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Fact: Waiting lists for organs swell by the thousands each year. The supply of organs from cadavers, or deceased donors, has reached a plateau. In 1999 fewer than a third of the 44,000 people waiting for a kidney got one and 2,969 died waiting.
While that statement is depressing, progress is being made in the meantime. Doctors have become more proficient at performing transplants and managing them. Until very recently it was rare to take donor organs from unrelated people, however, today those account for about 15 percent of the total kidneys transplanted.
Many heroic people, called altruistic donors, have stepped forward to donate their kidneys, annonymously. In the past physicians have turned away people who want to donate for a number of reasons. Physicians are bound to do no harm and doing surgery on a healthy person -- a healthy donor -- violates their professional oath. Another reason for their reluctance is there was concern that these donors might be crazy! Crazy is far from the profile that is being established for these donors. Typically the people who want to volunteer are stable, upstanding, and usually well-educated people, says Cheryl Jacobs, a social worker in a Minnesota program that is leading the way in establishing a program for nondirected (i.e., anonymous) kidney donations. Last year they evaluated about 20 donors and performed seven transplants, including a teacher from New England who wanted to donate his kidney, unconditionally. This schoolteacher is a Vietnam veteran who spent years as a Baptist preacher. He had finally come to the point in his life where he just wanted to “do the right thing, and move on.” At age 62 he became one of the first people in the United to States to donate one of his kidneys to a stranger.
Fact: 80 to 90 percent of kidney recipients live at least five years and that is due to improved anti-rejection drug therapies. It is possible that the donated organ may function for well over 20 years. Receiving this new lease on life means that the recipient will be free from continuous hospital visits to receive dialysis. During a dialysis treatment the patient’s blood is filtered artificially. The treatment is very time consuming, and needs to be repeated three times a week.
Fact: You can live comfortably with just one kidney! Kidney donors do not seem to suffer from being short one kidney.
The process of donating a kidney for the New Enlgnad school teacher, involved two trips to the center in Minnesota. The first visit for a living donor is the evaluation. A donor will be physically and mentally evaluated. He will be screened for heart disease, cancer, HIV, hepatitis B or C, viral infections and evidence of alcoholism or diabetes. After he passes both the physical tests and a mental evaluation to be sure he isn’t nuts, the donor returns home. When the time is right he will return to the center and be prepped for the operation. The operation lasts about four hours. The kidney (the Samaritan organ) is then taken to another part of the hospital to be transplanted into the recipients body.
What does the anonymous donor gain from this experience? We already know what he loses -- a living part of his body. While it is illegal to sell human organs, those who donate are rewarded in their spirits.
What are some of the new frontiers in transplantation?
1. Laws that make donor registration cards carry more clout as an advance directive. Many states have quite a little red tape to cut through before a person’s organs will be released for donation.
2. New scientific ground is being claimed. Among the new frontiers are:
Xenotransplantation - the transplanting of animal tissues and organs into human beings.
Genetic cloning of animals (mainly pigs) as a ready resource for transplant organs.
Genetic engineering of animal organs with human genes to make the animal organs accepted in the human body, without using anti-rejection drugs.
Organ regeneration -- is it possible to regroup a liver? Regenerated or lab-grown bone, cartilage, blood vessels, and skin--as well as embryonic fetal nerve tissue--are all being tested in humans. Livers, pancreases, breasts, hearts, ears, and fingers are taking shape in the lab.
Whole body transplants -- its been done on monkeys! The idea behind the science is that a person whose brain is functioning well but whose body is very sick or paralyzed could receive the body of a brain-dead person, whose body is still fully functional.
As we wait for science to provide us with all the organs we need, lets look at a few of the facts of organ donation.
1. If you sign an organ donor card you indicate your wish to be a donor.
At the time of death, however, your next of kin will still be asked to sign a consent form for the donation. If you are interested in being an organ donor be sure to discuss your wishes with your family members so they can be aware of your wishes before that moment arrives.
2. There are about 2000 new patients per month added to the already staggering 40,000 + awaiting organ transplants in the United States.
3. About one-third of the patients who are on the list for heart, liver and lung transplants die while waiting because of the lack of available organs.
4. Surprisingly, children 10 years old or under make up a quarter of all the individuals waiting for organs.
5. The age limit for donating organs of a deceased person is 75.
6. Expenses related to the donation are not paid for by the donors family or estate, but by the organ/tissue procurement program involved.
7. In the case of a deceased donor, the family will still be able to have an open casket funeral if they so desire. There is no alteration of the body relative to the surgical procedures in removing the tissues or organs.
What organs may a living donor give? He may give a single kidney, a lobe of a lung or part of a liver or pancreas. A heart can be donated from a living donor when that donor is receiving a heart-lung transplant; sometimes surgeons decide it's best to transplant a heart and lungs together if a patient needs a new set of lungs, and the heart-lung patient's heart may be healthy enough to pass on to a patient needing a new heart.
Recently kidney surgeons have begun to use laparoscopic surgery in which a tiny opening is made through which a kidney can be extracted. Donors undergoing this procedure are usually released from the hospital within 48 hours.
A donor, Linda Rise, who gave her son-in-law his “best part” said, “God gave us two kidneys, but we only need one. If everyone donated a spare to people who needed one, nobody would be waiting in line.”
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