St Vincent’s Recognized For Organ Donation Program

BRIDGEPORT — St Vincent’s Medical Center has been honored by the US Department of Health and Human Services (HHS) for substantially raising the organ donation rates of eligible donors.

“We are very pleased to receive this recognition. St Vincent’s has a longstanding commitment to support organ donation and all of our staff deserve congratulations. We continue to be humbled and in awe of the courage, generosity, and love shown by our donors and donors families. They truly give the gift of life to help save the lives of strangers in dire need or organ transplantation,” said Michael Smith MD, chairperson, Department of Surgery at St Vincent’s.

St Vincent’s is one of 371 of the nation’s largest hospitals, and only five in Connecticut, to receive the honor presented at the Second National Learning Congress on Organ Donation and Transplantation held recently in New Orleans. Hospitals that received awards had a donation rate of 75 percent, well above the 59 percent national average.

HHS administrator Elizabeth M. Duke, who is responsible for the federal government’s pro-donation activities, said St Vincent’s achievement shows that hospitals can improve systems to boost donation rates and save more lives in the future.

“The work of these hospitals and their organ procurement organizations [OPO] made possible 1,200 more life-saving and life-enhancing transplants in 2005 compared to 2004,” Ms Duke said.

Sheryl Doulens, RN, MSN, CPTC, donation coordinator of the Yale-New Haven Transplant Center/New England Organ Bank, said St Vincent’s is doing a better job than many other hospitals in identifying eligible candidates and notifying the organ bank.

 “The achievement shows that St Vincent’s has a culture that is sensitive to end-of-life issues and the positive option of organ donation. The staff embraces the concept that something good can come out of the loss of a family member,” Ms Doulens said.

Federal law requires hospitals that receive Medicare funding belong to an organ procurement organization and report deaths to the organ bank. OPOs coordinate organ procurement, work to preserve organs, and arrange for their distribution according to national policies.

Ms Doulens said that 2.2 million people die in the United States each year and that only 17,000 of those would make a good organ donors. In 2005, St Vincent’s recorded 776 deaths and identified four potential organ donors. Three of those became donors with 11 organs successfully transplanted.

“These aren’t big numbers, so it’s important that hospitals do all they can to make the process go the way it should. People don’t realize how rare this is to be given the opportunity to donate. Most people are not eligible because of age, disease, or other factors.

Families should feel they have a choice to make, ” Ms Doulens said.

Most people associate organ donation with trauma or accident, perhaps because of the driver’s license check-off for organ donation. Ms Doulens said it does not work that way, however. “It’s a myth that most organ donors are victims of trauma. We only had one trauma donation last year and it was not the result of a car accident.”

The most eligible donor is actually the person who dies from “brain death,” as opposed to cardiac death, which accounts for most of the mortality in the United States. Brain death is usually the result of a stroke or bleed (from unchecked hypertension, diabetes, or other conditions) that destroys the brain but leaves the heart, lung, kidneys, and other organs in tact.

Recently there has been a push to increase the recovery of kidneys and tissue after cardiac death. However, the heart, lungs, and other major organs are not viable once the heart stops beating.

Jane Winters, St Vincent’s Trauma/EMS coordinator, said under present protocols, hospitals are encouraged to identify patients whose conditions are “likely to progress to brain death.” The Yale Transplant team is notified and a coordinator is sent to do a chart review and gather basic information that will prove to be valuable should the patient become a donor.

Ms Winters said the family is only approached after the patient is pronounced brain dead. A specially trained team discusses the opportunity with the family and walks them through the steps.

Because organ recovery can only take place when the heart is beating, the patient is kept on the ventilator until the family makes its decision. Even if the deceased has not checked off organ donation on the license or is not listed on the registry, the family can make the decision to donate the organs.

“People have told us it’s either the toughest decision of their lives or the easiest,” Ms Winter said. “Toughest if they’ve never talked about it or easiest if they have. The point is, now is the time to talk about it with a loved one. It’s much more difficult when you get a call asking you to consider organ donation.”

Ms Winters said it usually takes a minimum of nine to ten hours from the declaration of death to the time of consent by the family. Blood and tissue samples are the sent out for typing, and other studies are conducted to determine that the organs are viable and can be successfully transplanted. A surgical transplant team is then dispatched to the hospital, where the organs are recovered.

Hearts need to be transplanted within six hours, while other organs such as kidneys can be held for a day once they have been properly recovered and maintained. Ms Winters said that the advance testing and preparation has led to much more successful transplants. Multiple organs can be recovered from one donor.

“Recently, we had a donor who made it possible for eight other people to return to a normal, functioning life. The donation really hit home with us because one of the people who received the liver was a lab worker who had contracted hepatitis as a result of her work in another New England hospital,” Ms Winters said. “Now she can live a normal life again.”

The man’s donation also resulted in a heart for young mother, kidneys for a grandmother on dialysis, and lungs for a 22-year-old who will now look forward to a productive life.

“Sometimes, one of the most generous things a family can do during their grief is to give back something that helps so many other families keep their loved ones alive,” Ms Winters said.

Ms Doulens, the Yale transplant coordinator who has checked the organ donor box since first getting her license at the age of 16, said while people are deeply moved by stories of lives saved by organ donation, they are more squeamish when it comes to the donation side of the story. Some are superstitious and feel they will jinx themselves if they add their name to the registry.

In short, many Americans are eager to receive but not necessarily to give.

“What if you got sick and you were told you needed a liver transplant. Would you take it to save your life? If you’re willing to take, you should also be willing to give, because everyone knows somebody with kidney or heart disease. You may never know when the day is going to come,” Ms Doulens said.

To date, an estimated 60 million Americans have indicated their wish to donate, usually through state motor vehicle department registries. HHS provides coaching and other logistics support to Donate Life America (www.donatelife.net) as that national nonprofit organization works to raise the number of Americans enrolled as designated organ donors to 100 million by June 2008.

Additional information on donation initiatives is available at www.organdonor.gov.