Organ Transfer

Introduction

Organ transfer has become the treatment of choice for end-stage renal disease (ESRD) in addition to other types of organ failure, notably heart, liver, and lung. By all accounts, the shortage of transplantable organs is a public health crisis with one person on the United Network of Organ sharing (UNOS) transfer waiting list dying approximately every 17 min. In 2005, there were more than 90,000 individuals awaiting transplantation (Sheehy 66).

There are two possible sources of organs for transfer: deceased organ transfer that has provided the major source of transplantable organs and living transfer usually, but not always, from the families of waiting recipients. Deceased donors are the only feasible source of heart transfer and are by far the single most important source of livers, lungs, intestinal organs, and pancreata. Most living transfer involves kidneys (92%) or liver segments (8%).

These trends in the organ donor profile reflect the continued shift away from the young adult who dies from a traumatic head injury to the older adult who dies from a cerebrovascular event. The progressive increase in the median age of deceased donors over the past 10 years has exceeded that of the general population since 1996.

Discussion

In 2001, there were 695 donations resulting from anoxic brain killings, up 12% from 2000 and up by 32% since 1995—the fastest rise amidst the causes of death for deceased donors. The rise in anoxic deaths resulted primarily from the increased frequency of drowning, drug intoxication, and cardiovascular events (Institute of Medicine 87). Cerebrovascular deaths extend to lead as the primary cause for deceased donations (43% of all deceased donors in 2001).

Consent to organ transfer by families of braindead patients has been a major barrier to maximizing the numbers of solid organs available for transfer in the United States. Despite public opinion polls reporting that more than 85% of the American public is willing to donate, fewer than half choose to donate a family member's organs when asked.

Two key components are to blame for the critical shortage of transplantable solid body parts in the joined States. First, it has been estimated that no more than 15,000 deceased brain-dead donors are available each year in the United States. In 2005, more than 90,000 individuals were waiting to receive a transfer. Second, the rate of consent for organ transfer by next of kin has limited the number of organs available for transfer. On average, no more than 50% ...