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Information on Organ Transplantation

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.

Taking action

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 match.

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.

Dr. Hesson is board certified in internal medicine and nephrology and serves on the medical staff at Cayuga Medical Center. His practice is located in the professional building adjacent to the Medical Center.

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