Donate life, for David

Waste has become a national habit, but it should never cost a life.

As we go about every day worrying about the usual things, more than 106,000 Americans wait on the national transplant list for a life-saving organ, according to organdonor.gov.

Each day, 17 die preventable deaths.

Every 10 minutes, another person is added to the list, needing a kidney (83%), heart (3%), liver (11%), lung (1%) or other organ (2%). Someone you know with high blood pressure, diabetes, or kidney disease is more likely to need an organ one day.

Sixty-eight percent on the transplant list are 50 or older; 30% are 18-49; the rest are children. There are exponentially more people on transplant waiting lists than transplants performed. And exponentially more wasted organs that could have saved lives. Unnecessary tragedies are hardest to grasp.

David’s story

My young cousin, David, was drawn to people who needed him, in this life and the next. A severe asthma attack killed David at the tender age of 23. No one saw it coming, but even as a young, otherwise healthy man, he knew he wanted to be an organ donor. One day, a sudden attack dropped him to the floor, unconscious. Despite a quick 911 response, he fell into coma, so when brain function ceased along with hope, his grieving mother (a nurse) told the doctors David wanted to be an organ donor and to set it up.

Recipients were notified and preparations made, but before David changed numerous lives, his mother asked for time. Over the next couple of hours, his family cried, talked to him, and held his still hand at his bedside. A Native American shaman sang a spiritual song (David was half Indian). The hospital staff were helpful, compassionate, kind.

It was beautiful. A couple of years later, his mother received letters from some of the people whose lives David’s organs saved or improved. She treasures them, and she says David lives on.

Our family celebrates David’s gifts on his birthday, which is today.

How it works

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

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

Why then are there so few donors? We won’t need our eyes, skin, hearts, liver, bones or kidneys past physical death. Unneeded organs from just one person could save up to eight lives.

Nor must it wait for death. Some things may safely be donated while living, such as marrow, a kidney, or tissue, with all expenses covered. One person could 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, contrary to myth, donation does not preclude an open-casket funeral for those who want one. Most religions strongly support donation, and hospitals and transplant organizations work with churches.

Myth

Ninety percent of Americans favor organ donations, yet only 60% are signed up.

Perhaps discomfort is a factor. While death is a fact of life, many have trouble contemplating it. TV and fiction play upon fears and feed fallacies, but life is not Hollywood. Not that most people would lack the humanity to need ethical oversight, but to prevent such exceptions there is an elaborate, continually advancing system in place of laws, medical ethics, procedures, and cross-checks to ensure no one is pressured, rushed, or conned into anything scary or unwanted.

Steps

Don’t let David’s story create a misimpression; coma is not enough to lead to the question of organ donation. In such situations, donors have also experienced major head trauma, a fatal stroke or some other fatal injury or condition. 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 means 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 that 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 (organs must be transplanted quickly).

The list does not reference race, gender, income or social status. Money or influence doesn’t move a person up a transplant list.

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

Which brings us to this 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.

Are you moved to register, but want to limit what can be donated according to personal beliefs? You can do that at the state donor registry.

Please tick the box on the driver’s license form, or sign the registry now at yesidaho.org/register. If you have already, thank you. For a lot more information on the need, uses, and process of organ donation see Organdonor.gov.

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Sholeh Patrick is an organ donor and columnist for the Hagadone News Network. Email Sholeh@cdapress.com.