Information on Organ Transplantation
Guidelines for organ donation
By Robert A. Hesson, M.D., F.A.C.P.
In recent years the guidelines governing organ donation and transplantation
changed in two significant ways: a broader range of people are now considered
to be viable donors; and more people in need of organs are deemed eligible
candidates for transplant surgery.
The previous criteria for organ donation were very restrictive, and many
people who were interested in donating their organs were prohibited from doing
so. The greatest common obstacle was age; if your chronological age was over 55
or 60, your organs were considered a poor risk. Under
the revised guidelines, the donor’s physiologic age (the shape your body is in)
is considered more important than the actual number of years you have lived.
This enlightened approach allows the transplant network to tap into a whole new
group of healthy, older donors.
On the receiving end, people in need of organ transplants were often deemed
ineligible because they were too old. In a similar vein, those restrictions
have also been eased, allowing older individuals to become candidates for
transplant surgery. Moreover, through UNOS (the Unified Network for Organ
Sharing), organ procurement agencies can more easily match donors and
recipients by age. This allows the organs of older donors to go to older
recipients. In the past, a 65-year-old man with kidney failure would have gone without a transplant, however, now he may become
the recipient of a kidney from a healthy 65-year-old donor.
The single biggest reason people in need of organs don’t receive them is
that there aren’t enough donors. Therefore, the most important thing each of us
can do is talk to our families about organ donation.
Signing an organ procurement card is not enough; we must all have a
conversation about organ donation with our parents, our spouses, our
significant others, and our children. Families often disagree about donating
the organs of someone they love, and one dissenting family member can (and
almost always does) prevent organ donation. However, if you have made your
wishes known by talking candidly with each family member, your family is then
likely to consider the fulfillment of those wishes as a last act of love, and
they will donate your organs.
What can be donated and by whom
Many types of organs and tissues are now successfully transplanted,
including heart, lungs (and heart-lung combinations), kidneys, pancreas, liver,
small bowel, skin, eyes (for the corneas), ear bones, and bone marrow. Healthy
people of all ages make good potential donors.
If you belong to an ethnic group that is not found in high concentrations in
the general population, it is especially important for you to become a
potential organ donor. It is a little more difficult to find good tissue
matches for ethnic recipients because of a low percentage of similar donors,
although transplantation across ethnic lines is done when there is a good
Individuals whose organs and tissue are not accepted for transplantation
include people with any type of cancer (except certain brain cancers that do
not spread to other parts of the body), diabetes, active infections (like
pneumonia), and chronic diseases such as AIDS and hepatitis.
Don’t put it off
The revised, more liberal guidelines for organ transplantation mean there
are more people than ever before who might be saved with donor organs. If you
are interested in the possibility of saving someone else’s life—perhaps the
lives of several people—by donating organs you cannot use in death, make the
necessary arrangements now. Sit down for a periodic review of your will, health
care proxy, and advance medical directive. If you have not made arrangements
for organ donation, there is no time like the present.
is board certified in internal medicine and nephrology and serves on the
medical staff at Cayuga
His practice is located in the professional building adjacent to the Medical Center.