The TNT television show “Heartland” recently aired several episodes depicting organ transplant situations. While highly dramatized, televisions shows like this often do shed a ray of light on the truths that occur in real-life circumstances.
Red Oak resident Susie L’Heureux knows first hand about organ donations. Her nephew Chuck’s organs were donated after he was in a car accident in 2001 and eventually died.
“A man had a heart attack getting on the highway and, when he did, his car veered all the way across the highway and hit the car Chuck was in - the man died instantly,” she said. “Chuck was at the hospital, but he had brain injuries, so they put him in a drug-induced coma hoping the swelling from his brain would go down.”
After nine days the swelling did not go down and the family determined they had done all they could do to save his life.
“This was my brother and his wife’s son,” L’Heureux says. “They had decided that it was time … and that was when the lady came to discuss the organ donation.”
“The organ donation process begins with a person dying in a hospital and on a ventilator,” said Pam Silvestri with the Southwest Transplant Alliance. “This is because the organs - heart, lungs, liver, kidneys, intestine, pancreas - require an oxygen supply until they are recovered for transplant.”
In the case of a person dying at home or in a hospital but not on a ventilator, he or she would not be an organ donation candidate. However for tissue, such as heart valves, skin, bone, ligaments, tendons or corneas, a person does not need to die on a ventilator. Although tissue donation candidates typically die in a hospital where most donation processes begin, some candidates come directly from the medical examiner or funeral home.
“Once a person dies in a hospital, a phone call is made to the contracted organ donation agency,” Silvestri said. “ Every hospital has a contract with an organ donation agency.”
When a potential donor dies who has been on a ventilator, the organ donation agency sends a representative to the hospital immediately to review the patient’s chart and make sure there is no contraindication including cancer outside of the brain or active hepatitis B.
If no contraindication exists, the representative begins to work with the hospital staff to develop a plan for approaching the family.
“The key here is typically having the donation representative go into the family conversation with the physician when the physician explains that the patient has died,” Silvestri said. “This is because, when a loved one dies on a ‘vent,’ many families have a lot of difficulty accepting the death and need to be counseled through what brain death actually entails.”
If a person dies off of the ventilator, the family may be contacted by phone about the possibility of tissue donation, as the family usually does not need counseling regarding the fact the patient is actually dead.
After the physician has explained that death has taken place, the representative will watch for the family’s reaction and begin some sort of counseling, which can take hours. Once the family has accepted that death has occurred, the representative lets them know their options.
“When the family is ready, we discuss with them the option of turning off the vent and the option of leaving it on in order to allow for the donation of organs and tissues,” Silvestri said. “Many families have many questions at this point and we take as much time as necessary to answer their questions so that they are comfortable with their ultimate decision.”
For the most part, organ donation is not dependent on age as the viability of each organ is more important than the age of the donor. But the patient must remain on a ventilator until the organs are recovered.
Chuck’s organs went on to save a number of people, from a 13-year-old girl to a 65-year-old man, L’Heureux said.
“The whole family was taken into a room and that was how they explained everything,” she said. “I didn’t know it until just a few months ago either, but my sister-in-law had talked to Chuck and his sisters about organ donation several years ago. Chuck had told Barbara, he was like 13 or 14, if anything ever happened to him, that was what he wanted - he said they could have everything but his eyes. So that is what Barbara and Chuck donated, I think the heart, I am not sure about the lungs. But five people got different organs.”
Silvestri said that, in most cases, a family says yes to donation, noting they can then experience the positive outcome of helping another family not have to go through what they have just endured.
“Families take much comfort in this,” she said. “They also get to know that their decision and their loved one saved lives. There are amazing stories, literally daily, of families who are going through tremendous pain and somehow find a way to have the presence of mind to think of how they can help others, even while facing tragic circumstances.”
She tells of a young man hit by lightning in 1995 in Forney whose parents decided to donate and eventually met the man who received a kidney from their son. The man had turned his life around and the family was happy to have been a part of it, she said.
L’Heureux said, even though her nephew’s death happened six years ago, she feels like it was just yesterday.
“We talk about this all the time,” she said. “Before Chuck’s death, organ donation never crossed my mind. It was something I never thought about, but now my husband and I both have cards. They even donated Chuck’s skin. They said that a lot of it could have been used in 9/11 where all the people were burned. They took skin from the skin bank and sent it there.”
“If someone wants to be an organ donor, the most important thing he or she can do is make sure the family knows, so that when we do our approach, the family is supportive,” Silvestri said. “Also, in Texas, folks can now officially register to donate.”
The choice to donate or not usually depends on whether the family has discussed donation before and whether the family knows what their loved one wanted.
“When a discussion has taken place prior to the death of the loved one, the decision is so very much easier on the family,” Silvestri said.
The most needed organs are the heart, lungs, liver, kidneys, pancreas and intestine. However, because of a high incidence of high blood pressure, hypertension and diabetes, most of the people on the waiting list are in need of kidneys.
Silvestri said when she started in 1995 the national wait list was about 30,000. Today it is over 96,000 and climbing toward 100,000 every day.
“Each day, 75 people get an organ transplant in the United States, but each day 18 people die before the organs they need become available,” she said.
The Southwest Transplant Alliance goal is 1,000 organs transplanted each year through about 300 donors as, on average, most donors donate three to four organs.
This year, to date, between 850 and 900 transplants have been done.