding $1 million. The transplant recipient — or taxpayers through Medicare and Medicaid— pays dearly. Intermediaries, providers, hospitals and surgeons benefit. While donors and their families get nothing.

Overall, public trust has suffered. Some states reporting sharp drops in new donors and spikes in people taking their names off donor lists.

As part of reforms, HHS Secretary Robert F. Kennedy Jr. announced the first time an OPO has been shut down for unsafe practices. And ordered all OPOs to appoint dedicated patient safety officers.

HHS Secretary Robert F Kennedy Jr. (Sept. 18, 2025): Our goal is clear every American must trust the nation’s organ procurement system.

Last December, whistleblower Nycki Martin testified to Congress.

Martin (Dec. 2, 2025): After I came forward as a whistleblower, the Health Resources and Services Administration launched an investigation into my former employer. In just 89 days, there were 103 cases in which the organ donation process was initiated in error.

She says it’s not about discouraging donating, but building a system people can trust.

Martin: It’s very, very needed. But I think you should always understand what you’re signing up for. It should be no different than going to a surgeon and, you know, for like a referral for a knee surgery, you wanna know all the ins and outs, the risks and consequences, all the information about what is going to happen and why.

Sharyl (on-camera): Senator Wyden has proposed a bill to force stricter safety standards, tougher penalties, and close the pancreas loophole. So far it hasn’t gone anywhere. The federal Center for Medicare Services is considering similar rule changes.

Watch the video here.