Vital organs
Number of patients needing transplants exceeds donorsBy R.J. Ignelzi
UNION-TRIBUNE STAFF WRITER
August 26, 2008
You can be a hero. You don't need to rescue children from a burning building or bring a frightened kitten down from a tree. To save multiple lives, all you have to do is register as an organ donor.
“Each of us can save as many as eight lives by donating organs. And if you donate tissue, you can enhance the lives of another 50 people,” says Sharon Ross, community outreach manager for Lifesharing, the local organ procurement organization, which is a division of UCSD and the organ bank for 26 hospitals in San Diego and Imperial counties.
LAURA EMBRY / Union-Tribune
Nurse Gina Gallardo (left) and Dr. Jonathan Fisher of Scripps Green Hospital in La Jolla get a biopsy of Gloria Rangel's newly transplanted kidney. The number of people needing transplants far surpasses the number of donors.
Unfortunately, the number of people needing an organ transplant far surpasses the number of donors. Nearly 100,000 people are on the national waiting list with about 3,700 added to the list each month, according to the United Network for Organ Sharing (UNOS). More than a fifth of the people on the waiting list, nearly 20,000, are Californians.
On average, 18 people across the country die each day waiting for organ transplants. Last year, 90 people died in San Diego and Imperial counties because there weren't enough donor organs, Ross says.
When surveyed, as many as 98 percent of people say they are in favor of organ donation, according to Lifesharing. So, why aren't more people registered as organ donors?
“The main barriers to donating organs are myths and misinformation,” says Alexander Aussi, director of transplants at the University of California San Diego Medical Center. “There's an inability of some of the population to understand the impact of organ donation on the organ transplant concept. They just don't have enough information.”
Hopefully, answers to some commonly asked questions may help clear up confusion about organ donation.
What organs can a person donate?
A person can donate a kidney, heart, lung, liver, pancreas, intestines, cornea, skin, bone, bone marrow and tissue.
What is the process for receiving an organ for transplantation?
If you need an organ transplant, your doctor will help you get on the national waiting list. Your name is added to a pool of names, and when an organ donor becomes available, all the patients in the pool are compared with that donor. Factors such as blood and tissue type, size of the organ, medical urgency of the patient's illness, time already spent on the waiting list and distance between the donor and recipient are considered. The organ is offered first to the candidate who is the best match. The organ is distributed locally first, and if no match is found, it is offered regionally and then nationally until a recipient is found.
What organs can a person donate while still living?
Live donations can include a kidney, a portion of a lung, a portion of the liver (it regenerates), and tissue removed after dramatic weight-loss surgery. Blood and bone marrow may also be donated.
How long do transplant patients wait for a new organ?
The waits vary, and there's no way to know how long patients will wait to receive a donor organ or if they'll receive the organ in time to save their life.
For example, as of last month, the waiting time for a donor heart at Sharp Hospital was six to 12 months, 12 to 24 months for a donor kidney at UCSD and 12 to 24 months for a donor liver at Scripps.
If you have a pink “donor's dot” on your driver's license, does that mean you're a registered organ donor?
It depends. If the license was issued before July 1, 2006, the date when the Donate Life California Registry began partnering with the Department of Motor Vehicles, you are not registered.
But you don't have to wait until it's time to renew your license to register as a donor. You can sign up and download/print an organ donor card at donatelifecalifornia.org. Sign the card and carry it in your wallet.
What's the best way to indicate you want to be an organ donor?
In addition to registering as an organ donor, one of the best ways to ensure that your wishes are carried out is to inform your family and primary physician.
Who manages the distribution of organs?
The United Network for Organ Sharing (UNOS) maintains the Organ Procurement and Transplantation Network for the country. Through the UNOS Organ Center, organ donors are matched to waiting recipients 24 hours a day, 365 days a year. Lifesharing is the organ procurement organization, or organ bank, for San Diego and Imperial counties.
Is every person registered as an organ donor guaranteed his or her organs will be used to help another person?
No. Only about 1 percent of organs are eligible for transplantation, because organ donation requires a certain set of circumstances. The donor usually must die in the hospital and be on ventilator support. They also must be stable before death, with no uncontrolled bleeding or infection.
“Because so few organs can be used, we need a much larger pool of donors so we have more organs (to choose from) for the patients,” says Dr. Steven Steinberg, medical director of the kidney and pancreas transplant program at Sharp Memorial Hospital.
Are there age limits for becoming an organ donor?
There's no specific cutoff age for donating organs. Newborns as well as senior citizens have been organ donors. If you are under age 18, you must have a parent's or guardian's consent. The decision to use your organs is based on strict medical criteria, not age.
If you smoke or drink two martinis a day and are in less than perfect health, can you still be an organ donor?
It may turn out that certain organs are not suitable for transplantation, but other organs and tissues are. Only medical professionals at the time of your death can determine that. Just a handful of medical conditions rule out organ donation, such as HIV-positive status, actively spreading cancer or certain severe, current infections.
Does it cost anything to become an organ donor?
No. The transplant surgery costs are the responsibility of the recipient.
Does being an organ donor affect the quality of medical care given?
No. The doctor or emergency room staff will work as hard to save a donor's life as anyone else's. The transplant team does not become involved with the donor until doctors have determined that all possible efforts to save that life have failed.
Why do minorities need to be especially concerned about organ donation?
The need for transplants is high among minorities because some diseases that can lead to organ failure, such as hypertension and diabetes, are found more frequently in minorities.
With the exception of Hispanics, who “are very generous organ donors,” Ross says, most other minorities have a low rate of organ donation and don't keep pace with the number needed for organ transplants. Matching donor organs to likely recipients requires genetic similarity. In most cases, people are more similar to people of their own race than to people of other races.
If a person's organs or tissues are donated, is an open-casket funeral still possible?
Organ and tissue donation don't interfere with having an open casket. If organs are removed, the body is stitched up as it would be after a normal surgery. A skin donation is taken from the donor's back, an area usually not visible during a funeral. In the case of an eye donation, an artificial eye is inserted and the lids are closed. For bone donation, a rod is inserted where bone is removed, leaving the external structure of the body in place.
Does organ donation conflict with any religious beliefs?
Organ donation is consistent with the beliefs of major religious denominations in the United States, including Catholicism, Protestantism and most branches of Judaism. Check with your clergy if you're uncertain of your faith's position on organ donation.
Staff librarian Beth Wood contributed to this article.
Find this article at:
http://www.signonsandiego.com/news/features/20080826-9999-1c26organm.html Web sites
Interested in organ and tissue donation? These resources will help you become more knowledgeable.
donatelifecalifornia.org/about
Organ and Tissue Donor Registry is a nonprofit group authorized by the state to keep track of organ donations.
nlm.nih.gov/medlineplus/
organtransplantati on.html
The National Institutes of Health site provides basic information and multiple links about organ transplant procedures. Financial issues, clinical trials and disease management are among the many topics.
dmv.ca.gov/about/organdonor.htm
Sign up through the California Department of Motor Vehicles to become an organ donor and get the pink dot on your driver's license or ID card.
organdonor.gov/donation/
religious_views.htm#a6
This page from the U.S. government's organ donor site describes the various views of religious groups about organ transplantation.
organtransplants.org
/understanding
Use this interactive site to learn more about the various organs that can be transplanted. Follow the “interactive body” link for diagrams and information.
mayoclinic.com/
health/organ-donation/FL000 77
The Mayo Clinic lists 10 distortions, followed by the facts, setting the record straight about transplants.
a-s-t.org
Download informative pamphlets from the American Society of Transplants by scrolling down to “Quick Links” and clicking on “Patient Education Brochures.”
BOOKS
“Mr. NewHeart (New Heart): Heart Attack to Transplant and Beyond,” David Hollar (2007) A personal account of Hollar's experiences before, during and after a heart transplant, this book explores how his Christian faith and family support helped him survive.
“Organ Transplants (Cutting Edge Medicine),” Carol Ballard (2007) Part of a student-targeted series called “Cutting Edge Medicine,” this 64-page book is written by a prolific children's science and health writer.
– Denise Davidson and Beth Wood, staff researchers
SOURCES: UNION-TRIBUNE ARCHIVE AND NEWS SOURCES
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