Thursday, November 30, 2023

Flowers, chocolates, organ donation – are you there?

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Chocolates and flowers make great Valentine’s Day gifts. But what if the gifts we’re giving this year could truly change lives? A gift that could save someone’s life or free them from dialysis?

You can do it. For people in need of organ, tissue, or blood donation, a donor can give them a gift that exceeds the value of anything you can buy. That’s why February 14 isn’t just Valentine’s Day, it’s also National Donor Day, a time when health organizations across the country sponsor blood drives and organ and tissue donation registrations. Read on if you’ve ever wondered what can be donated, if you have concerns about donating your organs or tissues after death, or if you were concerned about the risks of becoming a living donor.

The huge impact of organ, tissue or cell donation

It is difficult to overestimate the impact that donors can have on the lives of people whose organs are failing. Imagine that you have kidney failure requiring dialysis 12 or more hours a week just to stay alive. Even with this, you know that you are still at risk of dying prematurely. Or, if your liver is failing, you may experience severe nausea, itching, and confusion; death can only be a matter of weeks or months. For people with cancer who need a bone marrow transplant or those who have lost their sight due to corneal disease, finding a donor may be their only good option.

Organ or tissue donation can reverse these problems, giving recipients a chance for a long life, a better quality of life, or both. And yet, the number of people who need organ donation far exceeds the number of compatible donors: around 90% of people in the United States support organ donation, but only 60% sign up. About 109,000 women, men and children awaiting organ transplants in the USA. About 6,000 die each year, still pending.

What can we give?

The list of ways in which a donor can help a person in need has grown considerably in recent years. Some organs, tissues or cells can be donated while you are alive; other donations are only possible after death. A single donor can help up to 75 people!

Here is a list of the most commonly donated organs, tissues and cells.

After death people can donate

  • bones, cartilage and tendons
  • horny
  • face and hands (although rare, these are the latest additions to this list)
  • kidneys
  • liver
  • lungs
  • heart and heart valves
  • intestine
  • pancreas
  • skin
  • veins.

Online donations may include

  • birth tissues, such as the placenta, umbilical cord, and amniotic fluid, which can be used to help heal skin wounds or ulcers and prevent infections
  • blood cells, serum, or bone marrow
  • kidney
  • part of a lung
  • part of the intestine, liver or pancreas.

To learn more about the different types of organ donation, visit Donate Life America.

Becoming a donor after death: questions and misconceptions

Misconceptions about becoming an organ donor are common, and they limit the number of people willing to register. For example, many people mistakenly believe that

  • doctors will not work as hard to save your life if you are known to be an organ donor, or worse, doctors will harvest organs before death
  • their religion forbids organ donation
  • you cannot have an open casket if you donate your organs.

None of this is true and none should discourage you from becoming an organ donor. Legitimate healthcare professionals always keep the best interests of the patient first. Care would never be compromised because of a person’s choices about organ donation. Most major religions allow and support organ donation. If organ donation occurs after death, the clothed body will show no outward signs of organ donation, so an open casket is an option for organ donors.

The experience of being a living donor

If you donate blood, there is little or no risk. Other donations carry real risk. Surgery to donate a kidney carries a risk of complications, reactions to anesthesia and a long recovery time. Donating a kidney, or part of a lung or liver, is no small feat.

Donating bone marrow requires minor surgery. If general anesthesia is used, there is a risk of reaction to the anesthesia. Since the bone marrow is removed by needles inserted into the back of the pelvic bones on either side, back pain or hip pain is common. This can be controlled with pain relievers. The body quickly replaces the removed bone marrow, so no long-term problems are expected.

Stem cells are found in the bone marrow. They also appear in small numbers in the blood and can be donated through a process similar to donating blood. It takes about seven or eight hours. Filgrastim, a medicine that increases the production of stem cells, is given several days in advance. This can cause side effects, such as flu symptoms, bone pain, and fatigue, but these tend to go away soon after the procedure.

The large number of living organ donations go without complications, and donors generally feel quite positive about the experience.

Who can make a donation?

Almost anyone can be an organ, tissue or blood cell donor. Exceptions include anyone with active cancer, a generalized infection, or organs that are not healthy.

What about the age? By itself, your age does not disqualify you from organ donation. In 2019, approximately one third of organ donors were over 50. People in their 90s donated organs when they died and saved the lives of others. However, bone marrow transplants can fail more often when the donor is older, so donation of bone marrow by people over 55 or 60 is generally avoided.

Finding a good match: immune compatibility

For many transplants, the best results are obtained when there is immune compatibility between the donor and the recipient. Compatibility relies heavily on HLA typing, which analyzes genetically determined proteins on the surface of most cells. These proteins help the immune system to identify cells labeled as foreign or as individuals. Foreign cells trigger an immune attack; cells identified as themselves should not be.

HLA typing can be done through a blood test or a cheek swab. Close relatives tend to have the best HLA matches, but complete strangers can be a good match too.

Fewer donors among people with certain types of HLA make it more difficult to find a match. Already existing health disparities, such as higher rates of kidney failure Black Americans and communities of color, can be aggravated by less donors of these communities, an inequality due in part to a lack of confidence in the medical system.

The bottom line

As National Donor Day approaches, think about the impact you can have by becoming a donor, whether it’s during your lifetime or after your death. In the United States, you must choose to become a donor, unlike some countries where everyone is considered an organ donor, unless they specifically choose to opt out. Research suggests that an opt-out approach could dramatically increase organ donation rates in this country, but currently there appears to be no movement in this direction.

I hope that organ donation in the United States and around the world will increase over time. While you can still buy chocolates for Valentine’s Day, maybe this year you can get bigger and donate too. Let me know what you choose – and why.

Follow me on twitter @RobShmerling

The post office Flowers, chocolates, organ donation – are you there? appeared first on Harvard Health Blog.


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