Pros & Cons: Organ Donation

The Pros and Cons of Organ DonationOrgan Donations (1)

What is “Organ Donation”?

  • Organ donation is the process of providing a person with one or more of your organs, tissues, blood, and/or platelets.
  • Organs for organ donation are removed from a deceased or living donor for transplantation purposes through a surgical procedure known as allotransplantations, referring to human to human transplants or defined as same species to species transplant.
  • Xenotransplantation is the transfer of organs/tissues from a different species to another such as an animal organ transplant to a human or another species.
  • Living related donation refers to organ donations from parents, children, or siblings.
  • Living unrelated donation refers to organ donations from spouse, friend, or in-laws, and other acquaintances.
  • Non-directed donation refers to a donation from a stranger, unrelated, to the recipient.
  • For a living donation, the most common and awaited transplant is the kidney transplant. Other parts of the organs now being transplanted from living donors include the lung, liver, and parts of the pancreas.
  • • Organ donation in the United States (U.S.) is governed by the Uniform Anatomical Gift Act, drafted by the National Conference of Commissioners on Uniform State Laws.
  • An individual has the choice to be or not to be a donor even after passing away.
  • An average of 30,000 transplants are performed each year.
  • Over 100,000 Americans are on the organ waiting list.
  • The Uniform Anatomical Gift Act of 2006, last revised in 2009, can be accessed from the following link: http://www.uniformlaws.org/shared/docs/anatomical_gift/uaga_final_aug09.pdf

What types of transplants can be included in “Organ Donations”?

Organs: Organ Donations (2)
Organ donations cannot be stored and must be used within hours after removing them from the donor’s body. Organ donations from living or deceased humans include the following in their respective provisions:

- Living Donors: Kidney and parts of the Pancreas, Lung, Liver, and Intestines.
- Deceased Donors: Kidneys, Lungs, Heart, Liver, Pancreas, and Intestines.

*Note: In rare cases, a living donor can donate their heart. For example, if the person has severe lung disease, in which they would benefit more from a combined heart and lung transplant, they can donate their heart for the replacement. 


Tissue:
Tissue donations must be initiated within 24 hours of donor’s death; however, particular tissues can be processed and stored for extended periods. Tissue donations from living or deceased humans include the following in their respective provisions:

- Living Donors: Amnion, Skin, Bone, Blood, Marrow, Blood Stem Cells, and Umbilical Cord Blood.
- Deceased Donors: Corneas, Middle Ear, Skin, Heart Valves, Bone, Veins, Cartilage, Tendons, and Ligaments.


Blood & Platelets:
Blood and platelets are formed by the body which go through a life cycle and are continuously replenished. Blood and platelets can be donated more than once.

- Blood Donation: Safe to donate every 56 days, blood is stored according to type (A, B, AB, or O) and Rh factor (positive  or negative) in a blood bank, blood can be used whole, or separated into packed red cells, plasma, and platelets, all of which have different lifesaving uses.
- Platelets Donation: Safe to donate ever 4 weeks, platelets are tiny cell fragments that circulate throughout the blood and aid in blood clotting. Platelets can be donated without donating blood.

 

What are the common statistics of “Organ Donation”?

  • Up to 25 different organs and tissues can be donated for transplantation.
  • For a living donation, the most common is the kidney. Other parts of the organs now being transplanted from living donors include the lung, liver, and pancreas.
  • The organs candidates are waiting for include Kidney (90,565), Liver (16,067), Heart (3,113), Lung (1,677), the Pancreas (1,316), and Intestine (274).
  • In 2012, 62% of living donors were women and 38% were men. This is nearly reversed for deceased donation, where 60% were men and 40% were women.
  • In 2012, 66% of all deceased donors were Caucasian, 17% were African American, 13% Hispanic/Latino, and 3% Asian, Native Hawaiian and other Pacific Islander.

How can an individual become an organ donor for “Organ Donations”?

An individual can become an organ donor in 3 simple steps that are outlined below:

Organ Donations (3)

*Note: Registering as an organ donor can also entail further state specific requirements; Please be sure to check with physicians and state policies for becoming an organ donor. See www.organdonor.gov for more information. 

 

What are the Pros of “Organ Donations”?

Saving Lives
According to the United States (U.S.) Department of Health and Human Services (HHS), 18 patients in need of organ transplants die daily on average due to the limited availability of organs. Furthermore, one organ donor can help save up to 8 lives and even enhance the lives of 50 others. There are currently over 100,000 men, women, and children in the U.S. that are currently waiting for an organ transplant, in which each registered organ donor can help save and enhance many lives. Conclusively, saving lives is a significant advantage of organ donations that has the potential to affect the lives of many.

Recipient Gratitude
An indirect advantage of organ donations is the gratitude received from recipients of organs, in which for many donors can serve as a blessing. Through an organ donation, recipients are able to return to a normal lifestyle while saving costly health treatments that they will no longer need. Up to 95% of patients that received eye related donations were able to fully see again. Because of organ donors, thousands of people are able to live fuller and more productive lives. A new patient is added to the national organ transplant waiting list every 10 minutes. Patients that have received an organ and are off the waiting list have reported feeling highly blessed and forever thankful to the donor that brought “miracle” to their life and family, as many would not have otherwise survived their illness, giving them a new chance at life. Conclusively, donating organs to save and enhance the lives of patients is a significant advantage for proponents of organ donations as they receive recipients’ everlasting gratitude.

Kidney & Partial Lung Recipient Selection
An advantage of organ donations in the United States (U.S.) is the ability for kidney and partial lung donors to select the recipient. Organs for human transplant are commonly obtained through voluntary donation. Although kidney and partial lung donors may designate particular recipients’, organs such as hearts and lungs donated upon death are assigned to recipients by the United Network for Organ Sharing (UNOS), which is an organization established for this purpose in 1984. Conclusively, the ability for kidney and partial lung donors to select recipients is a significant advantage as their friends and family may be the individuals in need of a kidney and/or partial lung that otherwise would be prioritized based upon the national organ transplant waiting list.

See Cons for Organ Donor Recipient Selection.

Living Donations
An advantage of organ donations is the ability for living donors to donate various organs. While organ donors typically give their vital organs after they die, living individuals can also donate paired organs such as kidneys. A kidney from a living donor is easier to monitor as it often functions immediately, while in some cases kidneys from deceased donors do not function immediately. Many living donor transplants are also done between family members that are genetically similar, which lessens the risk of rejection. Potential donors can also be tested ahead of time in order to find a donor that is most compatible with the recipient. Conclusively, the ability for living donors to donate particular organs is an advantage for awaiting organ recipients as this increases the possibility for more organs to become available.

Medical Research
Many people opt to donate their organs or even their entire bodies towards medical research. Performing experiments on the donated organs, tissues, and bodies greatly benefits medical scientists to help find treatments and cures for many medical conditions like diabetes, cancer, etc. This can further assist medical practitioners in developing various cures that can help save lives in the future.

Organ Donor Care & Attention
Many people worry in becoming a registered organ donor as they fear that medical doctors/surgeons will not attempt their best to save a donors’ life in case they were ever to be involved in a medical emergency. However, this is not true as the organ donation team is completely different from the emergency team that would be responsible for saving a life of a patient involved in a medical emergency regardless of their donor status. Furthermore, surgeons do not consider any life more important than another and will do their best to save the person, organ donor or not, experiencing the medical emergency as part of their Hippocratic Oath before assuming their role as a licensed medical doctor.

Donor or Family Does Not Fund Cost
An advantage for organ donors and their families is that all costs for organ transplants are covered by recipients or the organ transplant program. According to the United States (U.S.) Department of Health and Human Services (HHS), the average cost of organ transplant surgeries can range from $200,000 to $1.2 million. Although donors are not financially compensated due to the U.S. Organ Transplant Act that prohibits the sale of human organs, organ donors and their families may be compensated for travel and minimal expenses incurred for the purpose of organ transplant.

Part of You Will Live On
Organ donors can see donating organs in essence of goodwill and self-gratitude through helping another in need and/or having a part of themselves to continue living on in goodwill. Even though others may feel otherwise, it is an advantage for those that find gratitude in the essence of having a part of their physical self to continue living on. Many donor families have also reported finding comfort in knowing that they and their loved one helped save a life.

Will Not Affect Funeral
An advantage for organ donors that opted in donating their organs upon their death is that their funeral will not be affected from the removal of any organs. Qualified surgeons treat the body of the donor with respect and dignity that are conducted under sterile conditions. The removal of organs from the bodies of deceased donors does not disfigure donors’ body as the surgical incisions will all be closed, which will not change the appearance of the donor in an open-casket funeral or cremation. Conclusively, the removal of organs from organ donors will remain confidential and will not affect funeral arrangements.

Act of Social Aid
As there are over 100,000 awaiting various organ donations in the United States (U.S.), any act in helping another person to heal, strengthen, or live longer is seen in positive light as act of social aid. Everyone has the power to save a life and giving the ultimate gift of life is priceless. Conclusively, becoming an organ donor and donating an organ is considered highly heroic as you will not only save a life, but touch the lives of up to 50 people that can be affected from one donor.

Living Donors Federal Assistance
Health Resources and Services Administration (HRSA) awarded a cooperative agreement, in September 2006, to the University of Michigan to establish a national program to provide reimbursement of travel and subsistence expenses to living organ donors who cannot afford these costs. The University of Michigan in partnership with the American Society of Transplant Surgeons, in October 2007, launched the National Living Donor Assistance Center to help donors with travel, lodging, and meal expenses associated with the organ donation process.

Non-Residents of United States Applicability
Non-resident aliens can both donate and receive organs in the United States (U.S.) according to U.S. Health & Human Services (HHS). Organs are given to patients according to medical need, not citizenship. In 2001, 334 (2.7%) of the 12,375 organ donors were non-resident aliens. In this same year, 259 (1%) of the 23,998 transplants performed were on non-resident aliens.

Medical Suitability
Medical suitability for donation is determined at the time of death, which allows donors to be eligible even with previous or current medical conditions. Transplant professionals will evaluate the condition of your organs at the time of your death and determine if your organs are suitable for donation. You should consider yourself a potential organ and tissue donor, indicate your intent to donate on your driver’s license, donor card, state donor registry, and discuss your decision with family members.

Organ Distribution Fairness
Patients are matched to organs based on a number of factors including blood and tissue typing, medical need, time on the waiting list, and geographical location.

Unrestricted Age Limitations
There are no age limitations on who can donate. Organ donations depend on physical conditions rather than age. Newborns to senior citizens can and have been organ donors.

Organ Donations Timeliness’
Time is of the essence for patients in need of organs and for organs itself. Organs must be transported to recipients as quickly as possible, since organs can remain healthy only for a short period after removing it from the donors’ body. The Organ Procurement Organization’s (OPO) representative makes arrangements for the organs to get to the hospitals of the intended recipients. Methods of transportation vary based upon the distance of organs, in which commercial and private airplanes, helicopters, and ambulances are used.

Organ Donation Consent Validation
A significant advantage to organ donations is the consent validation for all, organ and non-organ donors, to ensure consents and non-consents for organ donations have been accurately classified. The Organ Procurement Organization (OPO) representative will search the state’s donor registry to see if the deceased had enrolled as a donor. If so, that will serve as legal consent. If the deceased had not registered and there was no other legal consent for donation such as a driver’s license indicator, the OPO will seek consent from the next of kin. Upon obtaining consent, including obtaining the deceased’s complete medical and social history, the medical evaluation will continue to progress.

Contacting Donor Family
Transplant centers and Organ Procurement Organizations (OPO) are required by law to protect the confidentiality of donors and recipients. Nevertheless, they can arrange for contact between the families when both sides agree. The process usually begins with a letter from the recipient to the donor family, sent in care of the transplant center.

Different centers have different procedures; See Contacting Donor Family at the following link: http://www.transplantliving.org/community/patient-resources/contacting-your-donor-family/

Iran Organ Transplant Trade
In Iran the practice of selling kidney for profit is deemed legal. Iran currently has no waiting lists for kidney transplants. Kidney sales are legal and regulated, in which the Charity Association for the Support of Kidney Patients (CASKP) and the Charity Foundation for Special Diseases (CFSD) control the trade of organs with the support of the government. The organizations match donors to recipients by setting up tests to ensure compatibility. The amounts paid to the donor vary in Iran but the average figures range from $1,200 to $1,400 for kidney donations.

See Kidneys on Demand at the following link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1819484/

Xenotransplantation Research
Xenotransplantation is currently being research, in which organs are transplanted from one species to another. Current studies have suggested pigs are a good source for organ donors. This is an advantage as substantial decrease could be seen in the number of waiting patients in need for organs, if xenotransplantation is an option that can be exercised.

 

What are the Cons of “Organ Donations”?

Diabetes Development
Diabetes is a serious illness that may have greater risks in people that have had an organ transplant. Diabetes raises the danger of organ rejection, dangerous infections, and death. One review of studies suggested that diabetes could occur in more than 1 out of 10 people that get a transplant. Many of the drugs used to suppress the immune system such as the medication Prograf (tacrolimus) or corticosteroids may cause diabetes or worsen diabetes.

Donor Organ Wait
Waiting for a donor organ can be a stressful experience, especially since the wait time is unknown and may change from the average median national waiting time due to adequately matching recipients and donors to ensure a successful organ transplant. The median national wait in the United States (U.S.) for each organ is outlined below:

Organ Donations (4)

Organ Donor Recipient Selection
Organs such as hearts and lungs donated upon death are assigned to recipients by the United Network for Organ Sharing (UNOS), an organization established for this purpose in 1984. Organs are distributed according to a national waiting list without preferential treatment related to race, religion, gender, or financial status. Since the donor does not get to choose who their organs go to with the exception of kidney and partial lung transplants, this may be a concern for people that feel uncomfortable with their organs going to someone of a different gender, religion, class, faith, etc.

Donor Ventilator Life Support
The ventilator or life support machine provides oxygen to the donor that keeps the heart beating and blood circulating after death. Some people felt that donor families should be told beforehand that their loved one would still be warm and breathing upon visitation, as the ventilator keeps the body supplied with oxygen so that the heart can carry on beating and circulating blood. This preserves the organs so they can be adequately transplanted. When the ventilator is turned off, usually within minutes before taken to the transplant surgery room, the heart stops beating and switching off the ventilator or life support machine has been traumatic for some donor families.

Transplant Rejection
There is no short or long-term guarantee that the organ donor will have a successful outcome after the organ transplant. Transplant rejection is a process where a transplant recipients’ immune system attacks the transplanted organ or tissue. The recipients’ immune system may recognize the transplanted organ to be foreign, which happens when the immune system detects antigens on the cells of the organ are different and not matched.

Mismatched organs may trigger a blood transfusion reaction or transplant rejection. There are 3 types of transplant rejections outlined below:

Organ Donations (5)

Surgery Complications for Donor
The transplant system is mostly focused on the recipients’ acceptance of the transplanted organ, in which primary focuses are on the removal, storage, transport, and transplant of the donated organ. A small fraction of donors have reported lack of care from medical professionals; in which, donors have incurred lifelong health and financial problems in remediating further complications caused from the organ transplant.

For living organ donations, all complications of a major surgery apply that may include infection, blood clots, hemorrhaging, potential side effects, or damage to nearby organs and tissues. Organ transplant surgeries encompass various potential risks and complications, short and long-term, which should be discussed in depth with personal doctors and transplant teams.

See Organ Donor Risks and Complications at the following link:
http://www.transplantliving.org/living-donation/being-a-living-donor/risks/

Lack of Measurable Donors Data
Living kidney donations have been successfully performed since the 1950s, but it was not until 2006 that the United Network for Organ Sharing (UNOS) began requesting transplant center to report on the health status of their donors. According to reports by the Organ Procurement and Transplantation Network (OPTN), transplant centers averagely have lost track of more than one-third of their donors 1 year after their donations and two-thirds of their donors by 2 years.

Furthermore, only few centers report any laboratory results on their donors and some centers even consistently fail to report any data at all. Some argue that the cost of tracking down all of their donors while maintaining their records is very expensive. The lack of measureable donor data puts donors at risk in preventing or correcting further medical transplant complications and risks that may be developed overtime.

Surgery Complications for Recipient
The organ recipient may face surgical complications as the transplanted organ may not work right away, while there is a chance the organ will not function at all. Recipient complications may cause future problems and/or fatalities. Kidneys from deceased donors may not function immediately, causing the patient to be placed on dialysis until the kidney starts to function naturally with the recipients body. Conclusively, there is risk of rejection from the transplanted organ, risk of infection, risk of side effects, as well as complications due to any general anesthesia.

Recovery & Costs
Organ transplants take time for the body to recover from surgery that may cause costs to arise during the recovery period. Costs directly and indirectly related to the transplant may occur in essence of time lost from work, treatment expenses, medicine costs, and additional post-care costs.

Surgical Side Effects
Organ donors and recipients may also develop visible lasting scars from surgery. Anesthesia used during surgery may cause individuals to experience pain and discomfort. Prescribed medicines taken pre or post-transplant surgery may vary in reactions and effectiveness.

Psychological Effects on Living Donors
A number of living donors can experience post-surgical depression. According to Diagnostics and Statistical Manual of Mental Disorders (DSM IV), symptoms can include feelings of sadness or emptiness, reduced interest in activities that were once enjoyable, sleep disturbances including insomnia or excessive sleeping, loss of energy or fatigue, difficulty concentrating or making decisions, and/or suicidal thoughts. In the first 6 to 8 weeks after donation, common symptoms organ donors may experience include low energy, fatigue, lethargy, and excessive sleep due to the immune systems attempt in healing and adjusting to the new physiology.

See Depression in Living Organ Donors at the following link: http://www.livingdonor101.com/depression.shtml

Emotional Impact on Recipient
Organ recipients have reported emotional impacts pre and post-transplant, in which some feel relieved while most report an accumulation of stress from their organ conditions returning. Additionally, physiological experts believe guilt is a common reaction people have after a transplant, as patients often report thinking excessively about the donor and feeling guilty about benefitting from the death of the donor.

Organ Commercial Trade
The United States (U.S.) National Organ Transplant Act prohibits the sale of human organs for transplantation and violators of this law are subjected to fines up to $50,000 and 5 years in U.S. federal prison. This may be a disadvantage for those that wish to receive an incentive for donating their healthy organs, as there could potentially be a lot more people willing to give away their organs if they were to receive compensation. Buying and selling of organs are illegal in most countries but legal in Iran with specific provisions.

See Financial Incentives Should Be Used to Increase Organ Donation at the following link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766511/

Living Donor Constraints
Having a serious condition like cancer, Human Immunodeficiency Virus (HIV), diabetes, kidney disease, or heart disease can prevent individuals from donating as a living donor. A medical assessment will be done to determine what organs can be donated after death. Certain conditions, such as having HIV, actively spreading cancer, or severe infection would exclude organ donation from the deceased.

Black-Market Organ Trade
Numerous organ trade rackets have been caught by various legal authorities to date, while a number of them thrive worldwide. The imbalance in the ratio of available organs in comparison to the number of patients in need of organs is seen as the cause for such trades.

Total Body Donation & Organ Donor
Total body donation generally is not an option when choosing to also be an organ and tissue donor. Eye donors still may be accepted. Additionally, there are a few medical schools and research organizations that still may accept an organ donor for research. Individuals wishing to donate entire body should contact the medical organization of choice directly and make arrangements. Medical schools, research facilities, and other agencies study bodies to understand how disease affects human beings. This research is vital to saving and improving lives.

 

Citation for Use

APA Style:

References

The Pros & Cons (2014, March 19). Pros and Cons: Organ Donation. Retrieved October 25, 2014,

from http://theproscons.com/pros-cons-organ-donation.

MLA Style:

Works Cited

The Pros & Cons. “Pros and Cons: Organ Donation.” The Pros & Cons. The Pros & Cons, 19 Mar. 2014.

Web. 25 October 2014. <http://theproscons.com/pros-cons-organ-donation>.

Chicago Style:

Bibliography

The Pros & Cons. “Pros and Cons: Organ Donation.” The Pros & Cons. Last modified March

19, 2014. http://theproscons.com/pros-cons-organ-donation.

 

Links to Further Reading

Benefits of Organ Donation
http://www.livestrong.com/article/198025-benefits-of-organ-donation/

Coping Emotionally After Organ Transplant
http://www.webmd.com/a-to-z-guides/life-after-transplant-coping-emotionally

Donation and Transplantation
http://organdonor.gov/about/data.html

LifePoint, Inc. on Organ Donation
http://www.lifepoint-sc.org/facts_what.htm

MedlinePlus on Transplant Rejection
http://www.nlm.nih.gov/medlineplus/ency/article/000815.htm

National Kidney Foundation
http://www.kidney.org/exit_page.cfm?link=optn.transplant.hrsa.gov/latestData/viewDataReports.asp

NPR- Organ Donation Consequences
http://www.npr.org/blogs/health/2012/07/02/155979681/organ-donation-has-consequences-some-donors-arent-prepared-for

Organ Donation Pros and Cons
http://www.healthguidance.org/entry/15589/1/Organ-Donation-Pros-and-Cons.html

Organ Donor Statistics
http://www.statisticbrain.com/organ-donor-statistics/

Wikipedia on Organ Donations
http://en.wikipedia.org/wiki/Organ_donation

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