The Medical Minute: Organ donation -- the ultimate gift of life

February 22, 2006

By John Messmer, M.D.
Penn State Family & Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

A man develops a viral infection that causes his heart to fail, a woman's diabetes destroys her kidneys, a man damages his eyes in an industrial accident and is blinded, a child develops leukemia resistant to chemotherapy. Each of these people has something in common: each will need an organ transplant.

As of today, about 26,000 organs have been transplanted in the United States, gifts from about 13,000 donors, but 91,000 people are on the waiting list for an organ. Some will die before a compatible organ is found.

Where will they get these organs? Organs are usually obtained from people when they die, although a living person may donate a kidney and part of a liver. The problem is that too many people do not donate their organs. There are many reasons why. Perhaps they never thought of it. Maybe it's too macabre to think about death. It might be a perception of a religious objection. Or maybe they never got around to filling out a donor card. Whatever the reason, not enough people are willing to part with something they won't be using.

It's very easy to be an organ donor. Most states include the information on driver's licenses or one may carry an organ donor card. Go to http://www.organdonor.gov/signup1.html to print out a card. It is important that a potential donor tell his or her family of their wish to be an organ donor. When a person dies or is terminally ill and unresponsive, the next-of-kin will be asked about organ donation. He or she may be reluctant to make that decision without knowing the person's wishes.

It never costs anything for the donor's family and there is no visible disfigurement so a funeral, even with an open casket, can be held. Even older people can be organ donors; there is no upper age limit. Medical suitability is determined at the time of death.

Treatment does not change for an organ donor; every effort is made to treat and keep a donor alive. The physicians and nurses are probably not even aware that a person has chosen to be an organ donor and the transplant team is likely to be in some other hospital. Organs are not taken from people in a coma, only when the brain is actually dead. Brain death is not reversible.

Organs can not be bought or sold; it is truly a gift from donor to recipient. Despite some suggestion in news reports from time to time, celebrity status does not get a person an organ sooner. The list is based on urgency of need. About 300 people are added to the list each month.

There is a particular need for donors from ethnic groups other than Caucasian. Tissue must be matched in order to receive an organ and a match is more likely with someone of the same ethnicity. Many diseases that result in organ damage occur more frequently in African-American and Hispanic groups, making the need greater, even though these minorities are a smaller proportion of the population.

For those who wish to be donors before they die, there are other opportunities. Roughly 3,500 bone marrow transplants are done each year with increasing numbers from unrelated donors. Still, many more people are needed to register as potential donors. Increasingly, peripheral blood stem cell donations are replacing bone marrow transplants. This may be easier for the donor since it does not require surgical removal of marrow from bone, but draws blood from a vein as in blood donation. More information about registering as a marrow donor is available at http://www.marrow.org online.

Another way to provide usable stem cells is to donate umbilical cord blood. This is only available in some states so far (see http://www.marrow.org/cgi-bin/NETWORK/nmdp_cord_blood_hospitals.pl online). A mother may donate the part of the umbilical cord that gets disposed of. The cord has many blood stem cells that can be donated if a compatible recipient is found.

An easy way to make a valuable donation is to give blood. Blood donation is quick and can be done every eight weeks.

The need is great. Those that are willing to participate should designate themselves as an organ donor now. Go to http://www.shareyourlife.org to find out each state's requirements for organ donor designation. Other information on organ transplants is available at http://www.hmc.psu.edu/transplants online.

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Last Updated March 19, 2009