Organ Donors: Sowing Seeds of Hope

Organ donation is a public health crisis. In the U.S., there are more than 116,000 individuals waiting for a lifesaving organ transplant. Every 10 minutes, another individual is added to the national organ transplant waiting list. Due to the shortage of registered organ donors compared to the alarmingly high waiting list, 18 people die every day waiting for a transplant that would have given them a second chance at life.

There are currently more than 92,000 individuals waiting for a kidney with 140 of those patients on the transplant list at West Virginia’s only transplant center, Charleston Area Medical Center, and there are many more West Virginians waiting for other types of transplants at hospitals outside the state.

The Need for Organ Donors

The need for kidney transplantation in the U.S. and in West Virginia is mainly due to chronic kidney disease (CKD), an irreversible disease that results in the progressive loss of renal function over time. If an individual progresses to the fifth stage of CKD, it is referred to as end-stage renal disease (ESRD). At this point, the kidneys can no longer filter blood and remove waste from the body. As a result, hemodialysis or kidney transplantation becomes essential for survival.

Populations such as those in West Virginia with a high incidence of CKD and its risk factors—diabetes, hypertension, obesity, smoking, physical inactivity and a history of cardiovascular disease—have an increased need for access to kidney transplantation. West Virginia has the highest per capita rate in the nation of individuals with advanced CKD starting dialysis. In 2010, West Virginia had the highest adjusted incident rate of ESRD in the country. Furthermore, West Virginia has led the nation in the rate of patients beginning treatment for ESRD, a rate that is exacerbated by the high frequency of diabetes and hypertension in the state’s citizens.

Common medical issues that lead to the need for an organ transplant include diabetes, hypertension, genetic abnormalities, heart defects, cystic fibrosis, cardiomyopathy, polycystic kidney disease, cirrhosis, aggressive viruses and critical medication side effects that cause organ failure. Some people waiting for a transplant were born with these diseases, while others have developed them over their life span. According to national statistics, West Virginia is at an even greater risk for many of these medical conditions that lead to organ failure.

Tissue, skin and eye donation can help many people as well. Corneas, heart valves, dental implants, spinal fusion, tendon replacement, hip or knee replacements, rotator cuff repair and skin grafts are just a few procedures made possible by tissue and skin donation.

Who Can Donate? 

Any person, regardless of age or medical condition, who has sustained a severe brain injury and is on artificial life support can be evaluated as a potential organ donor. Organ donation is considered an end-of-life decision that occurs after all medical treatments have failed and death is imminent. Clinical exams are performed by physicians to determine if a patient has progressed to brain death, which is the total, irreversible cessation of brain activity and a legal declaration of death. Organs that can be transplanted are the heart, lungs, liver, kidneys, pancreas and intestines.

How the Donation Process Works

The first step is for the hospital to call all imminent deaths into their assigned Organ Procurement Organization (OPO). In West Virginia, the Center of Organ Recovery and Education, also known as CORE, serves 51 hospitals across the state. OPOs have trained staff, called organ procurement coordinators, that work with hospitals to help the patient’s family through end-of-life decisions and the donation process.

Once authorization is complete, the patient’s height, weight and blood type are entered into the United Network for Organ Sharing (UNOS), and a computerized match list of national waiting recipients is compiled. The list is broken down by organ, recipients in urgent need, length of time spent on the waiting list and geographical distance. Once the list is generated, each potential recipient will be ranked within the nation for that lifesaving gift. UNOS then notifies the transplant center when a recipient has been appointed to receive the organ. After each of the donor’s healthy gifts has been allocated to recipients, the surgical recovery is scheduled. The recipients’ transplant surgeons fly into the donor’s hospital to recover the lifesaving gifts, and once the surgical procedure is complete, the transplant surgeon will fly back with the organ and transplant it into the awaiting recipient. Great care is given to preserve each family the option for a traditional open casket funeral service.

The donation process can also involve living donors, where a living donor can give a kidney or a portion of the liver, lung or intestine, and, in some cases, eyes and tissues. Oftentimes, if living donors are a match, they can be a direct donor to an individual they know. However, many prospective living donors are not matches for the individual they know and can instead participate in a chain effect living donation kidney exchange where they may be a match for another individual.

Regardless of these dismal statistics, West Virginians can still take action to help the organ donation public health crisis. By registering to become an organ and tissue donor, one individual can save up to eight lives and improve the quality of life for more than 50 individuals. Individuals can designate themselves as donors by registering at the Department of Motor Vehicles or by visiting the Donate Life Web site at www.donatelife.wv.gov.