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Each time I renew my license, I think I’ll answer the question differently. “Do you want to be, or continue to be, registered as an organ & tissue donor?’’ No, I don’t, is what I inevitably respond.
I can’t really justify why I don’t sign up. Maybe it’s because I don’t like to think about death, or I don’t know enough about what donation entails. When I renewed my license in August, all I envisioned was this silly cartoon from the New Yorker of a headless angel with a floating halo. “Makes you want to think twice about donating body parts,’’ another angel quipped.
I’m not alone in saying no. In fact, I’m in the majority. According to the Registry of Motor Vehicles, 49 percent of registered drivers are organ and tissue donors. The figure is dramatically higher than just five years ago, when it was 32 percent, but it’s still less than half.
So, with Thanksgiving upon us, I’m tackling a subject I’ve long ignored, in the hopes that by reviewing all the facts maybe I’ll change some minds. Mine included.
Driver’s licenses have been tied to organ donation since 1976. Only a few states back then linked the two registrations, but that was example enough for Dr. John Libertino, founder of the transplant program at Burlington’s Lahey Clinic. Desperate for more kidney donations — 10 percent of those on dialysis were dying, Libertino said — he spearheaded the drive to have Massachusetts add the option.
Back then, in the days before mandatory seat-belt laws and air bags, more people died from car accidents, said Laura Dempsey, spokeswoman for the New England Organ Bank. The thought was that if victims were carrying their licenses, which double as donor cards, doctors would have instant permission to try to save their organs.
Organ and tissue donation has evolved light-years since then. While your driver’s license still states whether you’re a donor — the designation is now printed on the license, as opposed to the little “heart’’ stickers of years ago — nobody in a hospital looks at it anymore. When a potential candidate is brought to a hospital, a call goes out to the New England Organ Bank, which is staffed 24 hours a day, to see whether the person is registered in its database.
“Kidney, liver, heart, pancreas, and lungs, of course. And then tissue as well,’’ said Dempsey. “We can recover skin. We can recover bone, corneas, heart valves, and small intestines. A lot of people will say, ‘Oh you don’t want anything from me.’ Even if it’s some sort of accident where many of the organs are not medically suitable to be recovered, corneas are something we can quite often use. Someone who has been sight-impaired for their whole lives can see.’’
Most organ donations go to local transplant recipients, mainly because the operations must happen very quickly: within two to four hours after a lung is recovered; four to six hours for a heart; 12 to 18 hours for a liver; and within 24 hours for a kidney. If you’re a Massachusetts donor, you’ll probably be helping someone from New England.
There was one fact about organ donation I could never have guessed. While more than 2.2 million drivers are registered donors in Massachusetts, a truly minute number — usually fewer than 250 a year — actually become donors, Dempsey said. The reason is that vital organs are taken almost exclusively from donors who have been declared brain-dead and whose bodies are on respirators. Most people who die simply do not fall under that category.
Meanwhile, some 110,000 people nationwide are on a waiting list for a transplant, according to the United Network for Organ Sharing, which coordinates donation efforts across the country. That’s roughly five times the number of transplants performed this year. On average, 18 people die each day while waiting for a transplant, Dempsey said.
“If you’re waiting for an organ transplant, then the odds are kind of really against you,’’ she said. “You really want every single person who, unfortunately, dies to be a possible organ donor.’’
Dempsey asked me just what I was afraid of. Donors can have open-casket funerals, she said, as surgeons don’t leave visible traces of extraction. No matter what your faith, there are no religious barriers to donation, she said. And while senior citizens are less likely to be vital organ donors, their skin, tissue, and corneas are often viable for transplant regardless of age, she said.
“One organ donor can save up to seven or eight people,’’ Dempsey said. “In 2009, we had 116 organ donors in Massachusetts, but we had 382 organ transplants. You could do a double lung transplant or a single. You could use one or two kidneys. The liver can be split, then it regenerates in a matter of months.’’
Libertino, who now heads Lahey’s Institute of Urology, said the cost of a kidney transplant — about $55,000 — is less than the cost of a year of dialysis. The recipient’s quality of life is usually far better with a donated organ, too.
“I have a patient who I transplanted in the early 1970s who still sends me Christmas cards,’’ Libertino said. “I don’t think people have a sense of how much donation benefits mankind and society.’’
That message is getting out there, partly because of a new state law that also links donor registration to renewing your car’s registration. The Registry, with assistance from the New England Donor Bank, has beefed up its own education efforts, too, both in branches and online.
Which, after mulling over all the facts, is what I just did.
Peter DeMarco can be reached at firstname.lastname@example.org. He also updates a Facebook page, “WhotaughtYOUtodrive?’’