Tuesday, April 23, 2002

Live organ donors outpacing the dead

Long wait lists for transplants speeding trend

The Associated Press and The Cincinnati Enquirer

        WASHINGTON — Organ donations from the living reached a record high last year, outnumbering donors who are dead for the first time. With waiting lists growing, more than 6,400 people gave away a kidney or a piece of their liver.

        For more than a decade, the numbers of organs donated by the living have been growing more quickly than those given after death as desperate patients have turned increasingly to families or friends.

        In 2001, the number of living donors jumped by 13.4 percent, on top of a 16.5 percent increase a year earlier, the government said Monday. By contrast, donations from dead people inched up by just 1.6 percent.

        Surgeons across the country routinely suggest now that patients look for donors rather than rely on a growing waiting list.

        In the past, a patient facing a wait of a year or two for a kidney would resist

        asking family or friends for fear of putting them through a painful procedure with medical risk, said Dr. Jeffrey Punch, a kidney surgeon and chief of the University of Michigan Medical Center's transplant division.

        “Now that they're thinking about five or six years, they're more willing to accept it,” he said.

        Last year, there were 6,081 donor cadavers. Each can give several organs, so dead people still enable about three out of every four transplants.

        They now are outnumbered by living donors: In 2001, there were a record 6,485.

        In Greater Cincinnati, living organ donations have been rising. But the trend has neither eclipsed the number of cadaver donations nor expanded the number of people getting organ transplants, ac cording to the LifeCenter, the agency that coordinates cadaver organ donations.

        Locally, the number of transplants involving living donations of kidneys and livers grew 18 percent — from 66 in 2000 to 78 in 2001.

        However, the number of transplants involving cadaver-donated kidneys and livers dropped more than 19 percent — from 123 in 2000 to 99 in 2001.

        The result: The number of transplanted kidneys and livers dropped from 189 in 2000 to 177 in 2001.

        The LifeCenter figures include transplants performed at University Hospital, Christ Hospital and Cincinnati Children's Hospital Medical Center.

        Christ Hospital is the only Cincinnati-area hospital that more commonly uses living-donated organs than cadaver-donated or gans. In 2000, about 55 percent of kidney transplants there involved living donors. That figure grew to 65 percent in 2001.

        Nationwide, more than 90 percent of living donors gave a kidney. That is a relatively safe procedure for people with two healthy kidneys, because only one is necessary. There were about 500 living liver donations, in which surgeons remove a part of a liver for transplant, leaving each piece to grow into a whole organ. About three dozen people gave part of a lung.

        Medically, doctors have been dividing livers only for the last few years, which helps explain the fast rise in the number of liver donations from the living. The number shot up 36 percent last year.

        Still, some worry that the increasing popularity of living donation puts unfair pressure on would-be donors.

        “There needs to be some protection for someone who doesn't want to be a saint,” said Gregory Pence, a bioethicist at the University of Alabama at Birmingham. “This is a major assault to your body, and really bad things can happen.”

        He suspects that many patients don't know the true risks and said the surgeons who explain them have a conflict because they also are trying to save the life of the recipient.

        Many transplant programs provide would-be donors a way out. The program will report that medical problems prohibit the transplant if a donor secretly has a change of heart about donating.

        Tim Bonfield of the Enquirer contributed to this report.

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