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Video about brain stem death and different religious beliefs provided by the Halachic Organ Donor Society

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The Need for Donation
The Facts About Donation
Questions About Becoming a Donor
Donor Process
Statistics
Other Information
Arrange a Presentation
 
The Need for Donation
 
In 2006, more than 6,000 transplant candidates - one person every 90 minutes - died while awaiting transplantation. Right now, 18 people die every day waiting for a transplant. Many of these patients may have lived if the families of every medically suitable potential donor had said "yes" to donation. According to the United Network for Organ Sharing (UNOS), across the country there are currently nearly 100,000 individuals waiting for a life-saving organ transplant. As of February 2007, about 20% of the waiting list are children younger than 18 years of age. The need for kidneys tops the list, followed by liver and heart. Transplant hospitals place individuals on the national waiting list after they are given careful medical evaluations. Each month, approximately 500 people in the United States are added to the national waiting list.

Each year in the United States, approximately 15,000 people die under conditions that make them medically suitable potential organ donors. However, approximately one-third of those who died in 2006 became organ donors. This translates to an estimated 20,000 Americans (about 55 each day) receive organ transplants each year.

There is an urgent need for minority organ donation. As of February 2007, more than 28,000 African-Americans, 16,000 Latinos, 5,700 Asians, and approximately 2,000 other non-Caucasians were on the waiting list. However, in 2006, only about 1200 African-Americans, 10,000 Latinos, 2,000 Asians, and 1,300 other non-Caucasians donated organs after they passed away.
 
Northern California
More than 8,000 northern Californians are on the national waiting list for transplantation, and over 20,000 throughout California (2/07).

Each year in the Transplant Network's region (Northern and Central California, and the Reno/Tahoe area of Northern Nevada), about 350 people die under conditions which make them potential organ donors. In 2006, only 280 became donors.

For more up-to-date local and national statistics, please visit www.optn.org.
   
The Facts About Donation
  • One deceased donor can potentially provide: 1 heart or 2 heart valves, 2 lungs, 2 kidneys, 1 liver, 1 pancreas, 2 hip joints, 2 corneas, bones, connective tissues, skin, and blood vessels.
     
  • Donation is a sterile surgical procedure. Open-casket funerals are not affected by donation.
     
  • Organs are allocated based on the urgency of medical need, not according to a patient's financial, political, social or celebrity status. The length of time it takes to receive a transplant is based on medical criteria like blood type, height and weight, and time spent waiting. The most important factor that affects length of time waiting is a lack of organ donors.
     
  • Only increased medical need can "move" someone higher on the national waiting list for organs. Rich and famous people have to wait like everyone else.
     
  • Donation is consistent with the life-preserving traditions of most major religions.
     
  • Donation is not discussed until all efforts to save a life have failed. If someone is sick, injured and/or admitted to a hospital, the first priority is to save that person's life. If all possible efforts to save a patient's life have failed, and two physicians have tested the patient and certified that death has occurred, a family is then asked about giving the gift of life through organ and tissue donation.
     
  • Donor families incur no expense for donation.
     
  • Experience shows that families are more willing to donate a loved one's organs and tissues if they have had prior conversations about donation with the deceased. Talking to one's family about life allows this decision to be made easily and with the knowledge that a loved one's wishes are being carried out if that time comes.
     
  • Donor families say donation helps their grieving.
     
  • A 1986 law requires that family members be approached about organ and tissue donation at the time of a medically suitable loved one's death.
     
  • A 1997 federal regulation requires hospitals to notify the Transplant Network of all patients whose death is imminent or who have died in the hospital. It also requires that the person initiating the request for organ/tissue donation must be employed by the Transplant Network or trained by the Transplant Network.
     
  • In California, the law states that your decision to be a donor is legally binding (CA Health & Safety Code Section 7150.35). Nobody can override your choice to donate an anatomical gift. There is an ethical duty to honor your values and surrogate consent is not needed if you have already stated your desire to be a donor.
     
  • Transplantation is no longer considered experimental. It is desired treatment for thousands with end-stage organ disease. Each year, more than 600,000 Americans receive tissue transplants and more than 20,000 receive organ transplants. In 2006, there were 26,689 organ transplants in the United States.
     
  • Tissue donation can give the gift of sight, save burn victims from disfigurement, provide relief from amputation, and grant other life-enhancing assistance. In 2006, over 900,000 tissue transplants and more than 46,000 cornea transplants were performed.
     
 
Questions About Becoming a Donor
 
Q. How do I become a donor?
A. Traditionally, you would fill out a donor card and put the "pink dot" on your drivers license, and you would need to inform your family so they could honor your wishes upon death.

California now has an alternative and better method to becoming a donor – the Donate Life California Organ and Tissue Donor Registry. Now you can simply sign up online to record your wishes. Click on the link "Sign up to Become an Organ Donor" in our left-hand site navigation to learn more.

Q. What is First Person Consent?

A. California is among 45 other states which honor First Person Consent (CA Health and Safety Code Section 7150.35). This means that when an individual registers to be an organ and tissue donor through the Department of Motor Vehicles, online at www.donateLIFEcalifornia.org or otherwise makes the choice to donate (e.g., in their Living Will) there is a legal obligation to honor that choice. The decision is legally binding unless the person is a minor at the time of death. In that case, the parents have the legal right to revoke the prior consent given by the child.

Some families might not have known their loved one made the decision to donate so it might come as a shock to learn this information during a time of medical crisis. We advise that if you choose to become an organ and tissue donor, please discuss your choice with your family so that they are aware of your values. Even if they don't agree with your choice, you should still tell them how you feel and that the decision to donate is very important to you.

For families that are dealing with a medical crisis or are in the process of learning more about organ donation, we encourage you to read our brochure which explains more about the choice your loved one made: First Person Consent brochure Even if you don't agree with the personal values that your loved one professed, there is an ethical duty to honor those values. Also, you can celebrate the life of your loved one as he/she lives on through the gift they made.

Q. Can someone override my choice to be a donor if they personally don't agree with my decision to donate?
A. No. In California, the law states that your wishes are legally binding (CA Health & Safety Code Section 7150.35). Family consent is not needed if you have already stated your desire to be a donor.

Q. Is there an age limit for being a donor?
A. No. Each potential donor is reviewed on a case by case basis.

Q. If I were a donor, would there be any cost to my family or estate?
A. No. The OPO covers the costs of the donation procedures. You or your insurance company are responsible for your hospital bills prior to your death. Your next-of-kin or estate are responsible for the funeral expenses.

Q. If I had cancer, can I still be a donor?
A. For an individual who had cancer but has been cancer free for many years, it is possible to become a donor. Each case is given a full medical evaluation at the time of death.

Q. If I have Lupus can I still be a donor?
A. Yes. Lupus does not immediately preclude you from donation. Your complete medical history will be reviewed at the time of your death in order to determine the health of your individual organs.

Q. I am a diabetic, can I still be an organ donor?
A. Possibly. This would depend on the type of diabetes and the amount of time the individual was being treated for it. Again, any issues of medical suitability would be determined by a medical evaluation at the time of death.

Q. If I have Hepatitis, can I still be a donor?
A. A past history or exposure to hepatitis does not automatically exclude a person from being a donor. Your medical history would be evaluated at the time of death to determine whether you are eligible to be a donor.

Q. If I have tested positive for HIV, am I still able to be an organ donor?
A. Due to the risks of disease transmission, UNOS policy excludes the use of donors who have tested positive for HIV.

Q. How do I become a living donor?
A. If you want to be a living-related donor, please contact your relative's physician to discuss the possibility. If you are interested in non-related living donation, you can contact one of the transplant programs in the California Transplant Donor Network's area:
California Pacific Medical Center: 415-600-1000
Stanford University Medical Center: 650-725-9891
University of California, San Francisco: 415-476-1551
Also, you may want to consult these links for more information:
National Kidney Foundation
Transweb

Q. What if I want to donate my whole body?
A. You need to contact the Curator's office at a medical school nearby. The three in our region are:
Stanford University Medical Center, Palo Alto: 650-723-2404
University of California, Davis: 916-734-9560
University of California, San Francisco: 415-476-1981
   
Donor Process
 
Organ Allocation
The transplant center is responsible for placing someone on the national waiting list. The transplant center's medical profile on the candidate is stored in the Organ Procurement and Transplantation Network (OPTN) computer. When a donor becomes available, the computer compares candidates on the list and ranks them according to medical criteria.

Organs are allocated to listed patients in the Transplant Network's region first. If a match cannot be made, organs are offered to the highest-ranking patient elsewhere in the United States. We follow national organ sharing policies established by the national OPTN.
 
Factors Affecting Candidate Ranking
A variety of factors influence the match of donor organ to candidate on the waiting list. The results of the ranking are affected by tissue match, blood type, severity of medical condition, and immune status.

If the match is for a heart, heart-lung, liver, lung, or pancreas transplant, the potential recipient's distance from the donor hospital is also considered because these organs cannot survive outside of the body for very long. All ranking and matching processes are carried out without reference to gender, socio-economic or celebrity status. Ethnicity can be a criteria because matching donors with recipients of the same ethnic background helps the success rate of transplantation. However, there is no preferential treatment for any races or ethnicities.
 
Recipient Selection
After receiving a printout of the OPTN ranking, the Transplant Network contacts the transplant centers of the top patients on the list. The transplant centers help make the final selection of the recipient.

Often the first patient on the list will not receive the donated organ for several reasons:
  1. The patient has to be available and willing to be transplanted immediately.
  2. The patient has to be healthy enough to undergo major surgery.
  3. Laboratory tests measuring the compatibility between donor and recipient must show that the recipient will not reject the organ.
If the first patient is unable to receive the organ, the organ is then offered to the next patient on the list. Once the patient is selected and contacted and all testing is complete, surgery is scheduled and transplantation takes place.
   
Statistics
 
For a complete review of national statistics for organ donation and transplantation, go to www.ustransplant.org.
 
Donor-Related Statistics
 
Type of Donation
  2006 To Date
Deceased 20,493 307,529
Living 6,196 83,702
All Donors 26,689 391,231
Source: UNOS, February 2007 Note: Data subject to change based on future data submission or correction.
 
Donor Profile Averages
Donors by Age
  0-17 18-34 35-49 50-64 65+
2006 888 1,890 1,981 1,892 731
 
Donors by Ethnicity
  Asian Black Hispanic White
2006 176 1,136 1,021 4,988
 
Donors by Gender
  Female Male
2006 2,967 4,419
 
Donor Cause of Death
  Head Trauma Cerebro-Vascular/Stroke All Other
2006 2,840 3,084 1,462
Source: UNOS, February 2007 Note: Data subject to change based on future data submission or correction.
 
Organ Survival Rates Outside the Body
Heart 4 to 6 hours
Lungs 4 to 6 hours
Liver 16 to 24 hours
Pancreas 6 to 18 hours
Kidneys 24 to 48 hours
Source: CTDN statistical analysis.
 
Waiting List Statistics
 
Patients on UNOS Waiting List as of February 2007
Type of Transplant Patients Waiting for Transplant
Kidney 73,820
Liver 17,464
Pancreas 1,771
Kidney-Pancreas 2,446
Intestine 240
Heart 2,869
Heart-Lung 135
Lung 2,889
TOTALS Total Patients:
101,634
Source: UNOS, February 2007 Note: Data subject to change based on future data submission or correction.
 
Transplant Statistics
 
Average Cost of a Transplant
  National Cost Range Average Cost
Kidney $25,000 - 130,000 $51,000
Pancreas $51,000 - 135,000 $70,000
Liver $66,000 - 367,000 $235,000
Heart $50,000 - 287,000 $148,000
Heart/Lung $135,000 - 250,000 $210,000
 
Number of Transplants National and in California - 2006
  National California
2006 26,960 3064
Source: UNOS, February 2007 Note: Numbers reflect transplants from both living and deceased donors.
 
   
Other Information
 
Understanding Brain Death (PDF)
History of Organ and Tissue Donation (PDF)
Glossary of Terms (PDF)
How DCD Process Works (PDF)
DCD Process Algorithm (PDF)
AOPO DCD QandA (PDF)
   
Arrange a Presentation
 
The Transplant Network offers a community Speakers Bureau that can speak about organ donation to your organization or community group. The Bureau is comprised of Transplant Network staff and volunteers. All volunteers involved in public speaking go through a Speaker Training, which teaches them how to deliver effective and educational talks.

If you are interested in having a presentation made to your organization, please contact us.
   
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