Aetna: Organ donations slowing down while need grows
“Live organ donations have pretty much leveled off in the past five years. And without some big change in sentiment by the American people or some other big change, the opinion of the transplant community is that cadaveric donation will not measurably increase at this time either,” said James Coates, M.D., M.B.A., clinical head of Aetna’s National Medical Excellence Program®.
There are over 120,000 people waiting for a new organ.
According to the U.S. Department of Health and Human Services’ Organ Procurement and Transplantation Network (OPTN), a person’s wait for a transplant depends on the organ they need. For example, the average wait time for a new liver is 361 days, for a kidney it is between three to six years, depending on where you live. The OPTN estimates an average of 22 people die each day while waiting for a transplant. More live organ donations could make a big difference, Coates said.
Two kinds of donors
A recipient can receive an organ from a cadaver or a living person.
Receiving an organ from a living donor not only increases the chances of survival, but the organs also function faster than cadaveric organs, according to Johns Hopkins Medicine. A transplant involving a living donor can also cut down on the amount of time a person is on dialysis while waiting for an organ from a deceased donor.
A living person can donate a kidney or portions of their liver. In rare cases, a living person can also donate a lobe of the lung; portion of the intestine; or a portion of the pancreas. A person is able to donate one of their kidneys because the body can still function with one kidney. A portion of the liver can also be donated because the organ can regenerate and become fully functional.
Two paths for living organ donations
A living donor can make a direct donation or non-direct donation. A direct donation involves a living donor giving their organ to someone specific. A non-direct donation, or altruistic donation, involves a living donor giving an organ to someone they do not know. This type of donation is also known as stranger-to-stranger donation.
There were 82,400 total living kidney donors from 2002 through June 2015, according to OPTN. Non-directed donations accounted for only 2 percent of living kidney donations and just over 1 percent of living liver donations.
Myths, misconceptions of organ donations
Most myths involving living donors have to do with treatment post-surgery. For example, there’s a misperception that kidney donors will have to take medications for the rest of their life. In reality, a donor would take certain medications immediately after surgery. The medication is generally not necessary after recovery.
Another common myth is kidney donors will have to follow a new diet after surgery. There are no restriction on diet, however, and the Living Kidney Donor Network recommends continuing to eat a well balanced diet.
Why don’t more people agree to donate their organs after they die? For some people, talking about organ donation can be uncomfortable.
“It’s akin to making our will and acknowledging that we have to deal with death at some point, so it’s easy to procrastinate,” Coates said.
One myth is that doctors might not work to resuscitate you if you are an organ donor because they would prefer to harvest your organs. Another myth is that your organs could be harvested accidentally while you’re still alive. The Mayo Clinic points out that when you go to the hospital for treatment, doctors focus on saving your life — not somebody else’s. And they note that “people who have agreed to organ donations are given more tests (at no charge to their families) to determine that they’re truly dead than are those who haven’t agreed to organ donation.”
Coates said another common misperception is that a person’s donated organs may go to the highest bidder, like a celebrity or wealthy person. In reality, the factors that determine placement on the national waiting list include: severity of illness, time spent waiting, blood type and the potential to match with a donor.
Increasing the organ donor pool
Some states have started to allow people to sign up as an organ donor when receiving their driver’s license. There have also been government incentives to increase the organ donation pool. Even some tech companies are getting involved. In 2016, Apple Inc. announced it would allow people to sign up as an organ donor through their iPhones.
From 2002 through 2015, there were 82,400 living kidney donors.
Coates noted Apple’s decision was a good way to increase awareness about organ donations, but he emphasized more has to be done. “You can get people to sign up. The challenge is going from sign up to actual donation. It’s not as easy as it sounds but the effort is well worth it to help someone else.”
While incentives have been offered, various groups, such as the American Society of Transplantation, are trying to develop ways to encourage more live organ donations.
In 2014, the American Society of Transplantation and the Live Donor Community of Practice hosted a conference to create a more efficient evaluation process; create strategies for educating potential donors; reduce and remove financial and systemic barriers to live donation; and improve access to donation and live donor kidney transplantation.
By offering better education and higher quality information, as well as efficient care, the American Society of Transplantation believes it will increase the number of living donors.
The process of live donating
Deciding to donate an organ is a major decision that can affect your health and other areas of your life.
Living organ donors have a physical and psychological examination, and go through a series of tests and screenings before going into surgery. The physical examination confirms the donor can survive without the organ (or part of the organ) after surgery and that there are no contagious or other diseases that could be passed on through an organ donation. The psychological examination is meant to ensure the donor is making the donation for the right reasons, such as altruism, and not an expression of an underlying behavioral health disorder. As an extreme example, a person suffering from depression may think giving up an organ would help deal with personal issues, Coates said.
There’s no question giving an organ can be costly. To help, the American Transplant Foundation offers a Patient Assistance Program, which provides financial grants to living donors or transplant recipients.
If you or someone you know decides to become a living organ donor, it is important to communicate the decision to people in your life who need to know. Coates offered this advice: Tell everybody. “Make sure family members are aware of your decision so there are no questions when the time comes to give the gift of life.”