Organ Donation

According to current statistics, there are over 91,000 patients in the United States waiting for organ transplants with nearly 4,000 new patients being added to the wait list each month. Each day, an average of 18 people die while awaiting transplants for a heart, liver, kidney, pancreas, lung, or bone marrow. Although an estimated 12,000 people who die each year meet the criteria for organ donation, fewer than half actually become donors. Organ donation is a safe, carefully coordinated process that is highly successful in saving lives. Unfortunately, individuals’ concerns frequently prevent them from consenting to organ donation at the time of death. As a way to help meet the increasing need for transplanted organs, new techniques have been developed that allow living persons to donate, but even with living organ donation, a great shortage still remains.

The failure of a vital organ used to mean certain death for a patient. This all changed in 1954 when the first successful living-related kidney transplant was performed. Less than a decade later, the first successful cadaveric kidney transplant was performed. Since then, the field of transplant surgery has continued to make tremendous advancements. The current survival rate for most vital organ transplants is greater than 80 percent one year after surgery. The success rate for transplanted tissues is even higher at greater than 90 percent.

High survival rates following organ transplantation is not only a consequence of improved immunosuppressants and surgical technique, but also of improved organ selection. Donor eligibility depends on age, medical conditions, and circumstances at the time of death. Although donors are typically between the ages of 5 and 60, people both younger and older are able to donate as long as they are in good health. Individuals may express their wishes to be a donor at any time, but prior to actual donation, eligible donors undergo an extensive screening process that involves examining the body, testing for disease, interviewing the donor's family and close contacts, and reviewing the donor's medical records and lab results. Conditions that limit organ or tissue donation include active cancer, human immunodeficiency virus (HIV), hepatitis, syphilis, West Nile virus, severe acute respiratory syndrome (SARS), and Creutzfeldt-Jakob disease (commonly known as mad cow disease). One exception to these exclusion criteria involves individuals infected with hepatitis B or C. These individuals may sometimes donate their organs to others who are already infected with hepatitis B or C.

Individuals wishing to be an organ donor can sign a Uniform Donor Card, which they keep in their wallet, or indicate on their drivers licenses that they wish to donate. However, at the time of brain death, the per-son's relatives will still be asked to consent and may choose against donation. It is estimated that about 35 percent of would-be organ and tissue donors never actually donate because family members refuse to give consent. Even if individuals have not indicated that they wish to donate, their family members are still likely to be approached regarding the subject. This is because all hospitals are required by law to notify the local Organ Procurement Organization (OPO) of all patient deaths (including brain death). If the OPO determines that the individual's organs or tissues are appropriate for donation, it will have a representative contact the patient's family to offer them the option of donating their loved one's organs or tissues. Organs that can be donated include the heart, lungs, kidneys, pancreas, and small intestine. Tissues include corneas, skin, bone, heart valves, and connective tissue. Individuals may also choose to donate their bone marrow, which is used primarily in treating patients with leukemia.

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