organ donation


Want To Become An Organ Donor? It’s Super-Easy In Mass. Now Do You?

misscherryorchards via Compfight/Flickr

(misscherryorchards via Compfight/Flickr)

Veronica Thomas
CommonHealth Intern

Pestering someone with the same question over and over again doesn’t usually get you what you want. But with organ donation, asking repetitively might just be the key to increasing the number of much-needed organ donors.

According to a new working paper from the National Bureau of Economic Research, providing more information and opportunities for people to become organ donors could boost registrations dramatically.

This increase in donors is needed more than ever. Each day, 18 people die while waiting for a transplant organ to become available. The waiting list is over 123,000 people deep but there were only about 29,000 organ transplants last year.

The new findings are based on a survey of Massachusetts drivers, which The Washington Post’s Jason Millman describes in One Way To Boost Organ Donations: Just Keep Asking. From the article:

Researchers surveyed 368 people with a Massachusetts driver’s license or ID card, including 156 people (42.4 percent) who were already registered organ donors. Of those who weren’t registered donors, 61 people in the study decided to sign up after researchers presented them with the chance to update their status. Just two people who had been registered donors asked to remove themselves from the registry.

“Put simply, asking again for organ donation generates more donors,” wrote Judd Kessler of the University of Pennsylvania’s Wharton School and Stanford University’s Alvin Roth. They said this suggests that policymakers should look for more opportunities to keep asking this question, like on income tax forms, as the researchers said some states are considering.

Asking more than once may work for a number of reasons. Millman explains:

People may have missed the opportunity to register the first time; or, repeat requests may signal the importance of organ donation, Kessler and Roth write. The “guilt factor” may also kick in after repeat requests. And there’s also the chance that people learned something that changed their minds. On that final point, Kessler and Roth found that just informing non-donors about what organs they could donate made them more willing to register.

So, here we go. Let’s test out this strategy and see if it works. Continue reading

The Ultimate Craigslist Find: A Kidney

I’ve never seen a crowd so electrified.

It happened at a lively meet-the-authors brunch at American Jewish University in Los Angeles the other day. The speaker was talking about her new money-saving book, Bargain Junkie, and instructed the audience of about 80 women, “I want you to share with me your own greatest bargain stories. The best one I ever heard was about a woman who got a free kidney on Craigslist. It’s hard to believe, but I’ve been assured it’s true.”

There was some disbelieving laughter, and some odd murmuring: “She’s here!” And “Marcia!” At a table in the corner, a woman with feathered silver hair raised her hand and said, not very loudly, with dignified good humor, “That’s me!”

Invited to the podium, she told her story briefly and clearly. In 2009, she had been on dialysis for two years, and on the long waiting list for a kidney transplant for four years. One day, a friend called and said that a poster on Craigslist was offering to donate a kidney to anyone in need. She got in touch with him, and a few months later, the operation took place at UCLA. The donor was a man who wanted to make amends for some bad choices in his life. The kidney worked perfectly right from the start, and she became the grateful recipient of a new life.

I was sitting in the audience — I had been flown out for the L.A. brunch to talk about a book I co-authored — and I could feel the goosebumps rising on my arms. What were the odds? As soon as brunch ended, I accosted the silver-haired woman and begged her to repeat her story to my little Flip camera. Her name is Marcia Gould, and she has the reassuringly calm manner of the high school guidance counselor she once was. Here is her tale in just 95 seconds, but keep reading afterward for the inspiring fuller version:

This story is worth much more than a little YouTube clip. Marcia’s daughter-in-law, filmmaker Jennifer Barbaro, has followed and filmed her transplant journey, and is now finishing a documentary titled “The Perfect Match.” The film’s Website is here, and the trailer, including extensive footage of the donor, is below. The voiceover includes this concise line: “Two failing systems — two perfect strangers.”

Now to begin a bit closer to the beginning:

Marcia lives in the San Fernando Valley, and is 73. She taught high school business classes, then was a guidance counselor for 14 years. In the late 1990s, she started to gain weight mysteriously, and then suddenly found her ankles swollen to the size of her calves. When her doctor put her on a diuretic, she said, she instantly lost 32 pounds — some five gallons of fluid. For years, as her kidneys slowly failed, she remained working and generally active, but finally retired in 2001.

She joined the long waiting list for a kidney in 2005. She was initially told the wait would be one to three years; later, that went up to three to five years; then to five to seven years. (According to current estimates, some 80,000 Americans are waiting for kidneys, and 15,000 of them die a year. Debate continues over how kidneys should be allocated.)  Marcia called around the country seeking help, to no avail. By 2007, when she was finally put on dialysis, her kidneys were down to just 2% of their normal function.

Three time a week, for more than three hours at a time, Marcia went in for dialysis, a process that pumps out a patient’s blood to do the kidneys’ filtering work for them. The outlook was not good. Though obviously a highly rational type, she grew desperate enough to take a friend’s advice and write her wish — “I’d like to find a kidney in the next few months” — on a slip of paper, place it under a green candle and light the candle under a new moon.

Then on July 13, 2009, at about 10 a.m., Marcia’s old friend Jack Leibel happened to be poking around on the “free stuff” section of Cragislist — as many of us do — and came across this:

The listing that Jack Leibel came upon in 2009

Jack called Marcia right away, but she was in dialysis so he left a message. He called the would-be donor and left a message as well. Within an hour or so, Jack said, the ad had been taken down, apparently because it violated Craigslist rules. (Craigslist’s posted rules forbid ads for “blood, bodily fluids or body parts” in the “for sale” section, where the “free stuff” category resides.)

“As people say, timing is everything,” Jack said. “Some days, we get lucky.”

When Marcia got the message from Jack, she said, her initial instinct was that it wasn’t worth calling, but again — just as with the green candle — she thought, “What do I have to lose?”

She called the donor, Patrick McFarlane, and “he was very receptive,” she said. Patrick, then 49, told her that he’d tried to donate a kidney in Iowa when he’d lived there, but had run into insurmountable rules. Continue reading

The Emotional Toll Of A Race-Against-Time Organ Donation

All the doctors agreed. There was no question that the patient, a 54-year-old man, was going to die.

He’d suffered a stroke as a result of cardiac arrest. His brain injury was irreversible. His heart rate was dropping — fast. His family had been told there was no hope. Still, for a mix of complex reasons — denial, grief, overwhelming love, miscommunication — his daughters couldn’t fathom why their father was being rushed from the intensive care unit, where earlier, the family had hoped doctors could rescusitate him, to the operating room, where a team of transplant surgeons waited to remove his kidneys and pancreas before the organs ceased to be viable for donation.

A sense of urgency was in the air, according to nurses who were there, and though by all medical measures the patient had no chance of recovering, his dying, erratic heartbeat still registered on the cardiac monitor as he was whisked toward the operating table where his organs would be harvested.

“The daughters kept saying,’This is so wrong, this is so wrong,'” said nurse Jo Fontaine, a case manager who was there.

When The Heart Stops

We hear most often about organ donation after brain death, when neural activity stops. But there is another form of donation: after cardiac death, when donation occurs after circulatory and respiratory functions cease. As demand for organ transplants has increased, donation after cardiac death has been rising rapidly, now comprising about 35% of donations in New England and 11% nationally. The trend has helped increase organ supply — but brings with it different types of challenges.

At Norwood Hospital, where the 54-year-old man died in September, organ donation after cardiac death was something new for the staff. None of the ICU team had ever experienced this type of race-against-time donation. The entire episode was so fraught that several of the doctors and nurses involved in the case agreed to come together on a recent Monday afternoon and discuss their intense emotions.

“I wasn’t ready,” said Oscar Le, a critical care doctor who was involved in the case. “The healing process that we usually go through when a patient dies, we couldn’t go through it in this case. We had five minutes. When you go home, you go home feeling a little empty.”

Dr. Le said that this patient and his family “did not have the kind of death” any of us hope for.

More Compassionate Care

Dr. Le’s comments before a crowd of about 50 doctors, nurses and other hospital staff were part of a professional venting session known as “The Schwartz Center Rounds.” Continue reading