April is National Donate Life Month, a perfect time to learn more about organ donation and transplantation and to consider how many people have been saved by organ donation (Hint: 2,150,200 years of life have been saved through 533,329 kidney transplants alone!).
Why do we need organ donation?
There are many diseases that can result in organ failure. While there are many ways to support failing organs, these mechanisms are not well tolerated and also exact a toll on one’s life span. Kidneys can be replaced by a machine (dialysis), and we have machines to bridge people with failing lungs or hearts until transplant, but these options won’t work forever and have many risks associated with them. Because these artificial means are far from perfect, and because humans can’t survive without a functioning heart, lungs, liver, pancreas, intestines or kidney, organ donation and transplantation is life-saving.
What is organ donation?
There are two kinds of organ donation.
- Living donor transplantation happens when someone gives an organ, or a portion of an organ to another person. Because we have two kidneys, it is possible to donate one kidney to another person. People can also donate a piece of their liver, because healthy livers can regenerate. Donors go through a lot of testing to make sure that it is safe for them to donate and to make sure that they will stay healthy afterwards; however, there is still some risk associated with it.
- Another kind of donation happens after someone dies. When you check the organ donor box on a driver’s license, this is what you are agreeing to. This is the only way that someone could get a heart or lung transplant, and it provides most livers, pancreatae, and kidneys.
How can an organ from one person work in another person?
Our body’s immune system detects substances in our blood that aren’t part of our body, such as bacteria and viruses. People also have markers on their cells that are unique and identify them. So, if you were to put an organ from one person (unless that person was an identical twin) into another, the new person’s body would recognize the organ as foreign and the immune system would attack it. Because of this, medications that suppress the immune system are required to allow an organ from one person to work in someone else. So, organ transplant recipients need to take medicine every day to keep their new organ safe and working well.
What’s the fuss about transplantation? Why do we need a Donate Life Month?
Transplantation is transformative; it allows people to live longer, healthier and happier lives! A recent analysis of the outcomes of patients who underwent organ transplantation compared to those who stayed on the wait list from 1987-2012 showed that 2,150,200 years of life have been saved through 533,329 transplants. Kidney transplants were most common. In the 25 years studied, there were 314,561 kidney transplants, about 13,000 of which were in children. These kidney transplants saved about 1.3 million years of life. Children who underwent kidney transplantation had a median survival of more than 25 years compared to 11.5 years for those who stayed on the wait list and didn’t receive a kidney transplant (Rana, 2015). This is remarkable because it more than doubles children’s survival and allows them to grow into adulthood and pursue careers and contribute to society. It is also important to note that many of the children in the study are still alive and doing well. As such, we expect the survival will be higher.
If transplants save so many lives, why doesn’t everyone get one?
This is the greatest issue affecting transplantation. We know that they save lives and improve quality of life, but there aren’t enough organs for everyone. We are providing better care to patients with end organ disease, which results in more patients being listed for a life saving transplant. Unfortunately, the organ supply has been very stable. Many people are helped by their friends and family donating livers and kidneys, but living donation isn’t possible for everyone. We don’t have enough deceased donor organs for everyone on the list. To try to make it fair, there are waiting lists for each kind of transplant. Almost 124,000 people in the U.S. are waiting for an organ transplant. More than 1,000 of them are 10 years old or younger. Unfortunately, an average of 21 people die each day waiting for a transplant (OPTN data). Clearly, we need to do better. People are working on other ways to replace organs and save lives, but until we have new technology, we need to expand organ availability.
What can I do?
Learn more about organ donation (see resources below) and think about whether you would like to be an organ donor. If so, tell your friends and family about your decision and sign up in your state’s donor registry. You can specify restrictions regarding what you would like to donate. Click here to access information on how to plan being an organ donor.
If you would like to consider being a living donor, either for someone in your family or for someone you don’t know but who is on a waiting list, you can find information through these resources as well.
Learn more about the Transplant Surgery Program at The University of Vermont Medical Center.
Elizabeth Hunt, MD, is a pediatric nephrologist at The University of Vermont Children’s Hospital.
Rana A, Gruessner A, Agopian VG, et al. Survival Benefit of Solid-Organ Transplant in the United States. JAMA Surg. 2015;150(3):252-259. doi:10.1001/jamasurg.2014.2038.