Flowers, chocolates, organ donation — are you in? – Harvard Health Blog

Chocolates and flowers are great gifts for Valentine’s Day. But what if the gifts we give this year could be truly life-changing? A gift that could save someone’s life, or free them from dialysis?

You can do this. For people in need of organ, tissue, or blood donation, a donor can give them a gift that exceeds the value of anything that you can buy. That’s why February 14th is not only Valentine’s Day — it’s also National Donor Day, a time when health organizations nationwide sponsor blood drives and sign-ups for organ and tissue donation. Read on if you’ve ever wondered what can be donated, had reservations about donating your organs or tissues after death, or had concerns about the risks of becoming a live donor.

The enormous impact of organ, tissue, or cell donation

It’s hard to overstate the impact donors can make in the lives of people whose organs are giving out. Imagine you have kidney failure requiring dialysis 12 or more hours each week just to stay alive. Even with this, you know you’re still likely to die a premature death. Or, if your liver is failing, you may experience severe nausea, itching, and confusion; death may only be a matter of weeks or months away. For those with cancer in need of a bone marrow transplant, or someone who’s lost their vision due to corneal disease, finding a donor may be their only good option.

Organ or tissue donation can turn these problems around, giving recipients a chance at a long life, improved quality of life, or both. And yet, the number of people who need organ donation far exceeds the number of compatible donors: about 90% of people in the US support organ donation, but only 60% sign up. An estimated 109,000 women, men, and children are awaiting an organ transplant in the US. About 6,000 die each year, still waiting.

What can be donated?

The list of ways a donor can help someone in need has grown dramatically in recent years. Some organs, tissues, or cells can be donated while you’re alive; other donations are only possible after death. A single donor can help up to 75 people!

Here is a list of the most commonly donated organs, tissues, and cells.

After death, people can donate

• bone, cartilage, and tendons
• corneas
• face and hands (though uncommon, they are the newest additions to this list)
• kidneys
• liver
• lungs
• heart and heart valves
• intestine
• pancreas
• skin
• veins.

Live donations may include

• birth tissue, such as the placenta, umbilical cord, and amniotic fluid, which can be used to help heal skin wounds or ulcers and prevent infection
• blood cells, serum, or bone marrow
• a kidney
• part of a lung
• part of the intestine, liver, or pancreas.

To learn more about different types of organ donations, visit Donate Life America.

Becoming a donor after death: Questions and misconceptions

Misconceptions about becoming an organ donor are common, and they limit the number of people who are willing to sign up. For example, many people mistakenly believe that

• doctors won’t work as hard to save your life if you’re known to be an organ donor, or, worse, doctors will harvest organs before death
• their religion forbids organ donation
• you cannot have an open casket funeral if you donate your organs.

None of these is true, and none should discourage you from becoming an organ donor. Legitimate medical professionals always keep the patient’s interests front and center. Care would never be jeopardized due to a person’s choices around organ donation. Most major religions allow and support organ donation. If organ donation occurs after death, the clothed body will show no outward signs of organ donation, so an open casket funeral is an option for organ donors.

The experience of being a live donor

If you’re donating blood, there is little or no risk involved. Other donations do come with real risk. Surgery to donate a kidney comes with a risk of complications, reactions to anesthesia, and significant recovery time. It’s no small matter to give a kidney, or part of a lung or liver.

Donating bone marrow requires a minor surgical procedure. If general anesthesia is used, there is a chance of a reaction to the anesthesia. Because bone marrow is removed through needles inserted into the back of the pelvis bones on each side, back or hip pain is common. This can be controlled with pain relievers. The body quickly replaces the bone marrow removed, so no long-term problems are expected.

Stem cells are found in bone marrow. They also appear in small numbers in the blood and can be donated through a process similar to blood donation. This takes about seven or eight hours. Filgrastim, a medication that increases stem cell production, is given for a number of days beforehand. It can cause side effects, such as flulike symptoms, bone pain, and fatigue, but these tend to resolve soon after the procedure.

The vast number of live organ donations occur without complications, and donors typically feel quite positive about the experience.

Who can donate?

Almost anyone can be an organ, tissue, or blood cell donor. Exceptions include anyone with active cancer, widespread infection, or organs that aren’t healthy.

What about age? By itself, your age does not disqualify you from organ donation. In 2019, about a third of organ donors were over age 50. People in their 90s have donated organs upon their deaths and saved the lives of others. However, bone marrow transplants may fail more often when the donor is older, so bone marrow donations by people over age 55 or 60 are usually avoided.

Finding a good match: Immune compatibility

For many transplants, the best results occur when there is immune compatibility between the donor and recipient. Compatibility is based largely on HLA typing, which analyzes genetically-determined proteins on the surface of most cells. These proteins help the immune system identify which cells qualify as foreign or self. Foreign cells trigger an immune attack; cells identified as self should not.

HLA typing can be done by a blood test or cheek swab. Close relatives tend to have the best HLA matches, but complete strangers may be a good match as well.

Fewer donors among people with certain HLA types make finding a match more challenging. Already existing health disparities, such as higher rates of kidney disease among Black Americans and communities of color, may be made worse by lower numbers of donors from these communities, an inequity partly driven by a lack of trust in the medical system.

The bottom line

As National Donor Day approaches, think about the impact you can make by becoming a donor, whether during your life or after death. In the US, you must opt in to be a donor, unlike some countries in which everyone is considered an organ donor unless they specifically choose to opt out. Research suggests an opt-out approach could significantly increase rates of organ donation in this country, but currently there seems to be no movement in that direction.

I’m hopeful that organ donation in the US and throughout the world will increase over time. While you can still go with chocolates for Valentine’s Day, maybe this year you can also go bigger and become a donor. Let me know what you choose — and why.

Follow me on Twitter @RobShmerling