New life can grow in the shadow of death, if only family members can agree to donate a loved one's organs. As the waiting list for lungs, hearts, livers, and kidneys grows, only 30 percent of prospective donors are given the opportunity to give new life, because of the sensitive nature of organ donation.
"There is an incredible need for organ donations, but it is very difficult to ask family members to donate their loved one's organs, especially when that person is in the last stages of dying or no longer has any brain activity," says Lois Geist, MD, MS, professor of internal medicine at the University of Iowa Carver College of Medicine and medical director of the Iowa Donor Network, the local organ procurement organization.
Most individuals become organ donors acutely, so the family has little time to prepare for the inevitable death.
“They are always hoping for a miracle," Geist adds. "You are asking the family members to do all their grieving and go through all the things they need to go through to process the tragedy, yet still think of the future of several other individuals who could benefit from the donation."
Geist says families more readily allow donations of corneas, skin for burn victims, and bone for patients with bone cancer because these can be taken after the donor has died. But solid organs such as the heart, liver, lung, and kidney most often need to be removed before the heart stops beating; otherwise, the organs become damaged.
Kidneys and livers usually must be transplanted within about 12 to 24 hours. Hearts and lungs must be transplanted within five to six hours. In many hospitals, including UI Hospitals and Clinics, there are policies in place to allow for donation of primarily kidneys and liver after circulatory death. This increases opportunities for donation.
Once the family agrees to donate the organs, information such as blood type, size, and weight of the patient is fed into a computer. A list of people about the same size and blood type is produced from the computer files. Those who are the sickest and have waited the longest receive priority.
"Nothing is started in this process until the family agrees. No one wants the family to feel pressured. The decision has to be their choice," Geist says.
Kidneys have been transplanted for more than 40 years and the majority of the transplants go very well, she says. Hearts and livers also have high transplant success rates and have been transplanted for more than 20 years. Lung success rates lag behind in terms of recipient survival but progress is being made.
While the donations are very much appreciated by the recipients and their families, the identity of the donor family is kept confidential unless both sides agree to meet at some point.
"We encourage the recipient family to write a thank you note to the donor family," Geist says.
A majority of the organs donated stay local. In addition, organs that cannot be used for tranplantation can be used as valuable research tools to help other patients. The value of organ donation extends far beyond the value to a single recipient.
Marking "organ donor" on your driver's license is taken as first person consent in the state of Iowa, Geist says. In addition, individuals can make their donation decision known by logging on to the Iowa Donor Registry at www.iowadonorregistry.org. It remains important to discuss your decision with family and friends, Geist adds. |
