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Living organ donors hit record high

Contributions surpass donations from the dead for first time

Posted: Sunday, June 09, 2002

WASHINGTON -- Organ donations from the living reached a record high last year, outnumbering donors who are dead for the first time. With waiting lists growing, more than 6,400 people gave away a kidney or a piece of their liver.

For more than a decade, the numbers of organs donated by the living have been growing more quickly than those given after death as desperate patients have turned increasingly to families or friends.

In 2001, the number of living donors jumped by 13.4 percent, on top of a 16.5 percent increase a year earlier, the government said Monday. By contrast, donations from dead people inched up by just 1.6 percent.

Surgeons across the country routinely suggest now that patients look for donors rather than rely on a growing waiting list.

In the past, a patient facing a wait of a year or two for a kidney would resist asking family or friends for fear of putting them through a painful procedure with medical risk, said Dr. Jeffrey Punch, a kidney surgeon and chief of the University of Michigan Medical Center's transplant division.

''Now that they're thinking about five or six years, they're more willing to accept it,'' he said.

Rick Palank decided to donate a kidney after hearing about his boss' deteriorating health. He said his boss never suggested it, but after hearing that no one in the family was a match, Palank volunteered, even though the two are not particularly close or friendly outside the office.

''I was sitting there thinking, 'Wow, this guy looks terrible. I've had perfect health, and this guy's had all these problems. I should help him,''' said Palank, 55, of St. Louis, who donated a kidney last month and was out of the hospital a day later.

''He's a very nice, very good human being,'' he added. ''That probably had something to do with it.''

Last year, there were 6,081 donor cadavers. Each can give several organs, so dead people still enable about three out of every four transplants.

They now are outnumbered by living donors: In 2001, there were a record 6,485.

Public campaigns encouraging organ donation all revolve around cadaveric donors, encouraging people to talk with family about the issue before someone dies. A year ago, Health and Human Services Secretary Tommy Thompson launched an effort to work with employers. He pushed the effort again Monday.

He said he was not discouraged by the paltry increase in donations from cadavers. ''It's not as good as I would like, but it's an increase,'' Thompson said.

Of the living donors, more than 90 percent donated a kidney. That is a relatively safe procedure for people with two healthy kidneys, because only one is necessary. There were about 500 living liver donations, in which surgeons remove a part of a liver for transplant, leaving each piece to grow into a whole organ. About three dozen people gave part of a lung.

Medically, doctors have been dividing livers only for the last few years, which helps explain the fast rise in the number of liver donations from the living. The number shot up 36 percent last year.

For kidneys, research has found that living donations are just as successful, if not more, as kidneys from people who have died. And laparoscopic surgery, where the kidney is removed through a small incision, has reduced the pain and recovery time for the donor.

Still, some worry that the increasing popularity of living donation puts unfair pressure on would-be donors.

''There needs to be some protection for someone who doesn't want to be a saint,'' said Gregory Pence, a bioethicist at the Univer-sity of Alabama at Birmingham. ''This is a major assault to your body, and really bad things can happen.''

He suspects that many patients don't know the true risks and said the surgeons who explain them have a conflict because they also are trying to save the life of the recipient.

Many transplant programs provide would-be donors a way out. The program will report that medical problems prohibit the transplant if a donor secretly has a change of heart about donating.

Pence fears that transplant programs do not tell potential donors the true risks.

Laurie Post, who was in and out of the hospital six times after donating a piece of her liver to her cousin, does not regret her decision. She says she was never told the true risks, however, and she said there was not-so-subtle pressure from the surgeon.

''He said, 'If it's not possible for you to do this procedure, we don't know how much longer your cousin will live.' Then he said, 'You can back out at any time,''' said Post, of Flemington, N.J. She compared his comments to the courtroom lawyer who says something inappropriate and then withdraws it. ''It's already out there,'' Post said. ''The jury's already been tainted.''

Post, now 36, was a healthy athletic trainer and figured the surgery, performed in 2000, would be ''a piece of cake.'' She said she was never told of the myriad complications she could -- and did -- face, including bile leaks, trips to the emergency room, fever, vomiting and a collapsed lung.

''I'm not sorry I did it,'' she said. ''I'm sorry I wasn't better informed.''



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