Wednesday, April 14, 2010

Anatomical Gifts - the gifts that keep giving …


(originally published May 22, 2009)

News Item:  "Natalie Cole, singer and daughter of Nat King Cole, received a kidney transplant on May 19, 2009 at Cedars-Sinai Medical Center in Los Angeles, California.  The kidney came from an anonymous donor who recently died.  Her family directed that her kidney be given to Natalie." 

I saw this headline and was reminded of a former client and friend, I'll call him Theodore (1), going through divorce and an early mid-life crisis, who adopted a New Age name and went off to live in various group communities.  While living in Boston, he heard about people who voluntary donate one of their kidneys to strangers in need, took inventory of his kidneys, found he had one to spare, and so agreed to donate one.  Not when he died.  While he was still living.  And so he signed up with a particular hospital, they found a compatible match from their waiting list of people who needed a kidney, and then performed the simultaneous surgery, removing one of my friend's healthy kidneys, and then inserting it in place of a failed kidney in the woman recipient.  To my knowledge, the surgery was a success, and both patients are living happily ever after.  In both cases, the donor made an "anatomical gift" of their body parts to a willing recipient. 

The first instance was a case of "directed donation":  the donor selects the person to receive the anatomical gift.  This is more common among family members - who are likely to be compatible for donations of this type.  It is rare that you see directed donations to strangers.  You see examples of directed donation with blood donations, such as parents to children, and among family members.  Because family members have shared genes, they typically are more compatible for other procedures such as bone marrow transplants used in treating certain cancers.  They also have that common bond of family and love, and so are more motivated to help their own child, brother or sister.  But as the example of Natalie Cole indicates, you can direct your donation to a particular stranger, if you are so inclined, and you are a compatible match to the person in need. 

The second example, my friend Theodore, was what is called an "altruistic donor":  the person who is willing to give up a piece of his anatomy, a spare organ, for the good it will do for others.  The sale of organs is prohibited, and so the motivation to take this step comes from deeper within the donor.  Those of us who regularly donate blood to the Red Cross are motivated in that sense.  This is altruistic donation:  we don't know where our blood is going, but we do so hoping that it does some good for someone in need.  My son, following my college tradition at Penn State, regularly donates his plasma:  the plasma center withdraws a pint of blood, centrifuges it to separate the red cells from the white, keeps the white, returns the red cells to the donor, and repeats the process one more time.  However, there is a mixed motivation here:  the plasma centers pay college students to do this; and the pay is pretty good for an hour of their time.  But it feels good to know that your plasma is going to someone in need.  I have signed up for the national marrow donor registry.  I did so after learning about Alexandra "Alex" Scott and her famous lemonade stand.  Alex, from Wynnewood, Pennsylvania, was diagnosed with neuroblastoma, a type of childhood cancer, before she had turned one.  At age four, she decided to take matters into her own hands, and opened up a lemonade stand on her front lawn, to raise money for cancer research.  Alex passed away at age 8 in 2004, but her lemonade stand has raised over $25 million to fight pediatric cancer.  On her website, I read about the National Marrow Donor Registry, and followed through, receiving a kit in the mail and sending off swabs of cheek tissue to be tested and added to the registry.  If this little girl could endure what she endured, and make such a significant contribution in her eight short years, then the least I could do would be to volunteer to try to be a match for some other little boy or girl in need.  

Blood regenerates.  Plasma regenerates.  Marrow regenerates.  There are other bodily parts that regenerate, and that are now being transplanted from living donors, including the lung, liver and pancreas.  A living donor is able to donate a portion of their liver to someone in need of a liver transplant.  The liver is the only organ that can regenerate and will grow back to nearly 100 % of its size in a short amount of time.  Then you can do it again!

And the latest idea in this field:  paired donors.  One altruistic donor is needed to start the ball rolling:  he or she gives the gift of life to a compatible stranger, who has lined up their spouse or other loved one to "match" the gift; that gift is given to another compatible stranger who is willing to again "match" the gift.  And on it goes.  According to the March 12 issue of the New England Journal of Medicine, to date the longest paired-donor kidney transplantation chain has involved 10 organ transplants.  Talk about a matching gift.  Ten lives saved as a result of one altruistic donor.

According to the national registry maintained by the Department of Health and Human Services, as of May 15, 2009, there are 102,118 people registered to receive an organ of some kind when a donor is found:  80% of those are for kidneys; 15% for livers; and then pancreas, hearts, lungs, intestines rounding out the list of need.  We all may need blood from time to time.  We or our loved ones, all may need plasma, or marrow.  We are relying on the generosity of altruistic donors in each of these cases.  We have a population of over 300 million in this country.  It makes the number of people who need an organ transplant, 102,118, look small by comparison.  No matter how altruistic we may be, we can't actually give our hearts to these people; but we can certainly use the motivation that comes from that part of us to consider what we can do for those in need, whether while living, or upon our death.  When reviewing your estate plan, think about that issue.  It might not be for everyone, but it might be for you.  And for the people who would benefit for such a generous gift. 

1.  Theodore:  gift of God

©2009  Douglas P. Humes

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