Organ Donorship | Gift of Life or Not and at What Price?

Organ Donorship. We are sometimes confronted with the controversial question of who can be an organ donor and what can be donated? Is there a defining age and who determines if the conditions are viable for transplanting an organ? How do I decide?

We often think organs are only donated after death. In reality, there are "living donors" as well as deceased. Who are they and what did they donate?

The website www.organdonor.gov is an enlightening center of information and should be referred to before considering this program and before talking to any Organ Donor Bank or Registry, so that all the details are known and can be considered. The following information is taken from that website and is offered to highlight the answers to some of the basic questions and to put into question those issues that need to be addressed before agreeing to being an organ donor.

Local Organ Procurement Organizations (OPO) coordinate donations. They evaluate potential donors, discuss with the surviving family members the arrangements for surgical removal and transportation of a donated organs.

Organ Procurements and Transplantation Networks (OPTN) perform testing to match donated organs with recipients throughout the country.

Organs that can be donated are kidneys, heart, lung, liver, pancreas, and intestines. Combinations are also taken as heart and lung; and kidney and pancreas. These organs cannot be stored. They must be transplanted within hours of removal. Most donors are deceased, but "Living Donors" can donate a kidney, part of the pancreas, part of a lung, part of a liver, and part of the intestines.

As tissue is now also being used in transplant situation, the potential of improving "quality of life" for someone is ever increasing. Tissue banks now store corneas, middle ear parts, skin, heart valves, bone, veins, cartilage, tendons, and ligaments. These tissues are being used to restore sight, cover burns, regain hearing, replace veins, and mend damaged connective tissue and cartilage.

Adults 18 to 60 can donate blood stem cells. Two types of removal are possible: bone marrow; and peripheral blood stem cells.

Bone marrow is the soft tissue in the interior of bones and is the major site of blood cell production. Stem cells are removed from the marrow.
Peripheral Blood Stem Cells are the same stem cells found in marrow and can be pushed into a donor's bloodstream after receiving a daily injection of a medication called filgrastin. The medication increases the number of stem cells circulating in the bloodstream and provides a source that can be collected in a way similar to a blood donation.

Cord Blood Stem Cells is the current most controversial method of collection. The umbilical cord that connects the newborn to the mother contains high levels of stem cells in the blood of the cord. Cord blood stem cells can be collected and stored in storage freezers for long periods of time, offering another source for valuable life elements.

Blood and Platelets are formed by the body and go through a life cycle, continuously being replaced throughout life. Blood and platelets can be donated more than once. It is safe to donate blood every 56 days; and platelets taken up to 24 times a year.
Blood is stored in a blood bank by type (A,B, AB,O) and by the RH factor (+ or -). Blood can be used whole or separated into packed red cells, plasma and platelets.

Platelets are the cell fragments that circulated throughout the blood and aid in clotting. Platelets can be donated without donating blood. Where a specific patient needs platelets but not blood, a matching donor is found and platelets are separated from the rest of the blood, with blood being returned to the donor. A donor's body will replace the missing platelets with a few hours.

Theodore Miller in his book "The Day I Died" explains the timing and sequence necessary for harvesting and transplanting organs. Because of the critical nature of the procedures, timing must be precise and handling and transportation in place and ready. Imminent death isn't on a time schedule, but organ donors and transplants are. Mr. Miller puts it is a perspective you can understand.

"The Day I Died" ....buy it here.

Donation after Death is classified in two categories: Death after Brain Death; and Death after Cardiac Death.
Death after Brain Death. Most transplant organs come after the death of a donor as a result of an accident, heart attack, or a stroke. "Brain Death" is total cessation of brain function, including brain stem function. Oxygen is not flowing to the brain, the brain no longer functions in any manner and will never function again.
Organs and tissue in good condition can be removed in a surgical procedure and all incisions are closed so a standard funeral service (open casket) can take place if desired. It is not until the organs are removed that the patient is taken off artificial life support. Organs must be used within 6 to 72 hours after removal; tissues such as corneas, skin, heartvalves, bones, tendons, ligaments, and cartilage can be preserved and stored in a tissue bank for later use.

Death after Cardiac Death. Some patients cannot be declared dead even though it is the inevitable outcome. This is where they have sustained a traumatic brain injury based on the definition of brain dead, but cannot be declared dead until the heart stops - this is cardiac death which is the cessation of cardiac and respiratory function which usually occurs when life support therapy is withdrawn. Donation occurs only after a family decides to withdraw life support for reasons entirely apart from any potential organ donation.

Whole body donation can be done by those people who wish to donate their body to medical science. Arrangements should be made directly with the medical school or willed body program of choice prior to a death situation.

Deceased donor families should check procedures and costs involved. Consideration and decisions are usually requested in an immediate situation. There can be financial ramifications and should be known before proceeding. If you are an organ donor your family should be aware of it and details discussed before the need arises.

Living donors need to thoroughly check procedures, after care of the donor, and potential financial ramifications. The donor is placing his/her life and those in their family at risk as surgery is still surgery and continuing care of the donor is required as complications can occur. You need to know who is paying for the procedures, who is paying for continued care of the donor, especially where complications may place you at risk and your life in jeopardy for the balance of your life. It's not always easy and perfect, and can be financially devastating as insurance and Medicare do not always cover all of the potential charges. You are making a large personal life and financial commitment. Be informed and make informed decisions knowing the risks before you sign your name. Ask the questions and get the answers not assumptions.

Donating organs and tissue can be the difference in a quality of life for donors and recipients. Lives are being saved and prolonged because unselfish donors are offering help in donor programs and for research. Families of a deceased donor enjoy the knowledge that a life continues through another individual that would not have been possible otherwise. Living donors know the gift they share changes the quality of life for others because they took the chance to offer it.

The decisions are difficult, the potential life change for others is great. Talk to the people who have the answers. Social workers at the hospitals should be able to lead you to the right people in your area to provide the answers to your questions. Make the right decision for you and your family.