Why become an organ donor?

Waste should never cost a life, whether of 70 years or 7. Yet when what we waste is usable organs, it does. Each day, while 79 of more than 121,000 people who need one receive the gift of an organ, at least 22 more die waiting for transplant of a heart, kidney, liver, or marrow.

The hardest thing to grasp is that the gap between those on the waiting list and available donors continues to widen. In the early 1990s, that waiting list-to-donor ratio was about 3:1. Today, it's more than 8:1.

Know someone with high blood pressure, diabetes, or renal/kidney disease? Odds are you know several; they're more likely to need an organ one day. Is any of them a minority? If so they're less likely to get one; 42 percent of transplant recipients are minorities, yet they make up 58 percent of the waiting list according to the U.S. Department of Health and Human Services.

Will you help?

While odds of compatibility increase when both donor and recipient share race or ethnic background, neither is necessary for a potential match. Compatibility begins simply with blood and tissue type. Most people with a healthy organ can help, simply by ticking that box on a driver's license form.

It takes that little. To allow a dying child to live. The blind to see.

Why then are there so few, with only 14,200 donors annually (living and deceased)? We won't need eyes, skin, hearts, livers, bones, or kidneys past physical death; unneeded organs from just one person could save one life, or up to eight. Some things we may safely donate while living, such as marrow, a kidney, or tissue, with all expenses covered. One person can enhance the lives of up to 50 people on the transplant list.

Thanks to the care taken by surgeons and funeral directors and the availability of certain prosthetics, and contrary to myth, donation does not preclude an open-casket funeral for those who want one. Most religions strongly support donation (see official statements submitted to Organdonor.gov/about/religiousviews.html).

So why doesn't everyone tick the box on the driver's license, or sign the registry at Organdonor.gov/becomingdonor/stateregistries.html?

Perhaps because while it is a fact of life, some have trouble contemplating the death more than 2.5 million Americans face in an average year. Hollywood plays upon fears and feeds fallacies. We imagine unethical people taking bribes and letting the injured die just to harvest an organ for a waiting patient. Life is not Hollywood. Not that most people would lack the humanity to need it, but for the exceptions there is an elaborate, continually advancing system in place - laws, ethics, procedures, and cross-checks.

Fear not; coma is not enough, contrary to another myth. In such situations deceased donors also have had major head trauma or a fatal stroke. After the medical team exhausts all life-saving efforts without response (yes, more than one person verifies the checklist), a physician - usually a neurologist - conducts several tests for brain death. That's no breathing and no brain activity.

Once death is thus verified they check for donor consent through the donor registry or, if not registered, the family. With consent, next comes the health evaluation to see if the person has something to donate. If the answer is yes, a registry official checks the waiting list in the national Organ Procurement and Transplant Network to look for potential matches. Factors at this stage include blood type, tissue type, height, weight, how long the patient has been waiting, severity of the patient's illness, and distance between donor's and patient's hospitals. The list does not reference race, gender, income or social status.

The computer generates a list of potential matches by organ type. These are offered to the first patient on the computer match list, if the transplant surgeon determines the organ is medically suitable. About 75 percent of organs go to local patients. Throughout this process, the donor's body is maintained on artificial support post brain-death, and the condition of each organ is carefully monitored by the hospital medical staff and the procurement coordinator (OPO).

Which brings to mind the final element: The OPO. According to federal regulations, each case involves a trained coordinator who travels to the hospital from a local or regional organ procurement organization. In the Inland Northwest this is Life Center Northwest, based in Bellevue, Wash., with satellite offices in Spokane and Missoula.

Moved to register, but want to limit what can be donated according to personal beliefs? You can do that at the state donor registry (YesIdaho.org). For a lot more information on the need, use, and process of organ donation see Organdonor.gov and LCNW.org.

If Press readers are representative of national statistics, 90 percent support organ donation in theory. Have you made it fact yet?

Sholeh Patrick is an organ donor and columnist for the Hagadone News Network. Contact her at [email protected].