What you might not know about this lifesaving act
The most important fact to know about organ donation is that many people who need a new kidney or liver or heart never get one. Each day, about 18 people in the U.S. die while awaiting a replacement for a diseased organ that no longer works.
But that fact doesn’t tell the whole story. Organ donation is complicated. It sparks strong emotions and ethical debates. And, while the need for more organs can seem desperate, generous donors and new developments in transplantation give reason for hope.
Here, transplant surgeon Sameh A. Fayek, MD, talks about the acts of generosity on which his work depends. Ranging from the must-know to the quirky, the facts he shared paint a fuller picture of organ donation in America:
Anyone can sign up to be an organ donor.
No matter how old you are or what diseases you've had, you can register to donate your organs. Only after your death will doctors assess whether your organs might help people who need new ones.
"Years ago doctors would automatically say no to organs from people who were over a certain age or more likely to have health problems," Fayek says. "Today we look at the relative risk: It's often better to take an older organ that might not last as long rather than wait for a younger organ that might never come."
Living people can give more than their kidneys.
Most transplanted organs come from deceased donors. But the living can — and do — donate. Because humans have two kidneys and can live with one, giving a kidney is the least complicated and most common kind of living organ donation.
However, you can also donate part of your liver (and, in rare cases, part of your lung). In fact, Rush plans to start a living donor liver transplant program in the coming months.
It's possible to 'swap' organs.
Most living donors give their organs to close friends or family members. But some of them give to people they don't know.
This usually happens when someone wants to donate to a friend or relative but is not a good match. "Swaps" match two (or more) of these would-be donors with each other’s intended recipient. More and more common, swaps can involve two sets of donors and recipients or a group of several people.
Sometimes, the whole chain starts with an altruistic donor, someone who wants to donate while living without having any connection to a recipient. "You’d be surprised how often people simply feel called to donate an organ," Fayek says.
After you donate, your remaining organ picks up the slack.
What remains makes up for what's gone, so your body keeps working normally.This is one of the reasons that donating a kidney has few risks for the donor.
Some people have three or four kidneys.
Kidneys from deceased donors last for a median of nine years, and kidneys from living donors last for a median of 15 years. For that reason, some people with kidney disease need more than one transplant in the course of their lives.
These people can end up with three or four kidneys in their bodies because doctors usually don't take the old organs out. (While these organs don't work, they generally don’t cause any harm or discomfort, either.)
It's possible to get more than one new organ.
Some people need more than one new organ at the same time — a heart and lungs, for example, or a kidney and a pancreas. Others need different organs at different times in their lives.
For these groups, surgeons can sometimes transplant different organs at once or over time.
Transplantation has come a long way.
For one thing, new surgical techniques make it possible to remove living donor kidneys laparoscopically (that is, through a few small incisions rather than a single large one). In some cases, surgeons can remove a donor’s kidney through a single small incision inside the belly button, leaving virtually no visible scar. (Fayek was the first in Illinois to use this technique, called single-incision laparoscopic surgery, or SILS.)
The other big area of change involves the drugs people take after transplant. These medicines aim to stop the immune system from attacking the new organ. "But the immune system is very smart," Fayek explains. "It has lots of ways to attack the organ."
For that reason, researchers have focused on creating drugs that block these different pathways. "Today," Fayek says, "if the standard drugs don’t work as well for someone, we have many more options."
You will receive the same medical care whether or not you are an organ donor.
"There is a myth that, if you're an organ donor, doctors won't try as hard to save your life if you're sick or have an accident," Fayek says. "This is absolutely false. We treat everyone equally."