Connecting Lives: Honoring the Gifts by Completing the Circle of Musculoskeletal Tissue Donation for Allograft Use Across Orthopedics.

Background: Each year, more than 1 million patients in the United States receive life-changing musculoskeletal (MSK) tissue transplants. These transformative gifts save and restore lives. Unfortunately, data from organ procurement organizations suggest that orthopedic patients rarely contact donor families to acknowledge the gift, with less than 1% of tissue donor families ever receiving communication from recipients of their loved one's gifts.

Materials and methods: In response, our team launched the "Connecting Lives" initiative in 2015 to address this gap. Initially focused on osteochondral and meniscus allograft, it expanded to all MSK allograft recipients at our facility in 2022.

Results: Among osteochondral and meniscus allograft recipients, this quality improvement initiative increased the percentage of MSK tissue transplant recipients writing to donor families from less than 1% to nearly 18%, comparable to organ donation rates (approximately 20%). The main barrier for non-writers was uncertainty about what to say. Despite this improvement, further efforts are needed to close the Tissue Donation Circle.

Conclusion: Engaging patients before and after transplant surgery can help address emotional and practical barriers, fostering connection and honoring tissue donors. Orthopedic health care teams must contribute to "closing the loop" between allograft recipients and donor families through education, advocacy, resourcing, and support that drive completion of the Tissue Donation Circle. [Orthopedics. 2025;48(4):234-238.].