Transplanting organs: How are decisions made

-Dr.Dianne McCallister, Chief Medical Officer at Centura's Porter Adventist Hospital

The recent high profile cases of donated organs after severe auto accidents has raised our awareness of this life-saving gift from the victim's family.  

While organ transplantation has become much more common, many of us still have question regarding how it happens, and how decisions are made to use the organs, and to whom they go.

Transplants are such a gift to the recipient - what tissues can be transplanted?
 
Kidneys, liver, the pancreas, intestines, hearts and lungs are the most widely known, but skin, eyes bones, tendons and heart valves are among the other tissues that are transplantable.
 
How do organ donors choose to give their organs?
 
In our state (Colorado), we can choose to be organ donors, and note it, on our driver's licenses.  
 
The decision to donate multiple vital organs, which we hear about after severe accidents, is made after brain death - which verified by a specialist using tests of brain function.  
 
At that point, the family of the donor gives the consent to donate the organs.  Therefore, it is important to have this difficult discussion with your family, if you wish to donate your organs.  
 
It is important to note that in hospitals, we treat all patients with the goal of helping them live.  It is only after brain death - which is irreversible, that we consider organ donation.
 
A completely different ability to donate is after a natural death in the hospital - at which point skin and corneas can be donated - giving someone the gift of sight or the ability to heal large burns/wounds.
 
What type of testing is done on the donor to assure the organs are safe?
 
Donors cannot have cancer, or transmittable diseases.  The donor is also screened for infectious diseases such as HIV and hepatitis.  Also, the function of the organs is determined to make sure they will function well in the recipient.
 
Are there other options for donating - other than after death?
 
Yes, there is the option of being a living donor of certain organs - the most common is kidneys.  Because we have two kidneys, and one is enough for us to function, people can donate one of their kidneys - often to friends or family.  However, we've had instances of complete strangers giving someone this gift of life.
 
How do the organs get distributed?
 
For deceased donor organs, there is an organization called United Network for Organ Sharing (UNOS) which maintains a list of people in need of a transplant.  
 
There is a scoring system that ranks the people based on how critically ill they are, as well as how long they have been on the list.  This assures equality in the use of donated organs, which are in short supply.
In addition, the blood type and antibodies of both the donor and the recipient are tested to assure that they are compatible.
 
In the case of living donors, the organs are usually designated by the donor to go to a specific recipient.  However, there are organizations that help match donors to recipients in need.
 
Are there any psychological issues involved?
 
There can be, and there is an entire support team, including psychological support to help the recipients deal with the disease, and with the transplant process and recovery.
 
Also of note, almost every faith group supports the donation of organs to save lives as an act of generosity.
 
How do they prevent rejection?
There are drugs that the recipient of an organ have to take for the rest of their life, to prevent their body from rejecting the donated organ.  They are followed closely at regular intervals to test for rejection - and treat it if it begins.
They also test the function of the donated organ to be sure it is working well.
 
Are there other options for donating - other than after death?
 
Yes, there is the option of being a living donor of certain organs - the most common is kidneys.  Because we have two kidneys, and one is enough for us to function, people can donate one of their kidneys - often to friends or family.  However, we've had instances of complete strangers giving someone this gift of life.
 
Dr. McCallister is on 7NEWS at 11 a.m. every Wednesday. If you have a topic or question you would like her to discuss, email 11am@thedenverchannel.com .
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