Dr. Kevin Most: Organ Donation

Dr. Kevin Most on the Steve Cochran Show

December 23rd, 1954 was the date of the first successful living related kidney transplant. It occurred in Boston at Brigham Hospital. That landmark surgery opened the floodgates over the next 50 years. The impact that these surgeries has made on individuals is beyond words. I thought we would take a few minutes and discuss the importance of being a donor, what you need to do and hopefully educate you about some of the miscommunication that you hear about organ donations.

Is there need for organ donors? Yes, we have close to 120,000 individuals currently waiting for a lifesaving organ transplant. In the United States we perform over 30,000 transplants each year. Unfortunately 8,000 people die each year waiting for a transplant. Everyday there are missed opportunities from patients who had not registered to be a donor and did not share their desire to transplant with loved ones. The message here is go on line and register, share with your family and friends your support of the Organ Donation program.

Let’s clear up some old wives tales right away. First there is no age limit as to who can be a donor, in fact there have been donors that have been aged 92, so age is not a reason to not sign up. It is about the condition of the needed organ not your age that limits use. On the receiving end the same applies in many cases, they have done cornea transplants on individuals over 100 years of age.

Probably one of the biggest issues that needs to be addressed is that we as doctors do not treat you any differently as a patient. Our goal is your health and we continue to do that regardless of your donation status. No donations occur until the patient is considered legally and clinically dead.

Also there is no cost to being a donor. The donor family pays only for the medical expenses before death. They are not charged at all for any of the donor services. Second, being registered as a donor does not change any of the medical care patients receive. No actions for donations are even considered until there is complete and irreversible loss of brain function.

You will always hear someone say the system is fixed and only rich people get transplants. That is also not true. There is a national system that matches all of the information before a decision is made. This includes blood type, tissue type, distance and time to the donor, how sick they are and how long have they been on the list. Race, income, gender, social status or celebrity status are never considered.

Overall do we do a good job registering? Not bad we are over 54% of adults are registered but we really could do so much better. There is no reason that number is not closer to 80% or higher. One problem we have in the US is that the need for donations is growing faster than the donor list. We all need to help and take a part in this.

Today, ask everyone you see if they are registered donors, if they say no, ask them to consider it. Tell them that 50,000 individuals a year have their vision restored through corneal transplants, and over 1,000,000 have had this surgery since 1961. 50,000 individuals who may not have been able to see their grandchild in a play, or watch the Cubs win a World Series did so last year because of the generosity and planning of individuals who cared. The cool thing about corneas is they don’t have to match your blood type. Corneas are universal and can be transplanted in any patient.

Let’s talk a little bit about what this means to individuals. 80% of people on the waiting list are kidney failure patients. Unfortunately the kidney is at times a fragile organ and damage to it from high blood pressure, toxins and dye we use for CT scans can damage it to a point it no longer filters well and dialysis is needed. The average time to wait for a kidney donation can reach 5 years, for those 5 years the patient is very limited in activity. Their life is focused around the lifesaving dialysis they need. They can’t travel for vacations, they need to stay close to home. The most interesting thing about kidney donors is that many come from living donors. Yes! We were born with 2 kidneys and for most of us a single kidney can do the work of two and we can live with one. You have probably heard stories where a twin donates a kidney to his twin. Is there risk involved with this type of donation, well, your back up kidney would be gone and you would need to be careful to minimize the damage to the one remaining kidney by controlling your blood pressure and minimizing any drugs or dyes that may impact your kidney function. The other amazing organ is the liver which can also support a live donation. The liver can regenerate and get back to normal function.

Burn patients need skin grafts – the most painful of all injuries one can have is a burn. For those of you who have had a small burn you know the pain involved. Imagine the patient with a large burn that needs skin grafts and the pain they are going thru. Skin is our largest organ and probably one of the most important behind the heart and brain. Many individuals who have had surgery for obesity have raised the question of being able to donate skin as their body changes, unfortunately that has not proven to work and skin is not an organ that can be donated while alive.

And let’s not forget Blood donations, everyday there is a need for blood in hospitals. It is thru donations from blood drives that saves the lives of hundreds if not thousands of patients every day. We do have limits on how often you can donate blood, the standard is usually 60 days between donations of blood. The beauty of blood is that we continually form blood cells. The average blood cell will be functional in our body for 120 days. We have about 10 pints of blood in our system, blood donors donate one pint. A unit of blood lasts about 40 days before it needs to be discarded. All blood collected is screened for HIV, Hepatitis and other diseases.

So if you have not signed up please go on line and do so. In Illinois we do not allow 16 and 17 year olds to register as Organ donors, there is a law being reviewed right now in Illinois that would allow these individuals to register, so if you know your local state rep, encourage them to support the bill. ( HB1805/ SB 868) For those of you in Illinois it is on line at the DMV for others listening outside of Illinois go to organdonor.gov to register. Ask your coworkers, friends, people you pass on the street to sign up.