Organ Donors in Increasing Demand

[April 2008] At this moment, more than 98,000 people in the US are clinging to life, and their only chance for survival is a dead person's generosity.

The science of organ transplantation has improved by leaps and bounds. But despite the advances, almost 7,200 Americans died in 2005 while waiting for a replacement organ that never arrived, according to the US Health Resources and Services Administration.

"The success of the clinical side is phenomenal," says David Fleming, executive director of Donate Life America, a nonprofit alliance of national and local organizations dedicated to promoting organ donation. "Unfortunately, it's not a medical problem we're looking to solve. It's truly a matter of just not having the supply that we need."

To help meet that need, April has been designated National Donate Life Month, a call for people to agree to donate their organs as a final act of human charity.

Kidneys Needed Most

The waiting list for donated kidneys is longest. Almost 75,000 patients are waiting for a kidney, or about three of every four people waiting for an organ.

That is generally because a person without a kidney can be kept alive longer, Fleming says. Dialysis can sustain them, while patients in need of such vital organs as hearts or lungs often die quickly.

However, the nation's diabetes epidemic is expected to make kidney failure much more prevalent in the future, leading to even greater demand for donated kidneys, Fleming adds.

The waiting list for livers is next longest, with more than 16,000 patients awaiting help. More than 2,600 people are waiting for a heart, while an estimated 2,100 people need a lung, and around 1,600 patients are waiting for a pancreas.

Donation Eligibility Depends on Manner of Death

The main problem with supply is that donors must die in a very specific way for their organs to be useful to others.

"In order to donate a solid organ, you have to die a brain death," Fleming says. "It's a very small percentage of the population that die in a way that leaves them brain dead," he says. Brain death involves about 1 percent of deaths annually, which is approximately 20,000 to 30,000 people.

Of those who die under optimal conditions, only about 60 percent have consented to donate their organs, he says.

"Realistically, if 100 percent of the people consented to donate their organs, we still wouldn't be able to save everybody," Fleming says. "The need continues to outstrip the supply. But if we can get everyone to consent to transplant, that's nearly twice the number of people who can be saved."

Other Obstacles to Transplantation Remain

But supply is not the only obstacle facing transplant recipients. To keep their bodies from rejecting donated organs, patients must take a variety of medications that suppress the immune system.

Unfortunately, those drugs often come with a range of severe side effects. By suppressing the immune system, they also leave patients open to infection.

In the latest wave of innovation, researchers have discovered therapies that allow transplant recipients to stop taking the powerful drugs that keep their bodies from rejecting the new organ.

Such a breakthrough could end the frustration that organ donation experts feel on a daily basis, as more lives that could have been saved are instead lost.

Until then, calls for organ donation will continue to ring out.

"We have lots of national heath-care crises in this country that we don't have a solution for," Fleming says. "We actually know the solution for this one, for a big part of it. It's very frustrating when you know the cure for something, but you can't get someone to do it."

Always consult your physician for more information.