The Organ Donor Program
Finger Lakes Donor Recovery Network is one of 50 nonprofit, federally-designated donor programs that coordinates organ donations in the U.S.
There are approximately 117,000 men, women and children in the U.S. on the national organ transplant waiting list. The list is managed through the United Network for Organ Sharing (UNOS), based in Richmond, VA, which holds a contract with the Federal Government to oversee the system.
This system developed out of the National Organ Transplant Act in 1984, which established the Organ Procurement and Transplant Network (OPTN), a national organ sharing system to guarantee fairness in the allocation of organs for transplant. UNOS maintains a database of all patients waiting for various organ transplants.
Factors such as a patient’s income, celebrity status, and race or ethnic background play no role in determining how organs are given to patients.
Patients are added to the waiting list after having been evaluated by a team of physicians at their local transplant hospital and deemed candidates for transplantation. The rules that dictate the waiting list vary by organ. General criteria – a patient’s medical urgency, blood, tissue and size match with the donor, time on the waiting list and proximity to the donor – guide the distribution of organs. Special allowances are made for children under certain circumstances. Factors such as a patient’s income, celebrity status, and race or ethnic background play no role in determining how organs are given to patients.
Local patients also get special attention when an organ donation happens in their community. The country is divided into 11 geographic regions, each served by an organ procurement organization (OPO) like Finger Lakes Donor Recovery Network. With the exception of perfectly-matched kidneys and the most urgent liver patients, first priority goes to patients at Finger Lakes region transplant hospitals. Next in priority are patients in areas served by nearby OPOs. Finally, only if no patients in these communities can use the organ, organs are offered to patients elsewhere in the U.S.
Working with Hospitals and Donor Families
The end to a transplant patient’s wait begins with a call from a local hospital to Finger Lakes Donor Recovery Network to report a patient death. This call sets into motion a complex series of events that will bring FLDRN together with the potential donor’s family. This is typically a case in which a patient has suffered a life-ending injury to the brain and has been declared brain dead. The patient is in the intensive care unit and on artificial support to maintain heart beat and breathing; this is necessary so that the donor’s organs remain viable for transplant.
The end to a transplant patient’s wait begins with a call from a local hospital to Finger Lakes Donor Recovery Network to report a patient death.
Clinical staff from FLDRN will consult with the hospital staff caring for the patient and plan for a discussion with the family of the potential donor. If the patient is a registered donor with New York Donate Life Registry, FLDRN will consult with the family about how the organ donation process will proceed. If the patient’s wishes with regard to organ or tissue donation are unknown, FLDRN staff will explain the donation options to the family or next of kin. This process is handled with the utmost care by FLDRN staff to ensure that the family clearly understands their options and the potential benefit to patients in need of transplants.
Once consent for donation is obtain, FLDRN begins the process of identifying potential matches for the donor organs by entering basic medical information into the national transplant database. From that list, FLDRN contacts the doctors representing the priority patients on the list. Patients print out in order based on a number of factors that are different depending on organ. But they include:
- Medical match between donor and recipient based on blood type, tissue typing and size
- The transplant candidate medical urgency status (primarily related to liver and heart patients)
- Geographic proximity to the donor
- Time accrued on the waiting list
- And, in certain cases, age of the donor and recipient with additional consideration given to children and adolescents
Once a patient’s doctor has determined that the organ is a good match for the patient, FLDRN will coordinate the surgical recovery of the organs at the hospital where the patient died. When a donor is donating multiple organs – heart, kidney, liver, lungs – FLDRN must coordinate with multiple surgical teams to carry out the organ recovery. Once the organs are recovered, they are then packed in sterile solutions and a sterile icy slush for transport to the recipient’s hospital. In some cases, particularly with the heart, lung or liver, the surgeon recovering the organ will take it directly to their patient in the hospital. In other circumstances, organs may be destined for outside of the region and will be taken by courier or by airplane to a patient in another part of the region or the country.