In memory of
Howard Smith Vereen
WHO CAN BE
A DONOR?
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Individuals over the age of 18 can indicate their desire
to be an organ donor by signing a donor card or expressing
their wishes to family members. Relatives can also donate
a deceased family member's organ and tissues, even those
family members under the age of 18.
Donation of heart, liver, lung, pancreas or heart/lung can
occur only in the case of brain death. The donation of tissue
such as bone, skin, or corneas can occur regardless of age
and almost any cause of death.
CAN YOU STILL
CHOOSE TO DONATE IF YOU ARE YOUNGER THAN 18 YEARS OF AGE?
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Yes, but only with the consent of an adult who is legally
responsible for you, such as your parents or legal guardian.
The adult or adults should witness your signature on a donor
card.
WHAT CAN BE
DONATED? »Back
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Organs that can be donated include: Kidneys, Heart, Liver,
Lungs, and Pancreas. Some of the tissues that
can be donated include: Corneas, Skin, Bone, Middle-Ear,
Bone Marrow, Connective Tissues, and Blood Vessels.
Total body donation is also an option. Medical schools,
research facilities and other agencies need to study bodies
to gain greater understanding of disease mechanisms in humans.
This research is vital to saving and improving lives. If
you wish to donate your entire body, you should directly
contact the facility of your choice to make arragements.
WHY SHOULD
YOU CONSIDER BECOMING AN ORGAN/TISSUE DONOR?
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Advances in medical science have made transplant surgery
increasingly successful. Transplantation is no longer considered
experimental, but a desirable treatment option. The major
problem is obtaining enough organs for the growing number
of Americans needing them. As of October 2006, there were more than 100,000 registrants on the national waiting list. By contrast, as of this time there are only 8,671 donors in the United States. Each month, the waiting list grows by approximately 500 registrants. Even though most donors contribute
multiple organs, there still are not enough to meet the
need and many people die while waiting for an organ.
Everyone's help is needed to resolve the donor shortage.
The best way to assure that more organs and tissues are
made available is to sign and carry a donor card or go to
the Department of Motor Vehicles and sign the back of your
license. It is especially important to let your family know
of your wishes to dontate if the opportunity arises. It
will most likely be a family member who is in a position
to see that your wishes are carried out.
HOW DO YOU
BECOME A DONOR CANDIDATE? »Back
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Fill out a donor card and carry it in your wallet. Most
states have some way that you can use your driver's license
to indicate your wishes to be a donor. Some states have
a donor card on the back of the license; others have a place
to check or a colored sticker to put on the license.
It is also extremely important that you let your family
know that you want to become an organ and tissue donor.
Ask family members to sign your donor card as a witness.
When you die, your next-of-kin will be asked to give their
consent for you to become a donor. It is very important
that they know you want to be a donor because that will
make it easier for them to follow through on your wishes.
It would also be useful to tell your family physician, religious
leader and attorney that you would like to be a donor.
WHAT IS BRAIN
DEATH? »Back
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Death occurs in two ways: 1) from cessation of cardio-pulmonary
(heart-lung) functioning; and 2) from the cessation of brain
functioning.
Brain death occurs when a person has an irreversible, catostrophic
brain injury which causes all brain activity to stop permanently.
In such cases, the heart and lungs can continue to function
if artificial life-support machines are used. However, these
functions also will cease when the machines are discontinued.
Brain death is an accepted medical, ethical, and legal principle.
The standards for determining that someone is brain dead
are strict.
Tissue and bone may be useable in either type of death.
Organs, however, are useable only in cases where brain death
occurs.
WHAT IF MEMBERS
OF YOUR FAMILY ARE OPPOSED TO DONATION? »Back
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You can have an attorney put your request in writing. This
document, along with your donor card, may help ensure that
your wishes will be honored. In any event, tell your family
that you want to become a donor in the event of your death.
ARE THERE RELIGIOUS
OBJECTIONS TO ORGAN/TISSUE DONATION? »Back
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Most major religious groups in the United States approve
and support the principles and practices of organ/tissue
donation.
IS THERE A
NATIONAL REGISTRY OF INDIVIDUALS WHO WISH TO BE ORGAN/TISSUE
DONORS? WHAT IF YOU CHANGE YOUR MIND ABOUT DONATING?
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Yes. You can log onto New
York Organ Donor Registry and instantly become a "Gift
of Life" individual.
If you
have indicated your wises to be a donor on your driver's
license, ask your local office of the Division of Motor
Vehicles (DMV) what steps you need to take to revoke your
decision. An increasing number of states maintain registries
of individuals who indicate on their driver's licenses that
they wish to be donors. If your state has a registry, your
DMV personnel can tell you how to get on or off the registry.
In all instances, be sure to let your family know whether
you wish or do not wish to become a donor.
DOES THE DONOR'S
FAMILY HAVE TO PAY FOR THE COST OF ORGAN DONATION?
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NO. The donor's family neither pays for, nor receives
payment for, organ and tissue donation. Hospital expenses
incurred before the donation of organs in attempts to save
the donor's life and funeral expenses remain the responsibility
of the donor's family. All costs related to donation are
paid for by the organ procurement program or transplant
center.
WILL THE QUALITY
OF HOSPITAL TREATMENT AND EFFORTS TO SAVE YOUR LIFE BE LESSENED
IF STAFF KNOW YOU ARE WILLING TO BE A DONOR?
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NO. A transplant team does not become involved until
other physicians involved in the patient's care have determined
that all possible efforts to save the patient's life have
failed.
DOES ORGAN
DONATION LEAVE THE BODY DISFIGURED? »Back
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NO. The recovery of organs and tissues is conducted
in an operating room under the direction of qualified surgeons
and neither disfigured the body nor changes appearance of
deceased.
IS IT PERMISSIBLE
TO SELL HUMAN ORGANS? »Back
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NO. The National Organ Transplant Act (Public Law
98-507) prohibits the sale of human organs. Violators are
subject to fines and imprisonment. Among the reasons for
this rule is the concern of Congress that buying and selling
of organs might lead to inequitable access to donor organs
with the wealthy having an unfair advantage.
WHAT IS "REQUIRED
REQUEST?" »Back
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"Required request" is a policy requiring hospitals
to systematically and routinely offer the next-of-kin the
opportunity to donate their deceased relative's organs and
tissues. This policy enable hospitals and health care professionals
to play a key role in increasing donation because families
might otherwise not be aware of their right donate. As of
1992, forty-eight states and the District of Columbia had
enacted "required request" laws.
The Omnibus Budget Reconciliation Act of 1986 (Public Law
99-509) established additional requirements for hospitals
that participate in the Medicare and Medicaid programs.
It required each participating hospital to establish written
protocols for identification of organ donors and to notify
an organ procurement organization designated by the Secretary
of Health and Human Services of any potential donors it
identifies.
Since January 1988, the Joint Commission for the Accrediation
of Healthcare Organizations has required its member hospitals,
as a prerequisite for accreditation, to develop policies
and procedures on the identification and referral of potential
donors.
WHAT ARE ORGAN
PROCUREMENT ORGANIZATIONS (OPOs)? »Back
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OPOs are organizations that coordinate activities relating
to organ procurement in a designated service area. Evaluating
potential donors, discussing donation with family members,
and arranging for the surgical removal of donated organs
are some of their primary functions. OPOs also are responsible
for preserving the organs and making arrangements for their
distribution according to national organ sharing policies
established by the Organ Procurement and Transplantation
Network and approved by the U.S. Department of Health and
Human Services.
In addition, OPOs provide information and education to medical
professionals and the general public to encourage organ
and tissue donation and increase the availability of organs
for transplantation.
HOW MANY TRANSPLANT
PROGRAMS AND OPOs ARE THERE IN THE UNITED STATES?
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As of August 2004 there were 124 liver, 246 kidney, 139 heart, 139 pancreas, 73 heart-lung, and 70 lung transplants programs in the United States. Names and addresses of transplant programs can be obtained from the United Network for Organ Sharing (UNOS) at the following address:
United Network for Organ Sharing
700 North 4th Street
Richmond, VA 23219
(804) 330-8500
United Network for Organ Sharing
As of December 2003, 69 OPOs were certified by the Health Care Financing Administration of the U.S. Department of Health and Human Services. Their names and addresses can be obtained from the following organizations:
Association of Organ Procurement Organizations
1364 Beverly Road - Suite 100
McLean, VA 22101
(703) 556-4242
Life Link
409 Bayshore Boulevard
Tampa, FL 33606
(800) 262-5775
WHAT ARE THE
STEPS INVOLVED IN ORGAN DONATION AND TRANSPLANATION?
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| 1. | A potential donor who has been diagnosed as brain dead must be indentified. |
| 2. | An organ procurement organization is contacted to help determine organ acceptability, obtain the family's permission, and match the donor with the most appropriate recipient(s). |
| 3. | Next-of-kin must be informed of the opportunity to donate their relative's organs and tissues, and must give their permission. |
| 4. | Organ(s) and tissues(s) are surgically removed from the donor. |
| 5. | The donor organs and tissues are taken to the transplant center(s) where the surgery will be performed. |
When a
potential organ donor is identified by hospital staff and
brain death is imminent or present, and organ procurement
organization (OPO) is contacted. The OPO is consulted about
donor acceptability and often asked to counsel with families
to seek consent for donation. If consent is given, a search
is made for the most appropriate recipient(s) using a computerized
listing of transplant candidates managed by the United Network
for Organ Sharing (UNOS) which operates the National Organ
Procurement and Transplantation Network.
It is increasingly common for donors and donor families to
contribute multiple organs and/or tissues. Therefore, several
recipients may be helped by a single donor. When a match is
found, the OPO will arrange for the donated organ(s) to be
surgically removed, preserved, and transported to the appropriate
transplant center(s). A potential recipient(s) is also alerted
to the availability of an organ and asked to travel to the
transplant center where he or she is prepared for surgery.
The recipient's diseased or failing organ is removed and the
donated organ is implanted.
HOW ARE RECIPIENTS
MATCHED TO DONOR ORGANS? »Back
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Persons waiting for transplants are listed at the transplant
center where they plan to have surgery, and on a national
computerized waiting list of potential transplant patients
in the United States. Under contract with the Health Resources
and Services Administration, the United Network for Organ
Sharing (UNOS) located in Richmond, Virginia maintains the
national waiting list. UNOS operates the Organ Procurement
and Transplantation Network and maintains a 24-hour telephone
service to aid in matching donor organs with patients on the
national waiting list and to coordinate efforts with transplant
centers.
When donor organs become available, several factors are taken
into consideration in identifying the best matched recipient(s).
These include medical compatibility of the donor and potential
recipient(s) on such characteristics as blood type, weight,
age, urgency need and the length of time on the waiting list.
In general, preference is given to recipients from the same
geographic area as the donor due to the fact that timing is
a critical element in the organ procurement process. Hearts
can be preserved for up to 6 hours, livers up to 24 hours,
and kidneys for 72 hours. Lungs cannot be preserved outside
the body for any extended period of time.
WHY SHOULD MINORITIES
BE PARTICULARLY CONCERNED ABOUT ORGAN DONATION?
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Minorities suffer End-Stage Renal Disease (ESRD), a very serious
and life threatening kdney disease, much more frequently than
do whites. For example, from 1992 to 1995 African Americans
were more than four times more likely than whites to develop
ESRD; Native Americans were more than three times as likely;
and Asian Americans were almost twice as likely to suffer
from the disease.
ESRD is treatable with dialysis, however, dialysis is costly
and can result in a poor quality of life for the patient.
The preferred treatment of ESRD is kidney transplantation.
Transplantation offers the patient "Freedom" from
dialysis to lead a more normal lifestyle and can successfully
cure ESRD for many years.
As with any transplant procedures, it is very important to
assure a close match between donor and recipient blood types
and genetic make-up. Members of different racial and ethnic
groups are usually more genetically similar to members of
their own group than they are to others. It is important,
therefore, to increase the minority donor pool so that good
matches can be made as frequently as possible for minority
patients.
CAN ANYTHING
BE DONE TO IMPROVE ACCESS TO A DONOR ORGAN FOR THOSE IN CRITICAL
NEED OF AN ORGAN TRANSPLANT? WHAT ABOUT SPECIAL PUBLIC APPEALS?
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The primary barrier to transplant surgery for most of the
people on the waiting list is a lack of donor organs. Quite
simply, the demand far exceeds the supply. Therefore, anything
that can be done to increase the level of donation in this
country would be helpful to all individuals needing transplants.
Families and attending physicians need to maintain close contact
with the transplant team to keep them fully up-to-date on
the patient's condition. A family could assist community groups
in their on-going efforts to increase public awareness of
the need for organ donation.
While family appeals through the media have had a positive
effect on increasing donation overall, efforts do not necessarily
result in an organ being made available to the individual
for whom the appeal has been made. The decision as to which
patient on the waiting list will receive any particular ogran
is made according to objective criteria which include medical
urgency and length on the waiting list, and is not subject
to external influences including those that might result in
inequitable access to donor organs. All prejudicial or discriminatory
practices in organ allocation are forbidden by the policies
governing the operation of the Organ Procurement and Transplantation
Network. However, creating awareness on organ donation in
general will necessarily be of help to all those awaiting
transplantation.