Monday, April 28, 2008

Transplant Surgeon Pioneers New Way to Increase Supply of Organs

Donation after cardiac death is becoming more popular as waiting lists for organ transplants far exceed the supply of donors. Where I live in Ontario, somone dies every three days while waiting for a life-saving transplant. For an in-depth overview of Organ Donation after Cardiac Death, read the review in the New England Journal of Medicine.

Transplant surgeon pioneers new way to increase supply of organs

From Newswise Medical News — Transplant surgeons such as Dr. Robert Love of Loyola University Hospital are pioneering a new way to increase the supply of organs from deceased donors.

Today, most organs are obtained from donors on life support who have been declared brain dead. The organs are in good condition because the heart is still beating.

But more surgeons are beginning to use organs from patients who have been declared dead after their hearts have stopped beating. Last year, there were 793 donations after cardiac death in the United States. That’s up from 117 cases in 2000.

Kidneys and livers are the most commonly used organs from cardiac-death donors, but surgeons also are using lungs and pancreases. Love has done about 30 lung transplants from cardiac-death donors.

Nearly 100,000 people are waiting for organ transplants in the U.S. Some people wait for years. And many die while still on the list.

“We must do everything we can to encourage people to become organ donors,” Love said. “And we also have to make sure that every usable organ is used.” Love is a professor of thoracic and cardiovascular surgery at Loyola University Chicago Stritch School of Medicine.

Steve Schumann of Palatine is among the patients of Love who have benefited from a cardiac-death donation. The 60-year-old pharmacist had pulmonary fibrosis, a progressive and incurable lung disease. Schumann had uncontrollable coughing fits, and needed oxygen 24 hours a day, even in the shower.

Without a lung transplant, Schumann did not have long to live. If his only option had been a transplant from a brain-dead donor, an organ might not have become available soon enough to save his life, Love said. Fortunately, Schumann’s time on the waiting list was shortened when a pair of lungs became available from a cardiac-death donor.

Last July, Love and Loyola surgeon Dr. Michael Eng traveled to the donor’s hospital in Joliet to recover the lungs. Love brought the organs back to Loyola in an ambulance, and performed the transplant along with Dr. Mamdouh Bakhos.

Shortly after waking up from surgery, Schumann’s new lungs filled with air. For the first time in more than two years, he could breathe without an oxygen tank.

“The feeling was indescribable,” Schumann said. “It was such a relief.”

Schumann can walk again, without gasping for breath or being tethered to an oxygen tank. He has just joined an over-fifty softball league, and plans to play as much golf as possible this summer.

“It was a miracle,” he said.

Obtaining organs from cardiac-death donors can be technically challenging. Organs begin to deteriorate as soon as the heart stops beating. Surgeons generally have only a 30-minute to 60-minute window to remove organs.

A typical case involves a patient who has suffered severe and irreversible brain damage from, for example, a car accident, gunshot wound or brain hemorrhage. The patient still has minimal brain function so is not considered brain dead. But the patient is near death, and further treatment is considered futile. The family agrees to withdraw the patient from life support and donate the organs.

The patient usually dies shortly after being taken off the ventilator and other life support, such as medications to maintain blood pressure. Five minutes after the patient's heart stops beating, the body is taken to an operating room, where the organs are recovered.

Donation after cardiac death leaves the family little time to say goodbye. "But families are usually very understanding about this," said Joyce Maly, Loyola's in-house coordinator for organ and tissue donation. Maly's position is a partnership between Loyola and Gift of Hope Organ and Tissue Donor Network.

Families take solace from knowing that their loved-ones' organs will enable other people to live. "They are living on in someone else," Maly said.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network

In the United States, be sure to find out how to register in your state at or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

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