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Kathrynne McKinney

Professor Adrienne Cassel

English 1201

30 July 2017

Organ Transplantation

When it comes to transplant most people dont know much about the topic. A lot of

people I know have never had a surgery in general, let alone an intensive surgery such as a

transplant. Many people think that once you receive a transplant you are healthy and wont need

any further medical attention unless something goes wrong. But this is a common misconception.

The supply for organs continues to grow. There is not enough people donating their organs for

the amount that we have in need. There are two strategies a country can choose when it comes to

organ donation, these include opt- in and opting- out of being an organ donor. Our country, The

United States of America, opts- in. We are one of the leading countries in need for organs.

I chose this topic because I went through a kidney transplant in May of 2015. It has been

a life changing experience for the better. And because of my personal experience, I have a lot of

curiosity when it comes to the topic which is why I chose to research whether transplant is a

successful treatment for people in organ failure. Unfortunately, I am currently experiencing

chronic rejection of my transplanted kidney. According to Stanford University, Chronic

rejection is less well defined than either hyper acute or acute rejection. It is probably caused by

multiple factors: antibodies as well as lymphocytes. The definitive diagnosis of chronic rejection

is again generally made by biopsy of the organ in question. The heart is an exception to this

generalization: chronic rejection in heart grafts is felt to be manifest by accelerated graft

atherosclerosis. (Punch, Jeff)

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Transplant is a treatment, not a cure. There is a lot of aftercare associated with surgery.

The surgery is not the end of the road for all patients. You are healthier in most cases, but you

have to regularly attend appointments, and take all medication prescribed. This means sometimes

taking a few pills sometimes twice, or three times a day.

According to Emory Healthcare, Pros: ONE organ donor can save up to EIGHT lives.

There are nearly 115,000 men, women and children waiting for an organ transplant in the U.S.

By registering to become an organ donor, you can help save lives! For the transplant recipient, it

is a second chance at life. For some, an organ transplant means no longer having to be dependent

on costly routine treatments to survive. It allows many recipients to return to a normal lifestyle.

For the family of the deceased donor, they feel a sense of goodness that came from a tragedy

that if the organs are transplanted into a young, deserving person, then their loss was not in vain.

Donor families take some consolation in knowing that some part of their loved one continues in

life. Living Donation It is possible to donate organs while you are still alive. Living people can

donate a kidney, portions of the liver, lung, pancreas and intestines, as well as blood, and go on

to live healthy lives. Most often it is relatives who do living tissue donation. It is possible,

however, to register for completely humanitarian reasons and give organs to a stranger. Cons:

Families might be confused by the fact that donor bodies are often kept on life support while the

tissues are removed. Surgeons do not remove any tissues unless the person is brain dead, but they

sometimes put the body on a ventilator to keep the heart pumping fresh blood into the tissues to

keep them alive long enough to harvest. This is not the same as life, but there is a moment when

the ventilator is removed and the heart stops. Another con might be that the donor does not

usually get to choose who the organs go to, and perhaps an organ will go to someone of a

different faith, political viewpoint or temperament than the donor. The donor has to believe that
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all life is sacred and that anyone who receives the ultimate gift of a donor organ will be

grateful and be imbued with a sense of gratitude and a desire to pay it forward. (Emory

Transplant Center)

Many people experience rejection symptoms within the first few years after receiving a

transplant. Transplant rejection occurs when transplanted tissue is rejected by the recipient's

immune system. According to Organ Procurement and Transplant Network, every ten minutes,

someone is added to the national transplant waiting list. On average, 20 people die each day

while waiting for a transplant. (https://optn.transplant.hrsa.gov/)

Even though rejection is common, more people should be willing to donate their organs,

while alive or maybe even after their death. A majority of the public is very ignorant when it

comes to organ transplant. This is a big problem because transplant require organs, and deceased

organs are not enough for all the people in need. The website lists that as many as 17,155 organ

transplants performed so far in 2017 and as of 07/20/2017 8,099 donors donated organs as of

07/20/2017 (https://optn.transplant.hrsa.gov/), this shows you the substantial difference there is

living donors compared to deceased donors. The supply is not enough for demand.

There is a stigma attached to surgery because it is scary! When it comes to surgery most

peoples opinions begin and end with the fact they hope they wont need one. The biggest issue

is that more people should donate and even if they arent a match to a family member they can

still help them with a donation pool. When a donor and recipient are incompatible or

mismatched with each other, either by blood group or by tissue type, it may be possible for them

to be matched with another donor and recipient pair in the same situation and for the kidneys to

be exchanged or swapped. This is called paired kidney donation. Each recipient benefits from a
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transplant that he or she would otherwise not have had. When more than two pairs are involved

in the swap it is known as pooled kidney donation. Altruistic donation - This is used only in

kidney transplantation. It is where a person volunteers to donate a kidney to an unknown

recipient; someone they have never met before. The benefit of this type of donation is that a

person in the national transplant pool receives a living donor kidney transplant and the number of

patients waiting is reduced overall. This increases the chance of other potential recipients

receiving a kidney. (Choosing the Treatment Option That's Right for You)

Of course it is everyones choice what happens to their bodies. Ultimately it is their

decision whether they want to donate during life or after. Is it better to have a system where

people have to opt out of organ transplant instead of opting in? With an opt-in system, people

have to actively sign up to a register to donate their organs after death. In opt-out systems, organ

donation will occur automatically unless a specific request is made before death for organs not to

be taken. (McIntosh, James)

If people arent willing than it comes into question whether our government should

require everyone to donate after death. Why do they need their organs if they are not alive? The

US currently uses an opt-in system. According to the US Department of Health & Human

Services, 28,000 transplants were made possible last year due to organ donors. Around 79 people

receive organ transplants every day. Unfortunately, around 18 people die every day, unable to

have surgery due to a shortage of donated organs. (McIntosh, James) This would benefit the

general public because less people would be waiting on organs. The wait is long and excruciating

no matter the time frame because most of these people are doing everything in their power to

remain as healthy as possible. In the article "Opt Out" Policies Increase Organ Donation, the

author writes that In countries such as Austria, laws make organ donation the default option at
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the time of death, and so people must explicitly opt out of organ donation. In these so-

called opt-out countries, more than 90% of people donate their organs. Yet in countries such as

U.S. and Germany, people must explicitly opt in if they want to donate their organs when they

die. In these opt-in countries, fewer than 15% of people donate their organs at death. (Scheiber,

Francesca)

Both systems for organ donation have their flaws. Inaction in an opt-in system can lead

to individuals who would want to be donors not donating. In contrast to this, inaction in an opt-

out system can potentially lead to an individual that does not want to donate becoming a donor.

There are numerous reasons why people may not act; whether it be through lack of awareness,

loss aversion or belief that the policy makers have got it right and theres no need to do

anything. (MLA speaks of need for opt-out donor system)

If people were more open to organ donation, it would benefit everybody because this new

way of thinking would be enlightening, generally accepting, and it benefits everyone as a whole.

More organs would be available for people in need, they wouldnt have to be on dialysis (kidney

failure patients) so long. And people wouldnt have to be on the organ donation list so long. The

average median wait time to transplant is, Kidney 5 years, Liver 11 months, Heart 4

months, Lung 4 months, Kidney / Pancreas 1.5 years, and Pancreas 2 years. (Gift of Life

Donor Program) Another advantage to more people donating while alive is that living kidneys

usually last longer than deceased kidneys in most cases.

In conclusion, transplant is a treatment and not a cure. Other treatment is necessary after

surgery and sometimes rejection occurs. Transplantation is never a definite. More people should

be open to donating organs at some point in their lives. It would benefit every country as a

whole. No matter what organ transplant system a country adopts, their organs are still reliant on
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their active decisions. There is definitely not enough supply for the demand no matter the

country. Every country still has problems with organ shortage. With opt- in countries, not

enough people are choosing to donate. And with opt- out countries, some people may be put off

by the policy and choose not to donate on the basis of such. Hopefully for the sake of everyone

more people in the future will try to educate themselves on transplant, instead of just answering

the question at the BMV. Hopefully they put more consideration into it, and try to imagine

themselves in that situation. I dont think people put enough thought into the decision,

consequently we have a huge demand for organs and not enough donors.
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Works Cited

Punch, Jeff, Kidney Transplantation: Past, Present, and Future

https://web.stanford.edu/dept/HPS/transplant/html/chronic.html

https://optn.transplant.hrsa.gov/

Choosing the treatment option that's right for you

http://www.mykidney.org/TreatmentOptions/KidneyDonation.aspx

McIntosh, James, Organ donation: is an opt-in or opt-out system better?

http://www.medicalnewstoday.com/articles/282905.php

Scheiber, Francesca, "Opt Out" Policies Increase Organ Donation

https://sparq.stanford.edu/solutions/opt-out-policies-increase-organ-donation

MLA speaks of need for opt-out donor system

http://www.londonderrysentinel.co.uk/news/health/mla-speaks-of-need-for-opt-out-donor-
system-1-7068652

Gift of Life Donor Program, Understanding the Organ Transplant Waiting List
http://www.donors1.org/patient/waitinglist/