8 Organ and Tissue Donation Myth Busters

In celebration of National Donate Life Month, this blog is part 1 of a series to dispel myths and to get the facts straight about organ and tissue donation. Nurses Announcements Archive Article

8 Organ and Tissue Donation Myth Busters

Magical. Breathtaking. The vibrant pink lungs that appeared like soft pliable pillows were removed from the chest. All so unimaginable to this young, naive nurse.

Early in my career, I worked in the emergency department while moonlighting in the intensive care unit (ICU). During that time in the ICU, I had the honor of caring for two separate organ donors within a seven-day timeframe. Both times I stayed past my shift into the wee hours of the morning to go into the operating room to observe the donation. Mesmerized by the elaborate orchestration of multiple transplant teams working in unison along with the local operating room team and donor coordinator, I was hooked. I soon went on to join the area Organ Procurement Organization as an organ procurement coordinator working for donors and their families.

As I experienced first-hand the light that donation brought to many families facing unimaginable decisions, I fell in love with the donation experience; not just the idea of donation, but the actual gift of life. As I learned more and more about donation, I discovered how uninformed I had been.

In honor of National Donate Life Month, this article is part 1 of a brief series that aims to provide the down and dirty facts about organ and tissue donation and the donation process. Let's get the facts straight and dispel the myths.

Statistics

According to the United Network for Organ Sharing (UNOS), as of April 4, 2017, there are 117,960 people in the United States waiting for a life-saving transplant. This number is constantly changing as more and more people are added to the transplant list. You can obtain the most current numbers at United Network for Organ Sharing. The number of people needing organ transplants is far greater than the number of organs available. Then consider the numbers of people who would benefit from a life-enhancing tissue donation. The need for individuals willing to be donors is great. Therefore, dispelling myths about donation is critical so individuals can make informed decisions regarding their personal wishes.

8 Myths and 8 Facts of Donation

Myth 1: Celebrities and individuals who can pay for the organ receive the organ.

Fact: The United Network for Organ Sharing maintains a national computer system with specific standards that ensures organ allocation takes place in ethical and fair ways.

Myth 2: The elderly cannot be donors.

Fact: Age in itself does not rule out a person from being a potential donor. In fact, in 2016 there was a cornea donor who gave the gift of sight after her death at age 107!

Myth 3: People with medical problems cannot be donors.

Fact: A medical history does not rule out a person from being a potential donor. At the time of death, all medical history is taken into consideration as well as the current organ viability.

Myth 4: Most religions don't allow donation.

Fact: Most major religions actually support or permit donation.

Myth 5: Donors cannot have open-casket funerals.

Fact: Both organ and tissue donors can still have an open-casket funeral.

Myth 6: Donation costs a lot of money that most people cannot afford.

Fact:The donor family or estate is not responsible for any costs associated with the donation.

Myth 7: The hospital staff will not try to save my life if I indicate I am a donor.

Fact: Life-saving interventions are always first priority when a person is ill or injured. You must be declared brain dead by a physician using specific criteria before the donation is considered.

Myth 8: Not every ethnic group needs to consider organ donation.

Fact: The need for transplants affects all communities. In fact, over 58% of those waiting for a life-saving transplant are either Black, Hispanic, Asian, American Indian/Alaskan Native, Pacific Islander, or of Multiracial ethnicities. Interestingly, less than 34% of those who give the gift of life are ethnically diverse.

Now What?

Anytime is a great time to discuss donation with your family members, but maybe this is the month you should commit to making these discussions happen. Are you surprised by any of these donation facts? Have you signed up with the National Donor Registry? Is there something holding you back?

Eradicating myths is the first step in truly understanding the basics of donation. Now that the foundation has been covered, future blog posts will aim to further address who can become an organ donor along with the clinical ins and outs of donation. Until then, embrace the journey...wherever your journey may take you!

Reference

United Network for Organ Sharing (2015). Waiting list candidates by organ type: All patient states. Retrieved April 5, 2017 from Transplant Trends | UNOS

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NurseHeart&Soul

About NurseHeart&Soul, MSN

NurseHeart&Soul has 20+ years of acute care nursing experience across the critical care spectrum. She is a passionate nurse author and educator committed to supporting nurses on their journey. She believes every nurse deserves the resources and support they need to rise to their potential. Her peers describe her as “a nurse’s nurse” and a “true inspiration”.

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Specializes in Nephrology, Cardiology, ER, ICU.

Great article - I work in nephrology and for my transplant-eligible pts, organ donation is so important.

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Specializes in Corrections.

I am curious about the racial question, are there really so many differences between people? Is there little chance a Black, Hispanic, Asian, American Indian/Alaskan Native, Pacific Islander etc would be compatible with a Caucasian's organ? If so, that's sad, and we need to work on minority recruiting!

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Specializes in ED, Critical care, & Education.

Thank you TraumaRUs! I bet you really see the value and need for donation!

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Specializes in ED, Critical care, & Education.

Today is another great day to discuss organ and tissue donation with your loved one's. Have you done it yet?

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Specializes in ED, Critical care, & Education.
I am curious about the racial question, are there really so many differences between people? Is there little chance a Black, Hispanic, Asian, American Indian/Alaskan Native, Pacific Islander etc would be compatible with a Caucasian's organ? If so, that's sad, and we need to work on minority recruiting!

While transplants are often successful regardless of ethnicity the reality is 22 people die each day awaiting an organ transplant which means we need more people to join the organ, eye, and tissue donor registry. You are correct, we need to educate EVERY community to join the Donate Life Registry and all communities would be willing to Donate Life”.

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Specializes in NICU, PICU, PCVICU and peds oncology.
I am curious about the racial question, are there really so many differences between people? Is there little chance a Black, Hispanic, Asian, American Indian/Alaskan Native, Pacific Islander etc would be compatible with a Caucasian's organ? If so, that's sad, and we need to work on minority recruiting!

I've cared for a large number of both donors and recipients over the last 15 years. Never have I seen a donor document that includes the ethnicity of the donor, the location of the donor, the age or gender of the donor or anything else other than blood and tissue types and a tracking number. Obviously, it's not a consideration when it comes to matching donor with recipient. Conversely, the recipients' ethnicity IS known in those situations to all involved in their care. I cannot recall a single instance of an ethnic minority donor passing through our unit, but can think of a large number of ethnic minority recipients. When we have a potential donor from an ethnic minority on the unit there is usually some dialogue about them in the break room, with most participants agreeing the request will be refused. I once heard someone say, "We're not even going to involve the OPO because there's no point." And that bothers me a little.

My son became a liver recipient 28 years ago; I know first-hand the value of organ donation and am grateful every day for that family's sacrifice. I hope knowing that their child's death meant several others could live provides them with some peace in their hearts.

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Specializes in Critical Care.

While it certainly shouldn't be a reason to not be an organ donor, this isn't completely true:

Myth 1: Celebrities and individuals who can pay for the organ receive the organ.

Fact: The United Network for Organ Sharing maintains a national computer system with specific standards that ensures organ allocation takes place in ethical and fair ways.

Organ recipients is actually limited to those who can pay for it, while it's gotten much better since the ACA, prior to that about 1/3 of those who otherwise qualified for transplantation could not receive them due to lack of insurance coverage or ability to show they could pay the full costs out of pocket (typically about $500k)

And you can actually game the system with enough money. While there is a single nationwide database there is not one single nationwide waiting list, someone who can afford to travel the country and be evaluated at every transplant center, and who can get to any of these centers on short notice (access to a private jet) can be on multiple or even all the waiting lists at once.

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Specializes in ED, Critical care, & Education.

NotReady4PrimeTime~

Each hospital has a responsibility to notify an OPO when each patient meets clinical triggers. Each OPO conducts thorough data evaluation to assure each patient and family is given the opportunity to donate. If a hospital fails to make these referrals as required by the participation agreement CMS would be notified and a corrective action would be required. The bottom line is we as staff should never make a decision for a family whether they will or will not choose to donate. I consented several donors of diverse ethnic background but as you experienced, there is definitely a disparity in volume.

I'm so glad your son received his much needed organ. What a gift!

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Specializes in ED, Critical care, & Education.
While it certainly shouldn't be a reason to not be an organ donor, this isn't completely true:

Organ recipients is actually limited to those who can pay for it, while it's gotten much better since the ACA, prior to that about 1/3 of those who otherwise qualified for transplantation could not receive them due to lack of insurance coverage or ability to show they could pay the full costs out of pocket (typically about $500k)

And you can actually game the system with enough money. While there is a single nationwide database there is not one single nationwide waiting list, someone who can afford to travel the country and be evaluated at every transplant center, and who can get to any of these centers on short notice (access to a private jet) can be on multiple or even all the waiting lists at once.

UNOS manages the waiting list in the fairest and most equitable way. Organs are allocated using algorithms that find the sickest patient that is a match for a donated organ located in the distance that organ is able to travel (according to UNOS allocation policies). Every patient has the right to be waitlisted at multiple transplant centers following evaluation and acceptance into their program. A patient does need to pass social, psychological, and physical exams at a transplant center. One of those thresholds is a support system for care of a transplanted organ. This would include (as examples) access to care (insurance or ability to pay) and medication, likelihood of post-transplant care compliance, and a support system post-surgical.

My point was that people don't just say "I have $100,000 and want to buy that liver" for example. It's a long process for many with lots of challenges along the way. Thank you for your tactful way in expressing your points.

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This is a great article! I wish it had been around when I wrote a paper for biomedical ethics. The lingering question I personally have after doing research is this: pain control for the donor. I recognize that most people believe the donor cannot feel pain due to various factors but I also found research that showed elevated heart rates and similar signs of possible pain. I'm really interested to hear the perspective of someone as knowledgeable as yourself!

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Specializes in ED, Critical care, & Education.
This is a great article! I wish it had been around when I wrote a paper for biomedical ethics. The lingering question I personally have after doing research is this: pain control for the donor. I recognize that most people believe the donor cannot feel pain due to various factors but I also found research that showed elevated heart rates and similar signs of possible pain. I'm really interested to hear the perspective of someone as knowledgeable as yourself!

8130~

Thank you for your wonderful comment!

In my experience in working on dozens of donor cases both as a nurse in the intensive care unit and as an organ procurement coordinator, I never had any concerns regarding pain control for a brain dead donor or a donor following cardiac death. I have always been a huge advocate for pain control so I would be right there with you to request comfort measures if indicated. Obviously, I cannot personally prove that a brain dead person does not experience pain so I find your comment intriguing.

In the case of a donor who is not yet brain dead and life support is withdrawn, certainly it would be appropriate to maintain pain control as needed as you would for any patient when withdrawing support. In a donation after cardiac death, life support is withdrawn in the operating room and the donation does not occur until after after death is declared. You can read more about donation and donation after cardiac death in my second blog post in the series titled Organ and Tissue Donation: The Facts of Donating Life at https://allnurses.com/general-nursing-discussion/organ-and-tissue-1099897.html

Thanks for chiming in!

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