MANSFIELD, Ohio – Ohio drivers find themselves in the Bureau of Motor Vehicles at least once every four years, smiling awkwardly for an updated picture and answering a seemingly nonchalant question: Would you like to be an organ donor?
For those who answer yes, they earn a tiny red “Ohio organ donor” stamp on the bottom right of their license.
But what does that tiny red stamp really mean? What exactly will happen to you as an organ donor? A group of local experts responded an effort to dispel the common myths surrounding the organ donation process.
Myth: Organ donation is a given
Many people believe once they are registered as an organ donor, their organs will be donated no matter what after their death. In reality, the number of potential donors available to supply an overwhelming demand is extremely small.
“Only about one percent of people who die are going to die in a manner that could allow them to become an organ donor,” said Lauren Fitting, Community Outreach Coordinator with Lifeline of Ohio, an organ procurement organization based in Columbus. “It’s a rarity, which is why we encourage people to register because you could be one of those people who save up to eight lives with your donation.”
In 2014, 325 Ohioans donated organs at the time of their death, resulting in 1,074 organs that were transplanted. A single organ donor can potentially save the lives of eight people by donating vital organs – heart, two lungs, two kidneys, liver, pancreas and small bowel.
Unfortunately, the 1,074 organs transplanted in Ohio in 2014 is only a drop in the bucket: In Ohio, there are approximately 3,264 people waiting for an organ transplant. Once every 48 hours, an Ohioan dies waiting for an organ. In the last 10 years, more than 2,000 Ohioans have died waiting for a transplant.
In order to become an organ donor an individual must die through the process of brain death, the complete and irreversible loss of brain function including involuntary activity necessary to sustain life.
Only about one out of a hundred individuals in the U.S. will die through the process of brain death and have the potential for organ donation. Becky Jordan, Nurse Manager of the Critical Care Unit at OhioHealth MedCentral Mansfield Hospital, explained an individual who dies either in an accident or at home – any place other than a hospital – would not be eligible for organ donation.
“After you die, you don’t have blood circulating in your body so your organs wouldn’t get blood,” Jordan explained. “It’s the blood supply that carries the oxygen to keep it functioning. If you don’t have any blood going to the organ, the organ won’t function normally.”
At MedCentral Mansfield, Jordan said an average of two to three patients a year become organ donors. In 2014, 466 people died at MedCentral Mansfield and only two were eligible to become organ donors. This year, Jordan said MedCentral Mansfield has seen two organ donors so far due to drug overdoses.
“It depends on how quickly someone has overdosed and is found, even though their brain suffered damage their liver and kidney can typically be transplanted, they can go without oxygen longer than the brain,” said Jordan. “The brain injury may not recover but their organs are functioning enough to be viable.”
Fitting explained that regardless of past health, anyone is eligible to register as an organ donor. She noted donors go through a specific screening process to ensure the safest organ is getting to the recipient, varied depending on the circumstances and the organs being donated.
“People think if they have a health issue they can’t benefit someone else. I always tell people there could be a really healthy 60-year-old compared to an unhealthy 30-year-old, said Fitting.
“We look at everyone individually and if organ is not going to function it won’t be transplanted; but if you’re able to save someone’s life, we’ll do everything we can to honor that wish. There are even individuals with diabetes who can donate their heart or lungs.”
Myth: Doctors are more interested in obtaining organs than saving lives
According to a 2010 study done by Lifeline of Ohio regarding the state of organ donation in Ohio, 28 percent of more than 2,000 adults surveyed in Ohio believe doctors are more interested in obtaining organs than saving lives of organ donors.
This is the most common myth preventing individuals from registering as donors, and the furthest from the truth: An individual’s status as a donor is only considered after everything has been done to save his or her life and brain death has been declared.
“Doctors and nurses, individuals in a hospital setting, do not have access to the Ohio donor registry,” said Fitting. “Their main priority is to save the life in front of them. Our organization only becomes involved once we are notified of that death.”
Fitting said the family services department for Lifeline of Ohio is completely separate from the hospital staff, and specially trained to work with families and obtain information to benefit future recipients. Jordan added that Lifeline of Ohio is very specific that those providing medical care to a patient have only one goal: for the patient to have the best outcome.
“If they have deteriorating brain function and it’s determined they won’t recover and we switch gears into that mode. No one at the hospital asks the family’s permission to the start the process; all of that comes from Lifeline, said Jordan.
“We are the caregivers; they are the people who ask you about the other options. You don’t want people to have those lines crossed, our jobs are to care for the patient and if everything we’ve done doesn’t help they take over the process at a certain point.”
Jordan explained when a person comes to the hospital with a devastating neurological injury, medical staff have the responsibility to notify Lifeline of Ohio that the patient meets the clinical triggers and criteria to be an organ donor. Once Lifeline of Ohio is notified, Fitting said the organization would see if the person has suitability to be a donor and look their name up in the Ohio Donor Registry.
“In the absence of registration the legal next of kin would make that determination,” said Fitting. “If they’re 18 years or older and registered as a donor we will honor their wishes to be a donor. Under the age of 18 a parent or guardian makes the decision. That’s why we do encourage people to have that conversation.”
Once the designation has been determined, Lifeline of Ohio will work with the family to obtain a patient’s medical history to determine what can be donated. Once a determination has been made as to what organs can be donated, the donor’s information is entered into the United Network for Organ Sharing (UNOS) to determine who is the best medical match for each particular organ. Fitting said the medical matches are determined based on who is the sickest and who has been waiting the longest.
“Medical need and medical matching are very important, the person who is the best medical match and the sickest individual will receive the organ,” said Fitting. “We also look at travel time and body size – your organs are proportional to you as a person, so a huge football player could not donate his organs to a small child.”
Once placements have been made, a donor is moved into an operating room where organs are recovered, and the teams transplanting the organs are transported. At MedCentral Mansfield, transplant surgeons from The Ohio State University are brought in to recover any organs.
“We will only recover organs here, we don’t transplant them into other patients,” added Jordan. “Organs would be transported to wherever the patient is.”
Once the donations occur, Lifeline of Ohio then works with the hospital and funeral home to ensure whatever arrangements the family has made can proceed forward.
Myth: An open casket funeral is not possible after donation
Nine percent of those surveyed by Lifeline of Ohio did not believe that an open casket funeral is possible after donation. In fact, if an open casket was possible before donation, it will still be possible after donation.
“The myth is that organ donation precludes a traditional funeral, and that is genuinely a myth,” said J. Todd Snyder, director of Snyder Funeral Homes in Mansfield. “Our profession, long ago, adapted and encourages organ donation. Valuing life is what we do, and we encourage donation.”
Snyder explained once the organ donation process begins, an organ procurement organization like Lifeline of Ohio will contact the funeral home to alert them there will be a delay in receiving the decedent. The funeral home then begins the process of contacting the family of the donor.
“The donation organization contacts us to let us know about the passing and that there’s going to be a donation, they let us know when the procurement is going to occur and keep us posted on when it’s happening and will call us as soon as we can bring the decedent into our care,” said Snyder. “They keep us on a timeline so quality care of the family is never robbed, and we maintain quality care for the donation family. Communication is key.”
Once the funeral home receives the body of the organ donor, they begin the process of restoration. Snyder said the process is not unlike repairing the remains following an autopsy, and the invasiveness of the repair is dependent on the extent of the donation that took place. An extensive donation would create an addition four to five hours of preparation work for the funeral home.
“Repairing the body, though not always an easy process, is essential to restoring the body for viewing. It is what I train my staff to do,” said Snyder. “It can be labor-intensive but it is a labor of love. We’ve technically trained all of our embalmers and director embalmers to do that. It can be time consuming but it is essential.”
Because of the additional embalming care required to restore an organ donor’s body for viewing, most funeral homes have a “Donation Care” charge on their price sheet. Snyder emphasized the charge for preparing an organ donor’s body is not placed upon a donor’s family, but absorbed by the organ procurement organization.
“The family does not bear that cost through agreements with the organ procurement organizations,” said Snyder. “Those organizations understand the value of our profession and restoration work, so we submit a bill to those services and they pay us for our time, it’s at no additional cost to the families.”
In fact, there is no cost associated with donation at all to a donor’s family. Jordan noted there is a cost to the recipient of an organ, but the donor family neither pays for not receives payment for organ donation. Fitting echoed Jordan’s point.
“There is no cost to the donation portion, we are trying to emphasize that,” she said. “It is a gift they’re giving from the donor to the recipient. The family does not see a bill at all.”
Myth: Organ donation is not rewarding
It’s a very difficult situation when you have to say goodbye to a loved one. But when that loved one is an organ donor, it can be comforting to know something positive came out of a negative situation.
“We are very blessed in that we can walk with families as they are grieving their loved ones, and they often times tell us donation was the one good thing that came out of their loved one’s death,” said Fitting.
Jordan noted often times at MedCentral Mansfield, patients will say organ donation is the only good thing that came from a negative situation.
“Not only is it good for the person receiving but also an opportunity for the donor family to have something positive,” said Jordan. “We see patients that come in that have had transplants that have been able to live a lot better quality life after.”
“Once you meet someone who has benefited from organ donation, there is no price you can put on that,” added Snyder. “It makes it all worthwhile. It is a tremendous amount of work that is completely and utterly worthwhile; we love it and encourage it all the time.”
Through Lifeline of Ohio, once a donation has occurred the recipient and donor families are notified that if they’re interested in corresponding, they can do so. Fitting explained one party will write an anonymous letter to the organization and the other party will be notified they have a letter available. If both parties individually express they’re interested in meeting, Lifeline of Ohio will host the gathering.
Sometimes families are interested in keeping a relationship going – others simply want to meet face to face.
“It is very emotional; often times recipients say I’m not sure if saying thank you is enough,” said Fitting. “And for donor families, knowing someone’s life is continuing on because of their loved one makes a huge difference. It’s very impactful and life changing in many ways.”
Ohioans may declare their wish to become a donor by registering online in the Ohio Donor Registry through www.lifelineofohio.org. The Ohio Donor Registry is an individual’s first person authorization to donate the gift of life at the time of their death if possible through organ and tissue donation.
Additionally, individuals may indicate their intentions when renewing their driver’s license, or by completing a Donor Registry Enrollment Form available by calling 800-525-5667.
More information can be obtained at www.lifelineofohio.org
“We see patients that come in that have had transplants that have been able to live a lot better quality life after,” Becky Jordan, OhioHealth MedCentral said.
