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Occasional ramblings by an anesthesiologist/mother (and sometimes her husband).

Wednesday, May 17, 2006

Organ Donation

Organ donation has always been a pet project of mine. I was the president of the Organ Donation Interest Group at my medical school. I also worked on the Decision for Life project, which was geared toward education minorities about organ donation and encouraging organ donation. Organ donation is one of the most generous gestures a person or family can make. It has a profound impact on many lives.

There was an Op-Ed published in the New York Times a few days ago, titled Death's Waiting List . In it, Sally Satel talked about what it was like to wait for an organ (she received a kidney transplant) and put forth some suggestions as to what the government could do to improve the situation. She is one of the lucky ones because she got her kidney after being on the list for only a year. She does make some interesting arguments.

First, she points out that the Institute of Medicine issued a report titled "Organ Donation: Opportunities for Action" in which they only suggest one new initiative. They recommended expanding eligibility beyond brain death to people who die from cardiac arrest. Since there are a much larger number of people who die from cardiac arrest, this could potentially include more organs to the system. I think this is a great idea. This doesn't mean all of the people would actually qualify to donate or that their organs would be viable - but it still increases numbers.

Secondly she discusses some other options that she felt the NIM should have discussed. The European system is interesting. In contrast to the system in this country, where you need to expressly state your desire to donate and (in many states) tell your family of your intentions, in Europe they have "presumed consent." This means that it is assumed you wish to donate your organs unless you sign an "opt-out" card. This is an interesting idea. It would certainly increase the number of available organs. But I do find the idea of "presumed consent" slightly discomforting. There are some cultures that view organ donation as a desecration of the body, and if the way to opt out is not well publicized, it is possible for someone who does not wish to donate to become a donor by default.

Another option she discussed was offering incentives to donate, giving things in life to people who are willing to donate after death. Traditionally, this has not been discussed much because it is perceived as being "organs for sale." I think that the sale of organs should be banned. However, I think that if someone makes the choice to donate their organs deserves something. I know that in some states, living donors can have their medical expenses related to the donation covered by the state. I think that this is a good idea.

And there are options to donate while living. Living kidney transplants are being performed all the time. Live liver donor transplants are also being performed. There is a long list of people waiting for bone marrow transplants.

Last week I had the privilege to provide anesthesia to a living kidney donor. He was giving his kidney to his father. It also meant that there were TV cameras in the OR, because a local news program was doing a feature story on them. I admire the son. He's in his twenties and decided to give a kidney to his father. This puts him at risk of kidney problems in the future simply because he has one less kidney. Then there was the risk of the surgical procedure and the anesthetic. Essentially, we were performing surgery on a person who doesn't need it.

Think about being a donor. Talk to your family about it and make sure they know your wished. Check out the National Donor Marrow Program . Donate life.

5 Comments:

Anonymous Anonymous said...

Sounds like loads of fun...
Did your guests at least appreciate the efforts?!

4:40 PM  
Blogger TC said...

So, I'm perusing Grand Rounds, and suddenly I'm like, "Hey! Who'd talking about organ donation besides me?" Good post. Thanks,

TC

5:39 PM  
Anonymous Anonymous said...

I donated a kidney December 2005. The young lady that I donated to is doing great. I would do it again!

2:59 PM  
Blogger CODA-Organ Donation Charity said...

My Heart Transplant

My blog will take you through my personal experience of having a heart transplant. It will show the importance of organ donation. It will give guidance in case you or a loved one have to go through the transplant experience.

If the averages held, on the day I received my new heart 18 other people died somewhere in the U.S. because there wasn't a heart, kidney, liver or other organ available to save them. That makes me a very lucky guy.

I now have a chance to see my first two grandchildren this year. Both my daughter and my daughter-in-law are pregnant. Even more importantly my father, who has inoperable pancreatic cancer, has a chance to see his first two great granchildren before he dies.

What do you do when you have been blessed with a second chance in life? That's an individual decision for everyone. I decided to organize CODA. The aim is to provide financial help to the less fortunate for the cost of prescription drugs and medical costs. It also awards scholarships to young organ recipients to help them with school costs. It is a 501 (c)(3) charity so financial contributions are deductible according to state and federal law.

Organ recipients have to take anti-rejection drugs for the rest of their life. If they don't, they will die. Many people cannot afford the costs involved in a transplant. Through CODA I'm trying to help. You can visit our website at www.codacharity.org.

Don't be intimidated by the "Make a Donation" button. It's not asking for you to donate an organ. It merely takes you to "Paypal" if you'd like to make a secure tax-deductible charitable contribution via the Internet. Thanks and I hope you enjoy reading about my personal experience.

Any day is a great day for a patient to receive a transplant, but to receive my heart on Valentine's Day, 2004 is very special to me and my family.

2:24 PM  
Blogger Sara said...

This is a conversation I have been having with someone via email (most recent at top), I am happy to donate my organs, however I also support this persons argument, we should be told if the person recieving the organ is an alchoholic or drug addict, I would not be happy to donate my organs to someone who was not going to appreciate them or look after them, I would rather they went to someone who really needed them, but until we have this choice, I will be staying on the organ donation list, I would be interested in hearing other peoples thoughts on this. Sara


Sara

Going through your local MP is so simple. I know because i have had to do it recently. And the woman that i deal with at the MP's office is so good and willing to help.You can tell its a labour majority up here and that they are desperate to appease the voting public...clinging on to every seat they can i suppose.

I went to my MP's surgery to start the process but, with a thing like the transplant list i think its a case of emailing them or writing to them. Im not sure it would get very far though. Although i bet if other ppl thought about it they would understand where im coming from...probably me being a selfish cow again though...i just feel i should have a small say on the ppl i dont want to receive my organs. Not very P.C. i suppose but they are my organs at the end of the day and i think i have a right to have an opinion. Its not like im being racist,sexist,ageist,or bigoted i'm truly not. I really dont care if the people who receives my bits and bobs are black,white,purple,male,female,100,16,catholic,muslim, hindu or protestant. I just want to ensure that what little i can give goes to someone,who through no fault of their own,who is very ill should be the recipient rather than an alcoholic etc who has chosen to destroy their own body...i know its an illness of sorts but its not born to them or done to them in an accident.

Do you see where im coming from? I really dont mean to sound harsh or judgmental. And i honestly think that everyone that can donate should donate but if someone has a particular objection to something i think as part of their human rights and liberties then that objection should be taken into account.Blah blah blah, god i know i can go on, but this is one bee up my bum that i cant shift at the minute. You would think i was going to die tomorrow the way im going on. It's just something i want to get right before its too late, you never know what tomorrow will bring. And its not something i want my family to have to stress over if the question is ever put to them.

Harsh as it may sound but maybe if the ppl who are waiting for a transplant due to alcoholism,drug abuse and smoking(i wonder what percentage this is)were not permitted to be eligible for a transplant then that would ensure that only the truly "in need" get what they require.It sure as hell would make my dilemma easier. And anyway if the NHS can pick and choose who receive cancer treatment when it comes down to a post code lottery then surely a donator should have a small voice in certain elements.

Im going now before my soapbox gets any higher...

night



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Subject: RE: Still unsure
Date: Sat, 12 Aug 2006 21:14:47 +0100

Hello again,



I agree with what you're saying, and I think a disclaimer of some sort is a great idea, and I would certainly use it for the likes of alcoholism, and drug addiction, but until that comes along then I'll have to take the chance, but as you say, it's not a chance we or our families should have to take. Maybe we should write to our MP or something, how do you go about this sort of thing?




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Sent: 12 August 2006 12:09
Subject: Still unsure



Sara

I know what your saying but its not that simple. The two girls you mention are the very kind of ppl i would be pleased to receive my organs. I would be furious if the likes of George Best got my liver and pissed that up the wall the way he pickled his own. Thats just dispicable in my eyes i would be out for blood if the liver that was donated to him came from one of my family.

I have talked with my husband about this(after we watched a programme about it) and he felt the same. I just think as im treating my organs with respect i think i should have a small say in this. I would like to put disclaimer on my donor record stipulating i dont want my organs to be used by someone who was/is an alcoholic...its not a treatable disease after all!.

I have a heavy heart thinking about this but i think its a justifiable worry. Something i have to think over and decide in time i suppose but thanks for your view.

Take care




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Subject: RE: what do you think?
Date: Sat, 12 Aug 2006 10:54:21 +0100

Hi



I think I would be happy to leave my organs to whoever needed them, why punish the many for the failure of the few, I saw two litte girls die because they never got the transplants they needed, and if someone who was a smoker or a drinker did get them, then it could be the second chance of life that turns their life around, who are we to judge, there for the grace of god go I. Hope that helps.






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Sent: 10 August 2006 16:31
Subject: what do you think?



Sara

here's a question for you. I am have signed up to donate my organs and tissue in the event of my death. However i have recently been thinking of how i would feel if say someone like George Best received my liver to help save his life,we all know he wasted his own liver and that of the donated liver. I emailed the donation ppl and they told me that all donations are made freely and we can not put a disclaimer on to who we would like our organs to go to. I personally dont want my organs to go to some alcoholic who has ruined his own liver and i dont want my lungs going to anyone who needs a lung transplant who has a 20 a day habit!! What do you think about this? I would like to think that in the event of my death my healthy liver and lungs etc would go to someone i know would be grateful for a second chance of life...im now rethinking about having my name on the donation list!

5:08 AM  

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