Federal Organ Donation?
I was just Twittering around yesterday and searched on "organ donation" to see if anyone else Twitters as much about the subject as I do. The title on one person's message stood out: "And Now: Federal Organ Donation".
What?!?
Following the link, I came across this article "Federal organ donation plan faces local opposition" recently published in a local newspaper. I was in shock as I read through the article and realized that, indeed, the federal government wants to mandate that organs donated be sent out of the state of origin.
The current procedure of organ transplant works in a very simple and logical manner.
"Under the existing rules, the neediest and most appropriate patient in the state receives the donor organ."
The closest hospital to the organ donor receives the first call and if no recepient can be found, then the next closest transplant hospital is called and so on until a suitable match has been found. By following this procedure, my own husband received his donated lungs from just over Lake Michigan in Detroit (we are in Milwaukee).
However, 75% of donated organs stay within the state in which the organ donor has passed. It is possible, with this new plan, that families will be less likely to donate organs if they are leaving their own state.
It seems that the government does not understand that not only will the rate of organ donors be affected but also that the viability of the organs may also suffer. Every minute an organ is in transport to a recipient - every minute it is without blood supply - its viability decreases. In essence, the longer it takes to get to its new home, the more the tissue and organ dies. This increases an already high risk for the patient for the organ to not revive or for the recipient to have transplant rejection.
The current organ donation network procedure allows for greater possibility of a long and healthy life after transplant... so why fix what is not broken?
Hospital systems are asking patients, donor families and other concerned members of the community to voice their opposition to the proposal by April 24 at www.notacoalition.org.
Labels: Transplant News
1 Comments:
I don't know... I think this is a harder shot to call than just opposing it...
There were people opposed to the LAS/Lung Allocation Score when it came out -- particularly people with a lot of time on the list -- and come CFers who probably didn't need to be there... The effort was to transplant the neediest/sickest first -- to transplant the one more likely to die without it...
I believe that right now they're looking particularly at livers... Organs have historically been offered first locally, with certain accommodations for the very sickest "status 1" or whatever they call them... Now, they might be looking more at regions and beyond instead of just 50 mile concentric circles...
If there is someone in Wisconsin who is going to die in 24 hours -- and someone in Illinois who is bad off, but may have months left to live -- and transit is not an issue -- who do you save? The possibility/probability exists that both lives might be saved if that liver is rushed to Wisconsin because the Illinois candidate has the possibility of getting an organ later...
It is allocation of a very scarce resource with the desire to save as many lives as possible...
For some donor families, it is comforting that their loved one's organs help someone in their community (or within 50 miles or so...) But, that doesn't necessarily happen with kidneys now -- they can deal with a much longer ischemic time and they undergo tissue typing/matching and may be sent far away to the best match first... Granted, there are "paybacks" where the OPOs may owe each other kidneys in return for one coming into their service area and I'm not completely certain how that works...
Right now, the proposals on the UNOS website seem to involve livers... Your point about viability probably applies more to hearts and lungs -- but livers have substantially longer ischemic times -- not as much as kidneys, but substantially longer than hearts and lungs...
And, I don't know how much donor families -- and potential donor families -- would be upset enough that their organs were going out of state to refuse... Your husband's lungs came from Detroit -- Michigan has, I believe, more than one lung transplant program and your husband may have been the closest for the type and size offered, but I don't know that would have upset his donor family... My lungs came from Iowa and I'm in Chicago -- from what I've learned of the family who saved my life, in their grief they were happy to have saved a life -- My donor's Mom is in healthcare -- I think she would have wanted her daughters lungs go to the person who needed them most...
I haven't read the entire proposal... These decisions are made by several committees at UNOS who are manned by doctors, healthcare professionals, as well as people like you and me (I served on the Patient Affairs Committee for two years...) An incredible amount of thought goes into this process -- it is not a "government" decision -- it is a decision made by unpaid committee members who are people like you and me, and they often struggle with these decisions -- and they always welcome comments... All of their proposals are open for public comments always...
I've read some of the proposals, but not all (they're quite dry reading)... But I don't think I oppose this situation...
You take care... Love, Steve
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