Helping Your Family Decide if Organ and Tissue Donation is Right for You

If you are in the position of deciding whether or not to donate the organs and tissues
of someone you love, you may have many questions. This article answers some of the most
common questions and will help you think through your decision.

The Need is Great

The demand for organs far outweighs the number available for transplantation and thousands
die each year while waiting for a second chance at life. As the national waiting list continues
to grow, the number of organ donors has remained relatively unchanged over the past several
years.

According to the United Network for Organ Sharing, there are nearly 70,000 people waiting
for transplants in the United States alone. Given the current donation rates, less than half
of those waiting will ever be transplanted.

In the United States, a new name is added to the tranplant waiting list every 16 minutes.

While a national list does not exist for those waiting for tissue grafts and corneal
transplants, there is a great need for donations of both tissues and eyes. Each year donors
provide tissue for approximately 450,000 tissue grafting procedures, including hip replacements,
heart valve transplants and ligament repairs. Last year more than 46,000 cornea transplants
were also performed in the United States.

Understanding Brain Death

If a person has been declared brain dead, the following information maybe helpful to you.

Brain death means there is no blood flow or oxygen to the brain and that the brain is no
longer functioning in any capacity and never will again. The person cannot breathe without
assistance, has no pupil response to light and no response to pain. Failure of many organs
begins to occur soon after brain death.

Because the heart has its own “pacemaker,” however, it will continue to beat as long as
it has oxygen. Respiratory support equipment supplies oxygen and keeps the heart beating.

Once a patient is brain dead, he or she is dead. The brain will never recover. But
during a short time after brain death, while a respirator keeps the heart beating, some of
the patient’s organs and tissues may be recovered for transplant.

People who have died what is termed a “cardiac” death cannot donate organs but may still
be tissue and eye donors.

Both Organs and Tissues May Be Donated

The heart, liver, lungs, pancreas, kidneys, heart valves, corneas, bones, skin, tendons
and ligaments can be donated. The lives of several people can be saved or enhanced through
the donations of just one patient.

If You Decide to Donate

If your family decides to give permission for organ and tissue donation, you will first
be given an opportunity to say goodbye to your loved one. Use these minutes to hold and touch
the body of the person you have loved one final time.

The organ procurement team will then evaluate the patient as a donor and blood samples
will be taken for the matching process. When recipients are located, organs and tissues
will be removed by a team of surgeons and a specialist trained in organ recovery.  The
entire process may take between 10-30 hours.

The recovery of organs and tissue is a surgical procedure and takes place in a hospital
operating room. The person donating is cared for respectfully throughout the entire procedure.

How Donation Affects the Funeral

Because the recovery of organs and tissue is a surgical procedure, an incision or incisions
will be made. However, the incisions are typically small and will be covered with clothing for
the funeral. You may still have an open casket visitation or funeral if you wish. If you
should decide donation is right for you, you will want to consider what clothing would be best
for an open casket viewing.

You may want to let others know that your loved one was a donor by including this information
in the obituary, the funeral program or the eulogy. Ask your funeral director for ideas.

How Donation May Affect Your Grief Journey

Families of potential organ and tissue donors typically experience the sudden, often
traumatic, death of someone loved. For all families the death is senseless. Some families
must also cope with the knowledge that death resulted from the violent act of another or a
self-inflicted wound.

The unique circumstances surrounding the catastrophic injury that led to brain death creates
special needs for these families. Given no time to prepare and often little experience coping
with such devastating news, donor families are in need of immediate and ongoing support.

Acknowledging the reality of the death is often complicated by the very nature of the
death- brain death. A previously healthy person now lies motionless in a hospital bed with
vital signs, yet a family is asked to comprehend and accept the irreversible nature of the
injury and finality of the situation. A family may desire time with the body and reassurance
that all medical treatment options have been exhausted.

For many grieving families, the decision to donate organs is a helpful way to give meaning
to a senseless loss. Family members have told me on many occasions that the most positive aspect
of their painful grief experience has been knowing that some other family has been brought
comfort because of their loved one’s gift. While recognizing this comfort, remember that it
is always bittersweet comfort, and does not take away the pain of the grief that results from
the death.

If You’re Faced with the Decision Right Now

No one should rush or pressure you into the decision to donate. However, you should be aware
of time constraints that might prevent you from donating certain organs or tissues if too much
time elapses.

Take the time to talk among yourselves, openly and honestly, about your feelings about
donation. Consider what the dying person would have wanted. Listen to what your heart and
mind are telling you to do.

The United Network for Organ Sharing (UNOS) website (www.unos.org) provides good
information on national statistics, legislation, and policy on donation. For information
specifically pertaining to tissue and eye donation, the American Association of Tissue Banks
and the Eye Bank Association of America would be useful resources. Additionally, the National
Kidney Foundation Donor Family Council has a variety of resources specifically for donor
families at (800) 622-9010 or www.kidney.org.

About the Author

Dr. Alan D. Wolfelt is a noted author, educator and practicing grief counselor. He
serves as Director of the Center for Loss and Life Transition in Fort Collins,
Colorado and presents dozens of grief-related workshops each year across North America.
Among his books are Healing Your Grieving Heart: 100 Practical Ideas and The Healing
Your Grieving Heart Journal for Teens
. For more information, write or call The Center
for Loss and Life Transition, 3735 Broken Bow Road, Fort Collins, Colorado 80526,
(970) 226-6050 or visit their website, www.centerforloss.com.

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