Medicine

Organ Donation – The Shortage Around the World

Organ Donation In the U.S.

Currently, in the U.S., there is a growing disparity between the organ donor list and the organ transplant waiting list. The statistics are clear, 95% of U.S. adults support organ donation, but not nearly enough sign up to be donors. Additionally, even less are available as only about 0.3% of people die in a way to allow organ donation. In order to have your organs considered for transplants, the organs have to be maintained on artificial support systems, meaning that if an organ donor does not make it to a hospital before they die, they cannot become an organ donor. The system in the U.S. requires people to opt-in to become an organ donor, either online or when you are renewing your driver’s license at the DMV. Having an organ donor card isn’t necessarily enough as those may be misplaced or lost, and it is recommended to sign up for your state’s donor registry and tell family and friends so that they may let the medical professionals know your wishes. However, the waiting list is only getting bigger and bigger.

Statistics on the organ shortage in the United States. Number of people in organ transplant waiting list vs number of people receiving transplants vs number of donors.
Graph showing the difference between the number of people on organ transplant wait list, number of people getting transplants, and the amount of organ donors in the United States.

Challenges Around the World

So what can be done in the U.S. to help decrease the shortage? There has been extensive research on artificial or tissue-engineered organs and also on methods to preserve organs for longer periods of time. The pros and cons of financial compensation for organ donation have been discussed extensively, and some countries have taken steps towards this, such as Iran’s and China’s implementation of such programs. Some states have tried to pass laws to make organ donation registration an “opt-out” or “presumed consent” policy, which would ensure that a majority of the healthy population will be viable organ donors. Right now, there are a few European countries who have some sort of opt-out organ donation program with varying degrees of success or implementation in practice. Spain has had their opt-out system since 1979 and has been viewed as a world leader in organ donations. In Israel, organ donation is voluntary, but they have implemented a policy nicknamed “don’t give, don’t get” in 2008, which has slowly started to improve their historically low organ donation rates. France joined with its own opt-out program in early 2017. Many countries are reluctant to change their policies on organ donation, but just the other day, the Netherlands has passed a new law registering every adult citizen a potential organ donor unless they opt out. It was a close vote, but passed. Non-registered donors will be sent two letters asking them to indicate if they want to be an organ donor or not, and if there is no answer, they will be put on the donor list. These are just a few of the programs that are being implemented in different countries. What do you think about them?

The Controversy Surrounding Organ Donation

What makes organ donation a controversy? This can be due to several factors impacting organ donations such as the culture, the public opinion on organ donation, religious reasons, and fear and misconceptions concerning the process. The most common reason I’ve personally heard is not signing up to be an organ donor because then doctors won’t treat them properly if they were in the hospital or emergency room. This is false. The surgeons performing organ harvests are completely different from the physicians treating you, and also, there is no shortage of people dying and hence no reason to not give you the treatments you need, assuming you are a full code. Another question I have heard asks, how do the doctors know the patient is truly dead? There are two main reasons. First, organ donors are given additional tests to ensure that the donor truly is dead. Second, the clinical definition of death is either brain death (the complete and irreversible loss of all brain function) or circulatory death (the irreversible loss of function of the heart and lungs). Timing is a vital aspect to ensure that the tissues can be considered viable for transplants, and the physicians do not withdraw care on their own to meet those criteria. There would be a discussion with the family to talk about the situation and choices that have to be made. Then it would proceed from there. For each patient, the care and respect for the end of life process is highly regarded and will always be held to a high standard, whether or not they are a organ donor.

I urge you to think about it and take some time to learn about the process. Being a donor can possibly save up to 8 peoples lives – one heart, two lungs, one liver, one pancreas, two kidneys, and intestines. Each of them can possibly be transplanted in a unique person and save their life. You won’t be needing your organs after you die, but someone else might need them.

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About Phillip

Hello, I hope you enjoy reading our articles! My aim is to impart some knowledge in certain topics that you may have not thought about. There's always plenty to learn!
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