My father died on October 26, 1999, after falling down eight steps. That’s where some stories end. It’s where this one begins. Dad was an organ donor. And when you’re an organ donor in today’s world, where miracle machines can sustain the mechanical functions of the body, you don’t die in a conventional sense.
You don’t stop breathing. Your heart doesn’t stop beating. You don’t turn cold. Rigor mortis doesn’t set in. You’re dead, but every organ continues to function normally.
Well, except one. Your brain.
It’s called brain death, and it’s especially confusing to grieving families because it looks a lot like life. Consider: As my family gathered at my father’s bedside to say our last goodbyes, machines beeped and whirred behind him. One showed that his blood pressure was 146/100 and his pulse 98. Another reported that he was breathing 20 times per minute. His face was flushed. His skin was warm. Five minutes before, he was alive, technically. Then two doctors came by and declared him dead, technically. But nothing seemed to have changed, really. Time of “death” was 1:26 p.m.
Dad was only 59. Two days before, he’d met my future in-laws for the first time. They talked of grandchildren to come and vacationing together someday. I couldn’t believe this was the end. As I left Dad’s hospital room, I stopped and looked back. I saw him lying there as he’d been for the previous 44 hours. I saw the organ-recovery coordinator entering the room. I suddenly became uneasy, overcome with guilt. It felt as if I was abandoning my father. For 7 years after, I wondered: What happened to him next?
Now I know.
And as I pieced together the past, I learned a few things: That organ transplantation is brutal, gruesome, lifesaving, and far too rare. That there’s a huge shortage of organs in this country. That the extraordinary efforts of scientists will soon bridge that gap, saving many more lives — perhaps yours, perhaps mine.
But mostly, I learned how my father changed one man’s life that day.
PICKING FROM A SMALL POOL
Even if you’re among the 46 percent of Americans who’ve checked the organ-donor box on your driver’s-license application, you’re not likely to ever become one. If your heart stops — the most common cause of death — odds are your organs will go to the grave with you. After heart failure, they begin shutting down within minutes, poisoned by the hormones a dying body releases specifically for that purpose.
This keeps the pool of organs from deceased donors pretty small. With rare exceptions, they all come from patients who are hooked up to lifesaving equipment in a hospital at the moment their neurons cease firing. Patients like my father. Because the heart has its own built-in pacemaker, it can continue beating as long as it has access to oxygen. So doctors can trick the body into thinking it’s still alive long enough to recover healthy, functioning organs for transplant.
But of the 2.2 million people who die in U.S. hospitals each year, only 20,000 — less than 1 percent — are brain deaths. Almost half don’t consent to organ donation. A quarter of the rest can’t donate because at the time of death, they’re either too old or too sick. (All cancer patients are disqualified.) That leaves 7,500 deceased donors annually who pass on an average of two organs each.
Right now, more than 94,000 Americans are waiting for an organ transplant. Today, 77 of them will get one. But also today, 18 will die waiting, and 122 new patients will be added to the list.
“Even if every person in this country who died of brain death donated his or her organs, there still wouldn’t be enough to go around,” says Fadi Lakkis, M.D., scientific director of the Thomas E. Starzl Transplantation Institute, in Pittsburgh. “We need to find other sources, sure, but we must also reduce the number of recipients who need second and third transplants. That means eliminating organ rejection.”
Go to the next page for details about the process of organ recovery…
OCTOBER 26, 1:44 PM
My father was attended by a critical-care physician, a transplant surgeon, and the organ-procurement coordinator, who was also a registered nurse. Their top priority was to keep my father’s organs functioning until they could be “recovered.”
After brain death, my father’s body would have quickly shut down. But the organ coordinator wouldn’t let it. She gave him a dose of steroids to improve lung function, and slowed his ventilator so he’d take fuller, deeper breaths. The longer the air stayed in his lungs, the more oxygen would make it into his blood and, ultimately, his organs.
Meanwhile, a computer search was turning up potential recipients for my father’s organs. The coordinator entered various parameters — height, weight, and blood type — into the national database, and out popped a list of the sickest patients, organized by proximity to the donor.
The doctors treating the nearest “status 1” patients — people in danger of dying within a week — got first dibs. Because the University of Pittsburgh medical center, where my dad was taken after his fall, operates one of the largest transplant centers on the East Coast, most of the potential recipients were patients there. Farther down the list, however, were candidates from Puerto Rico and California. They’d be backups if the organs were healthy enough to transplant but couldn’t be used locally.
Now the phone calls began, starting at the top of the list for each organ. There was immediate interest in my father’s kidneys, liver, heart, and pancreas. His lungs were also under consideration, even though lungs are prone to collapse after brain death, and the slightest nick during recovery can ruin them.
My dad’s were still working well, so the coordinator was hopeful.
MAKING IT A FAMILY MATTER
The hospital actually didn’t need our permission to take Dad’s organs. His driver’s license said “organ donor” right on the front, and that’s legally binding in Pennsylvania, as it is in most states. But taking a dead man’s organs without consulting the family is bad form, so the decision is always left to the next of kin.
We met with the organ-procurement coordinator 5 hours before Dad was declared brain dead. She explained that, along with the major organs, doctors can recover tendons, cartilage, corneas, bones, and even skin. These tissues have a variety of uses, from knee surgeries to burn grafts. They’re blasted with radiation before they’re transplanted, so they’re dead on a cellular level and therefore won’t be rejected by the recipient’s immune system. Mom gave consent for corneas, but no other tissues. “I don’t want your father sliced up,” she told us.
The organ coordinator had actually been called in the night before. At that point, we’d known Dad wasn’t going to make it. But still, when your father is dying and you’ve agreed to give away his organs, you can’t help but sense vultures circling.
“We get that a lot,” says Bryan Nelson, a 3-year veteran of Gift of Life, the procurement organization serving eastern Pennsylvania, southern New Jersey, and Delaware. “We stay out of sight until the family expresses an interest in donation. But we do try to get a head start sometimes, because recipients will fare better if we can shorten the hours between brain death and organ recovery.”
The day my father died, a 53-year-old man named Shin Lee was in the same hospital, two floors away and close to death.
Go to the next page to learn the story of Shin Lee…
In many ways, Lee is the poster child for organ rejection. In 1984, at the age of 38, the Vietnam veteran was diagnosed with hepatitis B. It’s a chronic condition, affecting up to 10 percent of Asian-Americans, and it can progress to cirrhosis, cancer, and liver failure. And so it went for Lee, a father of three, who received his first liver transplant in 1992. He immediately started taking three drugs to suppress his immune system, so that his body wouldn’t see his new liver as a foreign invader and try to destroy it. But his immune response prevailed, and by the fall of 1998, Lee was back on the waiting list.
Lee waited 13 months for a new liver. Each day, he got sicker. Each day, he moved up the list. The day my father was put on life support, Lee made it to the top of the list. One man’s tragic day was another’s lucky day.
A few months before the transplant, Lee’s immune-suppressing drugs had begun taking a toll on his kidneys. They failed, and he started dialysis. Dialysis is the only artificial process that can replicate the function of an organ, but it’s also grueling — 4 hours a day, 3 days a week — and temporary: It causes dangerous calcium deposits in the blood vessels, lungs, and heart.
So, after receiving his new liver, Lee went back on the waiting list, this time for a kidney. In the summer of 2003, he got it.
That’s three new organs in 14 years. Lee’s case is not unique. Almost 15 percent of all patients on the waiting list are repeat customers. Organ recipients are rarely cured, says Dr. Lakkis. The cycle just continues.
Chronic rejection has a combination of causes: the continuous, low-grade immune response (drugs can’t turn it off completely) and the toxicity of the drugs themselves. But there’s another side to the problem: Many organ recipients die of strokes and heart attacks, not organ failure, says Dr. Lakkis.Chronic rejection causes scarring not just within the transplanted organ, but also within all the organs and vessels of the body.
In other words: If rejection doesn’t kill the organ first, it eventually kills the person.
REPROGRAMMING THE IMMUNE SYSTEM
Derek Besenfelder doesn’t take antirejection drugs. He doesn’t have to. The 27-year-old kidney recipient is one of just 10 patients in the United States who submitted to an experimental surgery that eliminates the need for immunosuppressants after a transplant. His immune system doesn’t attack his new kidney because, well, it’s not exactly his immune system anymore.
The immune system, for all its benefits, is pretty stupid. It doesn’t know the difference between a mosquito bite and a transplanted heart, for example. When it detects a foreign cell within your body, it issues the same order: Kill.
Besenfelder, who received his transplant at Massachusetts General Hospital in Boston last February, essentially had his immune system reprogrammed. He received new bone marrow along with his new kidney–from the same donor–and over the next 2 weeks, his bone marrow reconstituted with both his own and the donor’s immune cells. Now, his immune system accepts the kidney as his own.
“With a traditional transplant and anti-rejection drugs, you have a 90 percent chance of having a functioning kidney in a year,” says David Sachs, M.D., director of the Transplantation Biology Research Center at Massachusetts General. “That goes down 4 percent a year, so in 10 years, there’s only a 65 percent chance your kidney’s still functioning. And you may need a new kidney within 20 years. Plus, there are all the quality-of-life issues.
“With our new approach, the organ won’t be rejected and you won’t take immunosuppressant drugs,” he continues. “That’s pretty compelling for a young person.”
Go to the next page to learn the risks of such a procedure…
It’s also pretty risky. When you obliterate a person’s immune system, the potential exists for a serious infection, particularly in the first few weeks.
“It’s not an easy choice,” admits Dr. Sachs.
For this reason, the Starzl Institute takes a less radical approach to reducing chronic rejection, by manipulating the immune system with a drug called Campath. Dr. Lakkis compares the standard immunosuppressants to “a boot on the neck of the immune system. If you try to reduce the dose later, you lift the boot, and the T cells go wild.” The response is so extreme, in fact, that the immune system attacks not only the transplanted organ but neighboring tissues as well. “Our approach doesn’t hold down the T cells,” Dr. Lakkis says. “It kills them.”
Every transplant patient at the Starzl Institute takes Campath in the hours before the operation. Unlike an antirejection drug, it’s a onetime dose. When surgeons transplant the organ, the drug binds to the T and B cells as they leave the bone marrow, and destroys many of them. “So now, instead of having a mountain of cells attacking the organ, we have a hill,” says Dr. Lakkis. “And instead of giving three antirejection drugs after a transplant, we can sometimes use just one. Then we lower that dose over 6 months.
“We have a few patients who’ve been weaned from their immunosuppressants entirely,” Dr. Lakkis continues, “and are now leading normal lives.”
OCTOBER 26, 4:55 PM
Dad was taken to the cardiac catheterization lab. A local transplant surgeon was interested in his heart but wanted to confirm the results of an earlier echocardiogram — done bedside — that suggested his heart was strong and structurally sound.
Bad news: One of the vessels supplying his heart was 70 percent blocked. Another was thinning and bulging — an aneurysm in the making. Dad’s heart could not be transplanted. The same was true of his lungs: A chest x-ray revealed spots on them. The doctors suspected pus, which meant his lungs were probably infected.
Two hours later, better news: The results were in from the latest battery of blood tests — 23 in all — and Dad’s liver function was excellent. The recipient would be a 53-year-old man, Shin Lee. He was a status-1A patient, meaning he would die within a week unless he received a new liver. His doctor delivered the good news.
ORGANS FROM ANIMALS?
If chimpanzees were pests, our organ shortage might be solved. Genetically, we differ from them by less than 2 percent. And they’re just about our size. But they’re also an endangered species. And besides, organ shortage or not, it’s hard to ethically justify killing a first cousin.
Pigs, on the other hand, are bred for bacon. “Why not for hearts and livers?” asks Dr. Sachs, one of the world’s foremost authorities in the field of xenotransplantation — that is, transplanting organs from animals to people.
Over the past 3 years, Dr. Sachs has engineered a colony of identical pigs, each with a special quality: Its organs could be transplanted into humans, at least theoretically. But that’s years away. Dr. Sachs is first trying to prove that it works by transplanting these organs into one of our evolutionary relatives: the baboon.
Go to the next page to learn more about animal-to-animal organ replacement…
If the differences between a human and a pig seem obvious on the surface, they’re even more acute at the cellular level. Every pig cell is coated with a sugar called alpha 1,3-galactose. In fact, almost every cell in every living creature has this sugar. The only exceptions: old-world primates, which include chimpanzees, great apes, baboons, and, yes, humans. At some point, as we evolved, we lost our sugar, so to speak.
But since the sugar is in bacteria and on viruses, our immune systems have antibodies to fight it. Put a pig organ in a human being, and the person’s immune system would destroy it within minutes.
Dr. Sachs’s goal, then, was to engineer pigs that don’t have alpha 1,3-galactose on their cells. And he has, about 500 in all. He uses what’s called nuclear-transfer technology — it’s the same process that created Dolly, the cloned sheep. You take the nucleus out of a fertilized egg, replace the sugar-producing gene with a placeholder gene, then put the nucleus back in. The baby pig, when it’s born, doesn’t carry the sugar.
“We’ve been doing a few experimental transplants a week,” Dr. Sachs tells me, as we walk past the test pigs and baboons in pristine pens. “And the results have been phenomenal. We had a baboon live for 80 days with a pig kidney. And it died of a heart attack, not organ failure.”
I ask Dr. Sachs if he really envisions a day when animals are bred for organs. Will our society’s ethics ever allow that? “It’s a serious question, and I respect our opponents,” he says. “It’s a healthy debate that we’ll need to have as this research progresses.”
“The fact is, we have a long way to go,” Dr. Sachs continues. “Many years. But when you see what an organ transplant does for a person, that’s what drives us onward. It’s why I went into medicine: to help people who are being struck down by the failure of one organ.”
We stop in a hallway outside one of the center’s operating rooms, in front of a bulletin board. “This is what people don’t realize,” says Dr. Sachs, gesturing to a poster that says, “Animal research has added 28 years to the average human’s life.”
“Someday, we’ll be able to grow new organs from our own cells. But until then, xenotransplantation will save a lot of lives.”
OCTOBER 26, 10:42 PM
Dad was wheeled into an operating room. His upper body was stripped and coated with a yellow antiseptic. Sheets were placed over his head and legs, and a sticky, clear surgical film was taped over his abdomen. It would minimize the risk of infection and help hold the tissue together as the surgeons cut.
Twenty minutes later, the first incision was made. It went from the base of the neck to the top of the groin. Two surgeons worked at once, using an electric knife that cauterized the incision as it cut. There was very little bleeding, but lots of smoke. The room smelled like burning flesh.
Next, the surgeons made four horizontal cuts across the abdomen — two on each side — and peeled back the skin. Then, using a pneumatic saw, one of the surgeons cracked the sternum in two, placed a retractor between the pieces, and turned a hand crank. The rib cage parted, revealing the abdomen. The lungs expanded and contracted. The heart beat. A display above the operating table listed my father’s vital signs: blood pressure, 101/60; pulse, 100; breaths per minute, 10; oxygen saturation, 100 percent.
The surgeons did their first visual inspection of his organs. An ideal liver is maroon. Dad’s was brownish with sharp edges, but in good shape overall. His pancreas was covered with fat and could not be transplanted. The would-be recipient, who was being prepped in an adjacent operating room, would have to wait for another chance. The kidneys were also covered with fat deposits, but they could be salvaged.
Readying the organs for removal is intricate work. The surgeons have to trim everything that connects them to the body — except, of course, the arteries and vessels that are still circulating blood. Intestines could get in the way of this work, so they were wrapped up — all 25 feet — in a sterile cloth.
Surgeons also cut out eight lymph nodes and sent them to the lab for analysis. Lymph nodes are loaded with white blood cells, which carry human leukocyte antigens (HLA). Dozens of different molecules make up a person’s HLA profile — it’s your genetic fingerprint.
A 50-year-old woman and a 69-year-old man, both of whom had been on dialysis for more than a year, were the leading candidates to receive Dad’s kidneys. They shared his blood type, but it was their HLA profiles that would determine whether they got the organ. Kidneys are ultrasensitive to compatibility issues, so the closer the HLA profiles, the less the chance of rejection.
Kidneys also survive outside the body for up to 36 hours. Hearts and lungs, on the other hand, must be transplanted within 4 hours, and livers within 12. Because kidneys fare so well on ice, procurement coordinators can take more time picking the recipients.
Go to the next page for the solution to the world’s organ-shortage problem…
The incubator looks like a stainless-steel minifridge. Inside, says Mark Furth, Ph.D., may be the cure for heart disease, which affects 65 million Americans.
Furth opens the incubator slowly, revealing a…blood vessel? Yes, says Furth, but not just any blood vessel. This one’s been grown in a lab, from human cells. A liquid is coursing through it, much as blood would.
“Say you have a blockage in an artery,” explains Furth, the technology-development officer at the Wake Forest Institute for Regenerative Medicine. “Your doctor takes a few cells from you and grows an entirely new vessel. It’s transplanted into you, and you’re fine. It’s made from your own cells, so it’ll never be rejected.”
That’s the promise of tissue engineering — that is, growing human body parts outside the body. Most likely, it’ll be the technology that eventually solves the world’s organ-shortage problem.
The Wake Forest Institute for Regenerative Medicine, one of many labs around the country specializing in the technology, is trying to grow hearts, livers, lungs, kidneys, and more. And it’s already had a major breakthrough: bladders. When a person’s bladder fails, says Anthony Atala, Ph.D., the institute’s director, surgeons traditionally build a new one from intestinal tissue. “The problem is that intestines are designed to absorb,” says Atala, “whereas bladders are designed to excrete. That creates a lot of problems later in life: electrolyte abnormalities, gallstones, and, because you’re mixing two kinds of tissues together, cancer.”
So, about 16 years ago, Atala had a revelation. When any part of the body suffers an injury, cells multiply to heal the wound. “We thought, If the body can do it, why can’t we?”
After years of trial and error, Atala discovered that the cells on the inside surface of the bladder, called epithelial cells, have the ability to multiply outside the body — under the right conditions. So to grow a new organ, he layers these cells on a bladder-shaped scaffold. It sits in an incubator for a week, then he implants it into the patient. Within a couple of months, as the cells continue to multiply and the scaffold naturally degrades, the patient has a brand-new bladder. Atala has engineered bladders for seven patients so far, and all the organs are functioning well.
Of course, there’s a big difference between a bladder, which is essentially a balloon, and a solid organ like a liver or kidney. For one, Atala doesn’t have to create new blood vessels to keep his bladders oxygenated; bladder walls are so thin, they can suck up enough oxygen from neighboring tissues.
Still, Atala is confident. “We think all organs have these preprogrammed cells,” he says. “If we can find them and get them to multiply outside the body, we think we can grow any organ.”
Go to the next page for an account of the organ extraction…
OCTOBER 27, 12:10 AM
This was the most critical part of the recovery. One of the surgeons sliced through my father’s aorta. The nurse released a cold preservation solution from two IV bags, and it was fed into the aorta and through the organs. The other end of the aorta was cut as well, allowing the blood in the organs to be suctioned away. The other surgeon poured a big bowl of ice into the abdominal cavity. The numbers on the video monitor — pulse, respiration, blood pressure — fell to 0.
My father’s heart was cut out within 5 minutes. It wouldn’t be transplanted, but his valves would be. His liver was next. It was immediately moved to a back table, where it was infused with more preservation solution, packed in ice, put in a cooler, and rushed to the operating room in which Shin Lee was waiting, already under anesthesia. The kidneys came out last. They were packed in a cooler and would be transplanted the next day. Before the gaping hole in my dad’s chest was closed and sutured, surgeons also extracted his prostate gland and bladder. Both would be used for research.
My father had now given his all. An hour and a half later, he was wheeled out of the operating room and to the morgue. The funeral was 3 days later.
Bryan Nelson, the Philadelphia-region organ-procurement coordinator, would love to see a day when organs are grown in labs instead of recovered from the dead. “It’s hard to do this job longer than a few years,” he says. “Emotionally, it just drains you.”
On the summer night I meet up with Nelson, he’s working a particularly tragic case: A teenage girl lost control of her boyfriend’s car and hit a bridge abutment. She’d been in intensive care for 2 days before being declared brain dead. When I arrive, the girl’s family is huddled around her hospital bed. This is unusual. Most families leave after brain death is declared, as mine did. In this case, however, the girl’s mom and dad want to wheel her to the operating room and say their goodbyes there.
Meanwhile, Nelson is on the phone with Children’s Hospital in Pittsburgh. A surgeon there has an 11-year-old patient who needs a multivisceral transplant — liver, pancreas, kidneys, and intestines. The dead girl is a match. Nelson’s trying to figure out how soon the surgeon can reach Philadelphia, so he can set an O.R. time for the organ recovery.
A nurse hands Nelson the results of the girl’s latest blood work. Her lung function is worsening, so Nelson prescribes a steroid to improve it. The phone rings again. It’s Johns Hopkins. They’re coming for the heart, leaving in an hour. Nelson tells them to delay — Children’s Hospital won’t be there for at least another 6.
It’s late, after midnight. Nelson goes to the girl’s room to encourage her parents to go home and get some sleep. They’re reluctant, and who can blame them? It’s the last night they’ll have with their child. But Nelson assures them the recovery won’t happen for at least 7 hours. He tells them he’ll call them in a bit, to wake them up. As they leave, the mom gives Nelson a hug.
“This job is part doctor, part travel agent, part diplomat, and part social worker,” says Nelson, who was previously a medevac paramedic. (All coordinators have medical backgrounds.) “Ultimately, though, I’m the advocate for the family. I can’t save their loved one, so I do everything possible to see that he or she lives on in someone else. I take it personally. When a doctor tells me he doesn’t want an organ for whatever reason, and I believe the organ is healthy enough to work, I fight for it. I fight for the family.
“But, yes…” He pauses, looks at all his paperwork and notes and blood vials in front of him, and sighs. “It takes a toll.”
Go to the next page for a face-to-face with organ receipient Shin Lee…
Bill Morris knows that feeling. Morris spent 7 years running the donor program at the University of Rochester. He now runs the recipient program at the Starzl Institute, in Pittsburgh. “I handled more than 300 donors, and I remember every one,” he says. “I needed to get on the side where you see lives being saved.”
Morris continues, “One of my last donors was a 3-month-old baby girl. She died senselessly. Her father lost his temper and shook her to death. I was a cop for 20 years, and I saw lots of stuff, horrible things. But nothing was worse than holding that baby in my arms after we took her heart and liver and kidneys and gave them to other kids. When the medical examiner arrived, I didn’t want to give her up. I was living in a fantasy world. I wanted to bring her home. I wanted to make her better.
“That’s when I knew I needed a change,” Morris says. “Now, I see gravely ill people getting better every day. It’s great to watch. And they’re so thankful. We overuse the word ‘hero’ in this society, but every organ donor is a hero. Your dad is a hero to someone, trust me.”
THE GIFT OF LIFE AFTER DEATH
Last June, when I traveled to the West Coast to meet Shin Lee, he was in the hospital again. His herpes zoster virus had emerged from hibernation, covering his left leg with painful lesions. If you had chickenpox as a kid, you carry herpes zoster as well. But your immune system keeps it in check. Lee’s immune system barely exists.
Lee was in the isolation ward at the Loma Linda Veterans Hospital, outside of Los Angeles. I put on scrubs and went to his room. I was expecting to meet a beaten man, perhaps even an angry man. Instead, I found a man profoundly grateful to be alive.
“I wouldn’t trade the past 14 years,” Lee tells me, pausing occasionally to catch his breath. “Yes, it’s been hard. But I’ve survived three organ transplants. I’m lucky. I still enjoy life and spending time with my wife and my three children. I hope to someday meet my grandchildren. Your father’s sacrifice…”
Lee’s voice trails off. I nod. I know what he wants to say — that my dad saved his life, that my dad is a hero. But, honestly, I don’t want to hear it. I’d like to think that my father is a hero for how he lived, for the lessons he taught me, not for how he died. He simply chose, in the end, to help his fellow man. It was the right thing to do, a selfless act perhaps, but no more heroic than Shin Lee’s 14-year fight to survive.
When I think of my father, I don’t have much sadness left. Yes, he died young. And yes, he died tragically. But deep inside, I believe he was ready. My only regret, for him and for me, is that he didn’t live to meet his grandchildren, my two young daughters. He would have gotten a kick out of them — their passion and their stubbornness and how they both, at ages 4 and 1, have me completely figured out. It wasn’t to be.
Now, I can only hope that dream will come true for Shin Lee, the man who lives because of the way my dad died.
Cincinnati Bengals QB Carson Palmer has a little bit of woman in him. Doctors repaired Palmer’s left knee, which was shredded during a playoff game last January, with an Achilles tendon from a 44-year-old woman who died in a car crash.
More than 2,300 U.S. companies recover, decontaminate, and radiate–to prevent rejection–1.5 million bones, tendons, ligaments, corneas, heart valves, and other human tissue each year. The FDA recently shut down two of them for failing to properly screen for disease, which raises the question: Is donated tissue safe?
“The vast majority of donated tissue is highly processed to reduce or eliminate contamination,” says Scott Brubaker, chief policy officer of the American Association of Tissue Banks (AATB). “But we do need to increase the fines and sentences for anyone who acts outside the law.” In the meantime, if your best shot at getting of the DL requires an assist from a cadaver, ask your doctor these questions.
* “Who’s supplying the tissue?” “Call the tissue bank and ask where they get their tissue, what diseases they test it for, and how they determine its suitability for transplant,” advises Martha Anderson, executive vice president of donor services at the Musculoskeletal Transplant Foundation, one of the largest tissue banks in the United States. If you don’t like what you’re hearing, ask your doctor to find a better source. Or just play it safe: Insist that your doctor acquire tissue from one of the 95 U.S. banks that have earned an AATB accreditation. To find one near you, go to aatb.org.
* “Is your facility accredited?” Hospitals with a Joint Commission on Accreditation of Healthcare Organizations seal of approval must meet strict standards for acquiring, storing, and releasing tissue, says Brubaker. To find an approved facility, go to qualitycheck.org.
The liver is the only organ inside the body with the capacity to regenerate. For that reason, it’s now possible for a healthy person to donate a liver to someone in need.
The living liver transplant, as it’s called, was invented at the University of Chicago in the late ’80s, an adult donating a small portion to a child. But Dr. Amadeo Marcos, M.D., the clinical director of the Starzl Institute, has pioneered the procedure between adults over the past 7 years. Dr. Marcos transplants 60 percent of the healthy person’s liver. Within a month, both portions grow back to the original’s size. Because the new liver only sits outside the body, on ice, for an hour before being transplanted–versus an average of 10 for a cadaver liver–it acclimates to its new home more successfully. The one-year survival rate for Dr. Marcos’ living livers is 90 percent, versus 83 percent for cadaver livers.
Dr. Marcos has also found a way to minimize rejection. “If you activate the immune system well before a transplant,” he explains, “a lot of T-cells will die on their own, before they can harm the organ. Basically, we’re exploiting the immune system’s natural ability to turn itself off.” Roughly 17 days before the transplant, Dr. Marcos draws blood from the donor, isolates and concentrates the T-cells, then feeds them to the recipient via an IV. The recipient’s immune system attacks. But over the next two weeks, the reaction becomes more controlled as the T-cells die off. “Now, when we do the transplant, we see less of a reaction from the immune system,” says Dr. Marcos.
The living-liver transplant is still relatively rare: 323 were performed last year, versus more than 6,000 cadaver-liver transplants. Donors are almost always family members, who undergo intensive mental and physical evaluations first. “We turn down 70 percent of all volunteers,” says Dr. Marcos. “It’s a complex, challenging, 10-hour operation. Donors have died. We have to be very cautious.
“I don’t think it’s the type of thing that will be offered everywhere,” Dr. Marcos continues, “but there will always be a place for it. It’s not going to make the organ shortage disappear. It’s just one tool. But it’s nice that no one has to die so someone else can live.”
- Grieving Mikaela Shiffrin grateful she saw her father in his final moments
- Joy will come again: lessons from a life turned upside down
- Bella Thorne Pays Tribute to Late Dad on 13-Year Anniversary of His Death: 'I Still Feel Broken'
- Ashley Roberts steps out in a pink 'rock 'n roll vibe' suit in honour of her late father's 70th birthday
- EXCLUSIVE: Devastated girl, 14, is taken into foster care after her NHS nurse mother dies of Covid-19 and her father, also a health worker, battles deadly disease in intensive care
- Father-of-eight dies of coronavirus aged just 34 after believing he had recovered from the killer infection as well-wishers raise more than £90,000 for his devastated family
- Buhari commiserates with Okonjo-Iweala over father’s death
- Boy George received so many death threats during Culture Club days he had to wear a bulletproof vest
- Brian Dennehy's Death Has Social Media Mourning 'First Blood' and 'Tommy Boy' Actor
- Brian Dennehy Dead: What Was 'Tommy Boy,' 'First Blood' Star's Cause of Death?
- Brian Dennehy's Daughter Elizabeth Reveals Tender Portrait Photo of Father Amid News of His Death
- "Painful to just talk about it": Celina Jaitly talks about going through depression after losing her baby and her father
- Real Life 'Storage Wars' -- Man Hits DIKEMBE MUTOMBO Jackpot!!
- Coronavirus: Only 9% of Britons want life to return to 'normal' once lockdown is over
- Eight-month pregnant nurse Mary, who died of coronavirus but whose baby was saved, lost her father 'to virus' just two weeks ago
- COVID-19 claims life of another Pakistani taxi driver in London
- Malala Yousafzai on life in Britain: 'We have never seen women so free'
- Britain suffers another 888 coronavirus deaths - the worst figures for a week and the fourth worst day for deaths overall as total toll rises to 15,464 but cases remain steady with 5,526 new infections
- George H.W. Bush Was Last Seen in Public 1 Month Before Death — and It Was to Vote with His Dog
- Jeb Bush Calls George H.W. Bush the 'Greatest Human' as Obama, Trump & More Mourn His Death
My Father's Life (After Death) have 6152 words, post on www.menshealth.com at November 6, 2006. This is cached page on Talk Vietnam. If you want remove this page, please contact us.