Organ donations depend on family approval

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by Paul Schreiber|ret||ret||tab|

SBJ Reporter|ret||ret||tab|

pschreiber@sbj.net|ret||ret||tab|

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Donating one's organs requires more than just signing the back of a driver's license. For the more than 2 million signed up on the Missouri Donor Registry, taking that step doesn't necessarily mean their requests will be fulfilled.|ret||ret||tab|

An individual's intent to donate body organs or tissue can be declined by the individual's family. If the family won't allow the retrieval, the issue won't be pressed, said Don Lucore, director of pastoral care with CoxHealth. |ret||ret||tab|

"Even if the patient has left a written record on any advanced directives or anything, they will not generally retrieve without the consent of the legal next of kin," Lucore said.|ret||ret||tab|

In addition to an open discussion on donation between all parties, it's essential the person entrusted to complete the directive be comfortable with the decision and follows through with the plan, Lucore said.|ret||ret||tab|

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Transplant services|ret||ret||tab|

Following through with such personal decisions is what Mid-America Transplant Services at 3854 South Ave. is all about. The 72-employee nonprofit organ procurement organization, with headquarters in St. Louis, was launched in 1985. It also has offices in Springfield, Cape Girardeau, Carbondale, Ill., and Jonesboro, Ark.|ret||ret||tab|

Working with 115 medical institutions, Mid-America Transplant Services was involved with 1,329 donors in 2003, said Lonnie Boyd, vice president. Of these, 107 donated a vital organ, such as heart, liver, lungs, kidneys or pancreas; 599 were bone donors; 189 donated heart valves, and 434 donated eyes. |ret||ret||tab|

In the Springfield area, which also includes medical facilities in Bolivar, Lebanon and Rolla, there were 24 vital organ donors and 123 tissue donors, Boyd said. |ret||ret||tab|

Costs are difficult to fix because of the numerous details involved on each case, Boyd said. "I wouldn't even hazard a guess," he said, due to all the variables such as length of time to do a procedure, what organs are recovered, ground and air transport costs to move the organs, hospital time, cost of supplies, staff, organ recovery and transplant physicians, and more, he added. |ret||ret||tab|

There is no charge to the donor family for organ or tissue donation, Boyd said. |ret||ret||tab|

"The transplant programs pay us," Boyd said, "except for kidneys. Those are paid by Medicare." In Missouri, facilities such as Barnes-Jewish Hospital, St. Louis University Hospital or Cardinal Glennon Children's Hospital in St. Louis are locations where vital organ transplants are performed, he said.|ret||ret||tab|

In Springfield, no vital organ transplants are done. Tissue transplant work is common in Springield, including bone grafting for cervical fusion procedures, reconstructive knee surgeries, corneal transplants, and occasionally scleral tissue is harvested eyes for use with eardrum problems, Boyd said.|ret||ret||tab|

Eyes are the concern of Heartland Lions Eye Bank, which utilizes the cornea for transplant purposes and the sclera, or white of the eyes, for tympanic membrane repair in the ear, said Shelly Rasley, branch manager. |ret||ret||tab|

In 2003, the Springfield branch retrieved 976 eyes from 488 donors, Rasley said, and through May 10, 190 donors have contributed about 380 eyes. Beyond Springfield, the operation has branches in St. Louis, Kansas City and Columbia, she said. It is funded with Lions Club contributions and by five fund-raising triathlons held each year. |ret||ret||tab|

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The right thing to do|ret||ret||tab|

For Kari Niewald, the idea of donation just seemed like the right thing to do. A 17-year-old friend of Niewald's died after not being able to find a successful match on a kidney donor list.|ret||ret||tab|

Cindy Niewald, Kari's mother, said when her daughter received her driver's license, she indicated she wanted to become a donor, prompted by her friend's failure to obtain the kidney she needed. A year and a half later, in 1999, Kari was killed in a car accident. She, too, was 17.|ret||ret||tab|

When medical staff at the hospital approached Cindy Niewald about letting Kari become a donor, she remembered her daughter's request and fulfilled it. The tragedy reinforced for Niewald how necessary it is for all family members to be fully involved in decisions of such magnitude.|ret||ret||tab|

"It's so easy to ask for money, but it's so hard to ask for you to make a decision like this," Niewald said, referring to the ongoing need in Missouri alone for organ transplants. "Money is not what they really need. These people's hope relies on somebody else's family having a tragedy."|ret||ret||tab|

To address the need for organs in a systematic way, the Missouri Donor Registry was initiated in 1990 to allow people to make their donor intentions known. Since then about 2 million people have signed on, indicating their willingness to become donors, Boyd said.|ret||ret||tab|

Still, the registry is not a failsafe mechanism to ensure the person's desires will be honored. "It is not a registry of consent; it is a registry of intent," said Boyd, who is also chairman of the governor's advisory committee overseeing the registry. |ret||ret||tab|

In the event of death, and the family is unaware of any previous decision to donate, the medical or pastoral staff can inform the survivors of the deceased's intention by referring to the registry, Boyd said. Most families take a great deal of comfort in this knowledge, Boyd said, because the actual decision may never have been verbalized to them. |ret||ret||tab|

Bolivar resident Renee Brown knows how powerful and heartfelt the decision to donate can be. In 1998, her daughter, Chilua Redd, was watching television with her father. After a program on emergency trauma had aired involving a real-life situation, the child indicated to her parents that she wanted to become an organ donor.|ret||ret||tab|

Less than three weeks after that TV show, 7 1/2-year-old Redd was struck by a car in front of her home and killed. That was in April 1998.|ret||ret||tab|

Since then, Redd's decision to donate has provided a new heart and a new lease on life for another Missouri girl. Brown hasn't met the girl, but has received pictures the child drew the Christmas after the transplant. Brown is now on the advisory committee with Mid-America Transplant Services and does volunteer work regarding organ donation. |ret||ret||tab|

Niewald has heard similar good news from her daughter's decision per a letter she received from Heartland telling her that Kari's corneas had been transplanted in a successful operation. |ret||ret||tab|

Of her daughter's decision to donate, Brown said, kids understand more than they are given credit for. "My daughter's legacy her story goes on. Mid-America has helped me keep her alive. My work with them keeps me going," she said. Such work assisting others has helped her move forward, she said. |ret||ret||tab|

Lucore said that seeing that the deceased's wishes have been honored proves beneficial to all parties in the long run.|ret||ret||tab|

"When you see how good that can be on results for both for the one family feeling that something good has come out of a tragedy and a loss and someone else's life has been saved, as well as those who have been given new life it just really gives you a sense of purpose as far as helping facilitate that," Lucore said.|ret||ret||tab|

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