25 Facts About Organ Donation and Transplantation

The success rates of transplant surgery have improved remarkably, but growing shortages exist in the supply of organs and tissues available for transplantation. Many Americans who need transplants cannot get them because of these shortages. The result: some of these people die while waiting for that "Gift of Life." Each year, the National Kidney Foundation develops special public education programs aimed at increasing public awareness of the need for organ and tissue donation. Learning more about organ and tissue donation will help every American to make an informed decision about this important issue. Here are some facts everyone should know: Over 79,000 U.S. patients are currently waiting for an organ transplant; nearly 3,000 new patients are added to the waiting list each month. Every day, 16 to 17 people die while waiting for a transplant of a vital organ, such as a heart, liver, kidney, pancreas, lung or bone marrow. Because of the lack of available donors in this country, 2,025 kidney patients, 1,347 liver patients, 458 heart patients and 361 lung patients died in 2001 while waiting for life-saving organ transplants. Nearly 10 percent of the patients currently waiting for liver transplants are young people under 18 years of age. Acceptable organ donors can range in age from newborn to 65 years or more. People who are 65 years of age or older may be acceptable donors, particularly of corneas, skin, bone and for total body donation. An estimated 10,000 to 14,000 people who die each year meet the criteria for organ donation, but less than half of that number become actual organ donors. Vital organs may be recovered and transported thousands of miles to a transplant center for transplantation. This is due, in part, to advances in preservation techniques. Following are the approximate preservation times for a variety of organs and tissues. Table 1: Approximate preservation times for various organs ----------------------------------------------------------------------------- Kidney Liver Heart Heart/Lung Pancreas Corneas Bone Marrow Skin Bone Heart Valves up to 72 hours up to 18 hours up to 5 hours up to 5 hours up to 20 hours up to 10 days varies by individual program 5 years or more 5 years or more 5 years or more Donor organs are matched to waiting recipients by a national computer registry, called the National Organ Procurement and Transplantation Network (OPTN). This computer registry is operated by an organization known as the United Network for Organ Sharing (UNOS), which is located in Richmond, Virginia. Currently there are 59 organ procurement organizations (OPOs) across the country, which provide organ procurement services to some 261 transplant centers. All hospitals are required by law to have a "Required Referral" system in place. Under this system, the hospital must notify the local Organ Procurement Organization (OPO) of all patient deaths. If the OPO determines that organ and/or tissue donation is appropriate in a particular case, they will have a representative contact the deceased patient’s family to offer them the option of donating their loved one’s organs and tissues. By signing a Uniform Donor Card, an individual indicates his or her wish to be a donor. However, at the time of death, the person's next-of-kin will still be asked to sign a consent form for donation. It is important for people who wish to be organ and tissue donors to tell their family about this decision so that their wishes will be honored at the time of death. It is estimated that about 35 percent of potential donors never become donors because family members refuse to give consent. All costs related to the donation of organs and tissues are paid for by the donor program. A family who receives a bill by mistake should contact the hospital or procurement agency immediately. Tissue donation can enhance the lives of more than 50 people. Donated heart valves, bone, skin, corneas and connective tissues can be used in vital medical procedures such as heart valve replacements, limb reconstruction following tumor surgery, hip and knee joint reconstruction and in correcting curvature of the spine. In 2000, a total of 11,650 organ donors were recovered in the U.S. Of these, 5,985 were cadaveric donors, which represented a small increase over the total of 5,824 in 1999. Living donors increased from 4,779 in 1999 to 5,665 in 2000. Donor organs and tissues are removed surgically, and the donor’s body is closed, as in any surgery. There are no outward signs of organ donation and open casket funerals are still possible. Acceptable organ donors are those who are “brain dead” (whose brain function has ceased permanently) but whose heart and lungs continue to function with the use of ventilators. Brain dead is a legal definition of death. Organ transplant recipients are selected on the basis of medical urgency, as well as compatibility of body size and blood chemistries, and not race, sex or creed. Advances in surgical technique and organ preservation and the development of more effective drugs to prevent rejection have improved the success rates of all types of organ and tissue transplants. About 88.3 percent of the kidneys transplanted from cadavers (persons who died recently) are still functioning well at one year after surgery. The results are even better for kidneys transplanted from living donors. One year after surgery, 94 percent of these kidneys were still functioning well. Following are one-year patient and organ graft survival rates: Organ Patient Survival Rate Graft Survival Rate Kidney (cadaveric) Kidney (live donor) Pancreas Liver Heart Heart-lung Lung Intestine 94.8% 97.7% 95.9% 86.9% 85.8% 74.7% 75.8% 69.6% 87.5% 93.5% 70.2% 79.2% 85.5% 76.1% 75.0% 59.4% Following is a comparison of the numbers of organ transplants done in 2000 and the numbers of individuals who remained on the national waiting list as of February 2002. Organ Number of Transplants in 2000 Number of Patients on Waiting List* (as of Feb 2002) Kidney Kidney/Pancreas Pancreas Liver Heart Heart/lung Lung Intestine Total: 13,372 911 435 4,954 2,198 48 956 79 22,953 50,955 2,478 1,229 18,434 4,163 211 3,819 187 79,125 Of the single kidney transplants performed in 2000, 5,293 were from living donors and the rest were from cadaveric donors. In addition, 911 kidneys were transplanted in combination with pancreas transplants. Over 1,000 bone marrow transplants were performed in the U.S. in 1999. Marrow is collected from a pelvic bone using a special needle while the volunteer donor is under anesthesia. The majority of bone marrow transplants are done for leukemia. The number of Americans on waiting lists for corneas averages as high as 5,000 at any given time. Corneal transplantation results in improved vision in nearly 95 percent of those who undergo the procedure because of corneal disorders. Corneas are acceptable for donation regardless of abnormalities in vision. Virtually all religious denominations approve of organ and tissue donation as representing the highest humanitarian ideals and the ultimate charitable act. February 2002 Data Sources: American Association of Tissue Banks Eye Bank Association of America National Marrow Donor Program National Kidney Foundation, Inc. UNOS Scientific Registry