Who is in charge of the organ donation process? ← Organ Donor - Donation Process The federally chosen, non-profit, organ procurement organizations (OPO) are in charge of the process. Missouri has two that serve different parts of the state; Mid-America Transplant and Midwest Transplant Network. Missouri also has a tissue bank, Saving Sight. The agencies are in charge of and make the donation process easy. The recovery and transplant process is regulated by the Centers for Medicare and Medicaid Services, a Division of the U.S. Department of Health and Human Services.