Donated organs go to people in the greatest need so they are usually very sick, sometimes within hours of death. What happens to them?

When all goes well with a transplant operation patients who couldn’t walk across the room without having to stop for breath are out of the hospital in a few days after their transplant, back at work soon after, playing sports again. Athletes return to compete, including the Olympics, NBA championships and marathons.Generally, their whole life changes. They become rejuvenated, take up pursuits they have never had the energy for, have babies that were previously not even a possibility, climb mountains, get degrees and travel to faraway places. They relish even the most mundane routines – shopping, driving the car to work, being alone without worrying about a catastrophe. They come from all walks of life, all temperaments and all philosophies. Some are deeply religious, seeing the hand of God in their own experience; some are intermittent worshippers, some firm non-believers – in fact, a cross-section of society. A common thread, however, brings them all together: gratitude: they have their donor’s photo in their wallet, send flowers to the family on birthdays, light candles and determine to be worthy of the gift they received. The other people in this inspiring equation are the ones who saved them. The great majority of donors never met the recipient and never will. They died and, in dying, their families, often acting on what their loved one had told them, agreed to make their gift without any knowledge of where it would go.

What kind of people are donors?

Donor families are as diverse as recipients. Some had scarcely heard of transplantation until suddenly faced with the death of one of their members. Others had talked about it freely. Some came to the decision agonizingly. For others it was so obvious they didn’t even debate it. But all, at the moment when they were most vulnerable, instead of turning inward in bitterness and despair, set aside their grief long enough to help people they could only dimly imagine. Some donors didn’t die. Nowadays, one in five are living donors, who undergo a major and otherwise completely unnecessary operation, to give a kidney or part of their liver or lungs, to help someone in need. Mostly that someone is a close relative and they regard the donation as a privilege. But at times it is a casual acquaintance or even a total stranger. When asked why they would put themselves at risk they typically shrug and say simply: “They needed it more than I did.” Despite all these differences, the power of transplantation has produced a strikingly uniform response among donor families. Among all the hundreds of donor families I have met, I can scarcely remember one who regretted the decision. Almost all say it was the one good thing to come out of a terrible time. It is those who didn’t donate who often have regrets. At meetings about organ donation people will come up, with tears in their eyes, to say, “I wish I’d done that.” Five, ten, sometimes twenty years earlier a family member had suffered brain death. No one approached them about donating or they were too upset to think about it or at the time the idea frightened them. Now they feel that somehow they let that loved one down. Not that donation takes away the loneliness. More often than I like to remember, I will meet a young couple who say quietly something like this: “A few months ago our daughter’s school had a presentation on transplantation. She told us that if anything happened to her she’d want to be a donor.” They pause to pluck up courage and my heart sinks, knowing what is coming. “A few weeks later,” they add, “she was killed coming home from school on her bicycle. We didn’t hesitate.” People like that speak of the peace of mind the decision has brought them and the way it has helped them heal. “It’s given a meaning to her death,” they say. “It produced something good instead of everything being a waste.”

If you want to be an organ and tissue donor, you must tell your family. Here’s why:

In the absence of any previous discussion, a family in the waiting room of a trauma hospital is often bewildered. The circumstances of sudden death are always searing but, in addition, family opinion may be divided, some members who need to be consulted may be away, emotions can be running out of control. Misconceptions are commonplace. Some people are convinced that if they sign a donor card the doctors will not try as hard to save them. Some think their church is against transplantation. Others say of someone who has just died, “I don’t want her to be hurt anymore.” Everything is working against calm thought. A mother may have to call her husband at work to tell him their child was hit by a car. A father may have to tell his children their mother is not coming home. Making a major, irrevocable decision there and then about something they have never seriously thought about is too much for many people. They say ‘no’ and often regret it for the rest of their lives.

Do you know why the need for donated organs is so urgent?

The need is urgent because the potential supply is so limited. In the great majority of deaths, where the heart stops beating, the organs deteriorate too quickly to be transplanted. Most donated organs come from the small number of people, whose brain has stopped working and are truly dead, but who are on a ventilator that can keep their organs viable for a short time. By contrast, almost anyone can donate tissue – corneas to restore sight, skin to cure burns, bone to straighten spines, ligaments so that invalids can walk again. A donation produces on average three or four organs, saving three or four families from devastation, in addition to tissue that can help up to 50 people. Most people in their whole lives will never again have as great an opportunity to change the world for the better as they have at that moment. With that much on the line, I often wonder what possible debate there can be about what is the right thing to do. Material on this blog often comes from Reg Green’s published articles and books. This preface is from “The Gift that Heals” (www.authorhouse.com)