University of Iowa Health Science Relations and
Lois Geist, MD, MS
Associate Professor of Internal Medicine
First Published: November 2000
Last Revised: December 2003
Peer Review Status: Internally Peer Reviewed

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 someone 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 Dr. Lois Geist, associate professor of internal medicine at the University of Iowa College of Medicine. "You are asking them to do all their grieving and go through all the things they need to go through. They are always hoping for a miracle," she adds.

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 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 14 hours. Hearts and lungs must be transplanted within five to six hours. In some hospitals there are now policies in place to allow for donation of 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 done 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 35 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.

While the donations are very much appreciated by the recipients and their families, the identity of the donor family is kept confidential. "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 now taken as 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.