From Tragedy to Second Chances: Honoring Alex Migliore’s life through organ donation

Alex Migliore was 26 years old, full of energy, and deeply connected to his family. His mother, Donna, said he was the kind of guy whom everyone loved, especially his younger cousin Thomas, who was only 14 when a poor decision changed everything for their family. 

Alex invited Thomas and a couple of his friends to his place in a New Orleans suburb for an early morning ATV ride one Saturday in January 2022. The three boys arrived the night before and decided to hop on their off-road vehicles to visit one of Alex’s friends. 

They made a poor decision not to wear helmets. 

It was that choice—and a subsequent crash into an unseen trailer parked along the trail in the dark of night—that ended Alex’s life. 

In her grief, however, Donna made an extraordinary decision to save the lives of several others who had been waiting for an organ transplant. It might seem like it was the hardest decision one would ever have to make. But, as Donna explained, though she and Alex had never talked about life-saving organ donation, she somehow felt it was something he would want her to do. 

A painful path to an uplifting decision 

Donna’s sister, Patty Clesi, BSN, RN, coordinator of the Trauma Injury Prevention Program at University Medical Center New Orleans, received a call from Thomas about the accident. He was emotionally shaken to his core but otherwise safe. Patty’s husband dropped her off at Donna’s nearby home and then headed to the accident scene. Patty was left with the devastating task of breaking the news to her sister and brother-in-law. 

“I was in the bathtub when Patty arrived, and Frank came into the bathroom, dropped to his knees, and told me Patty was here and that I needed to get to the hospital,” Donna said through tears, the pain resurfacing as she recalled the moment. “I didn’t really understand what was happening. Maybe it was a car accident, I told myself. I just prayed I would get to the hospital and that Alex would be injured but alive.” 

Frank had COVID and was not allowed to enter the hospital, so he stayed home and prayed. The sisters got into the car but didn’t know which hospital to go to. That’s when Patty called the family’s close friend, Dan P. Kiff, MN, RN, who serves as director of Trauma Services at the Norman E. McSwain, Jr. MD, Spirit of Charity Trauma Center at University Medical Center. 

“I knew Dan would know if Alex was involved in a traumatic event. At first, he hadn’t received any news. But then, he said, ‘Oh my God, Patty, you and Donna have to get to University Medical Center right now.’ That’s when I knew this wasn’t an ordinary car accident,” Patty said. 

The sisters clung to each other through the night. Donna begged her son to wake up. “I remember promising him that I would take care of him no matter what—that I would help him relearn everything if he could just come back to me,” she said. “But in the early hours of the next morning, I started to accept the unimaginable. I knew my Alex would not have wanted to remain in a vegetative state, nor would he have wanted to live without independence. I knew I had to let him go.” 

Choosing to give life in the midst of loss 

Patty went home briefly to check on Thomas – leaving Donna at the hospital with Alex’s girlfriend, Sarah. “I know my son loved helping people,” she said. “When Patty came back into the room, I remember looking up at her and saying, ‘I want to donate Alex’s organs.’” 

They were words that were both difficult and, in some ways, comforting for Donna to say aloud. It meant facing the truth. Alex was gone, but she knew that donating his organs could give many others waiting for transplants a second chance at life. 

How University Medical Center and LOPA walk alongside families 

At University Medical Center, families are not left to navigate these moments alone. The hospital works closely with the Louisiana Organ Procurement Agency (LOPA) to guide families through the donation process with care and respect. 

Medical teams focus on the patient. LOPA coordinators focus on the family, helping them understand what donation means and supporting them through each step. Together, they create space for families to make decisions in their own time, without pressure. 

“Most importantly, the patient is treated with dignity throughout the entire experience,” said Kiff “We view organ donors as heroes. They have lost their lives but are giving the greatest gift one can possibly give to another.” 

The donor walk and flagpole ceremony: quiet moments of honor 

One of the most meaningful ways University Medical Center New Orleans honors its “heroes” is through the Donor Walk, where staff line the hallway and stand in quiet reflection as the donor’s body is wheeled past. There are no announcements or formalities—only a shared understanding of what the moment represents. 

For families, it is both heartbreaking and comforting. It marks the final recognition that their loved one is gone, while also affirming that they will not be defined by how they died, but by the gifts they are giving to others. 

“We stood in that hallway and knew that Alex was a hero passing by,” Patty said. 

For Donna, the grief was almost too much to bear. “I knew they were taking my baby, and I already knew how much he would be missed by our family,” she said. “But there would be parts of him out in the world still living—and that was comforting to me.” 

This all occurred during the COVID-19 pandemic. Unfortunately, very few people from outside the hospital were allowed to be inside by Donna’s side. Her husband, Alex’s father, waited outside for her and joined her at the second memorial activity – the flagpole ceremony. 

Following the Donor Walk, recognition continues at University Medical Center as the Donate Life flag is raised in honor of each donor, creating a visible moment for families and the community to gather. Many people gathered around the flagpole that day to say goodbye to Alex. Donna was in despair, but she held on to one very important thing that remains close to her today. 

“I know I was surrounded by love,” she said.  

Both the Donor Walk and flagpole ceremony are moments when grief and gratitude existed side by side. 

Alex’s legacy is carried forward 

Alex’s gifts reached far beyond New Orleans. 

His heart went to a man in Arkansas. His lungs helped someone in Florida breathe again. His liver went to a patient in Texas. His kidneys stayed local, helping patients in his own community.  

While Donna knows she will never meet the recipients of Alex’s organs, she said she knows they are out there and that continues to be a comfort to her and her husband. 

Finding meaning without losing the memory 

Organ donation does not take away the pain of loss, and it does not fill the space left behind. What it can do is give families a way to honor the person they love in a way that reflects who they were. 

“It doesn’t make the loss less painful,” Patty said. “But it gave us a way to honor Alex’s life.” 

Across the country, more than 113,000 people are still waiting for an organ transplant, including thousands in Louisiana. For families facing loss, donation offers a way to create something meaningful in the midst of grief. 

According to data from the Organ Procurement and Transplantation Network (OPTN), managed by the United Network for Organ Sharing (UNOS), more than 48,000 organ transplants were performed in the U.S. in 2024—a record-setting year. While the need remains high, with more than 100,000 people on the national waiting list, the 2024 total represents a 3.3% increase over 2023. 

One donor can save up to eight lives through organ donation and help many more through tissue donation. 

According to the LOPA website, even when organs cannot be used for transplant, they can still be donated for medical research to develop new medical treatments. 

How to become an organ donor 

Becoming an organ donor in Louisiana is much easier than many people realize. Individuals who choose to donate their organs after death can make that decision through a simple legal process. 

You can register to be an organ donor in Louisiana in one of three ways: 

1. Visit registry.donatelifela.org register online through the Louisiana Donor Registry. 
   After entering basic identifying information, a person can authorize that their organs are to be donated upon their death. It’s important to note that this registration serves as a legal “document of gift” under Louisiana law. Unless it is revoked before death, living relatives are not required to provide consent. 

2. You can visit your local Office of Motor Vehicles and check “yes” to the donor question when you apply or renew your Louisiana driver’s license or state ID. This designation will be recorded with the Louisiana Organ Procurement Agency (LOPA) and acted upon at the time of your death. 

Similarly, you can register to be an organ donor when purchasing or renewing a hunting or fishing license through the Louisiana Department of Wildlife and Fisheries portal. Visit this website to learn more: Louisiana Wildlife & Fisheries. 

3. LOPA also provides a way for Louisiana residents to register to be an organ donor through the state’s mobile ID system. Visit Louisiana Organ Procurement Agency for more information. 

Finally, consider having a conversation with your family about your decision. In Louisiana, registering as an organ donor is legally binding, but your loved ones are the ones who will carry out your wishes and cope with the loss. Having that conversation ahead of time can bring clarity and comfort during an incredibly difficult moment. 

According to LOPA, “If family members know your decision to be an organ donor in advance, the process is smoother and more likely to follow your intent.”  

And remember, “Donation only occurs after all life-saving efforts fail and death is formally declared by physicians,” the LOPA website said. “It does not affect medical care, and there is no cost to the family for the donation itself.” 

To learn more about the Norman E. McSwain, Jr. MD, Spirit of Charity Trauma Center at University Medical Center in New Orleans, please visit: https://www.lcmchealth.org/university-medical-center-new-orleans/our-services/norman-e-mcswain-jr-md-spirit-of-charity-trauma-/