Organ donation: We need to make it stronger and more efficient

Like so many others, I was moved by the recent story of California residents Yolanda Espinoza and Laji Kattaungal. After experiencing the unbearable loss of her son nearly seven years ago, Yolanda was able to hear his heart beat in the man it saved. Today, the recipient Laji is healthy, thriving and realizing the life he didn’t expect to have.

“You are a miracle,” Yolanda told him. “This means so much to us.”

We marvel at the science. Our hearts break alongside grieving families. And we celebrate the lives saved when the gift of an organ is given. As someone who has worked in this space for more than 30 years, I am proud of the role that organ procurement organizations (OPOs) play in providing care — and hope — for people like Yolanda, Laji and others.

In close partnership with transplant centers and area hospitals, the 58 non-profit, federally designated OPOs work every day to maximize donations and bring lifesaving organs to those on the transplant waiting list.

They provide state-of-the-art community and hospital donor education, donor identification, authorization, medical care management and trusted stewardship of organs from donor to recipient.

Leading these critical efforts requires more than medical and management expertise. It means understanding our work is about people, and that success must ultimately be defined in human terms, by the number of families that are reached and the lives that are saved.

Beyond facilitation, OPOs work directly with the families of potential donors to present them with the opportunity for something positive in the face of terrible loss. And, after the decision for donation is made, the local OPO stays with them to ensure they receive needed support. This holistic approach is often what inspires similar future gifts.

In fact, more and more people are becoming registered donors and choosing to give the gift of life. Fifty-eight percent of adults have registered themselves as donors, and that number is increasing daily.

In 2018, the number of organ transplants in the U.S. increased for a sixth consecutive year, with 71 percent of OPOs reporting record donations. Moreover, the number of organ transplants performed has increased by 120 percent from 1991 to 2017, with a 20 percent increase in the past five years.  

In its most recent annual report, the agency overseeing the organ donation and transplantation system concludes, “Remarkable increases in solid organ transplants occurred in the U.S. over the past five years … mostly due to increases in deceased donor transplants.”

This is remarkable growth indeed. But ultimately, as people continue to live longer and overall health declines, the need for donated organs continues to far outpace availability.

We have a complex and very highly regulated system for organ donation in the U.S. that ensures the integrity and transparency of the process. However, eligibility and systemic barriers present ongoing challenges. Most notably, a finite pool of potential donors. While there are nearly 3 million deaths in the U.S. each year, the number of viable potential donors is actually very small — little more than half of one percent of total deaths result in successful organ donations.

Additionally, federal policies regarding transplant center reimbursement and evaluation, access to electronic records and surgeon preference also create challenges and may preclude otherwise successful transplant matches.

The unfortunate truth is that even if every potential deceased donor’s organs were transplanted, there would still be people who die while waiting for an organ transplant.

The good news is, working together, there are ways to address these issues and save as many lives as we can.

OPOs were on Capitol Hill recently talking with lawmakers about ways to strengthen the organ donation system through policies focused on: promoting use of organs from more complex donors, improving clinical support, aligning hospital reporting procedures to ensure more meaningful and accurate data and providing OPOs access to donor hospital health records.

It was clear from these discussions that we all share the same goal: working to ensure that more lives are saved through donation and transplantation.

A strong and successful infrastructure is in place. We must continue to build on it and make the organ donation process even stronger, more efficient, and better able to meet demand.

We are privileged to play a role in this critical process. But it is the donors and their families — selfless, courageous people like Yolanda — who are the real heroes. And everything we do is in support of them, in hopes of saving more people like Laji.

Diane Brockmeier is president of the Association of Organ Procurement Organizations and president and CEO of Mid-America Transplant.