The Writer’s Guide to Organ Donation & Transplantation Part 1: Myths and Facts

Hey all! Welcome back to Aunt Scripty’s Little Shop of Organs. Today we’re going to talk about one of the most amazing parts of modern medicine: organ donation and transplantation.

We’re going to cover some myths about organ donation that are prevalent in our society, then cover a whole mess of facts.

Myth: Organ Donors Receive Less Care.

Here’s how the myth goes: when you’re hurt and almost dead, the organ donation people will encourage doctors not to save your life in order to preserve your organs.

Fact: Organ Donors May Receive More Care.

The critically ill and injured who are also organ donors are cared for by teams of doctors whose interest is purely in saving their life. Only after they are diagnosed as dead or brain-dead is organ donation and harvesting even a consideration.

Deceased organ donation occurs only after a diagnosis of death or brain death. That means that the brain has to be completely non-functional. The test to determine brain death is wholly scientific and involves testing deep brain reflexes and taking the character off the ventilator. If they make even one attempt at a breath, they are not brain-dead, and are not eligible for organ donation.

Once the diagnosis is made, most doctors would simply cease care. Their patient is dead. But for organ donors, their care continues, often at great cost, and in many cases for multiple days after the diagnosis.

If they’re not already in there, they’ll be admitted to the ICU. The goals of care for the donor are the same for any ICU patient: ensure they’re warm, ensure they’re oxygenating well, ensure that the organs are getting excellent flow of blood, sugar, and oxygen. The character with an organ donor card will have many more heartbeats after death than the one who is not.

Oh, and the donor’s family and insurance are charged for all care given before the diagnosis of brain death — but not for any of the care that occurs afterward. That care is paid for by the recipient’s insurance, typically Medicare and Medicaid in the US.

This Myth is Harmful Because: The pervasive myth that doctors won’t work to save your life if you’re an organ donor decreases donor enrollment and makes it harder to convince families to permit donation in those who are not already registered.

 

Myth: Organ Donation Precludes an Open Casket

Because multiple surgeries have been done to harvest the organs, the character cannot be buried with an open casket after organ donation. Maybe they even cremate the remains after harvest!

Fact: Organ Donors Have Open Casket Funerals All the Time

The organ harvest surgeries involved are largely in the chest, which means that the donor characters have no visible wounds once the body has been dressed. All incisions during the harvest process are closed, meaning that, on the outside, the character will look the same.

The one exception to this, which is still incredibly rare, is facial transplantation. But even eye donation doesn’t preclude an open casket.

This Myth is Harmful Because: …again, it prevents potential donors from signing up for the donor registry.

 

Myth: Organ Donors Don’t Save That Many Lives, Anyway

So few people are organ donors, and they are in such bad shape anyway, that really, why bother?

FactOh Yes They Do 

Organ donors save up to eight lives with their gift, and can donate a slew of tissue. Each donor can give:

  • Heart (One life)
  • Lungs (Two lives)
  • Kidneys (Two lives)
  • Liver (One life if transplanted whole, but the liver can be split and two lives can be saved. I’ve heard of twins being saved by a split-liver transplant.)
  • Pancreas (One life)
  • Corneas and Eyes
  • Skin for grafts, which can save lives in burns cases or severe allergic reaction
  • Even if the heart isn’t viable for transplantation, they can still give heart components such as valves

Every 10 minutes, another person is added to a transplant recipient list, and 21 people die every day waiting for an organ. The United Network for Organ Sharing says that over 110,000 Americans are currently waiting for life-saving transplants.

 

Myth: The Decedent’s Families Can Overrule Their Wishes

Even if a character is a registered organ donor and has made their wishes known, they’re unable to consent after their demise. Their family can overrule their decision and decide not to donate on whatever grounds they like, especially religious.

Fact: This Is Sometimes, But Not Always, True

In a great many places, a family can overrule the withes of the deceased character and choose not to donate. (Though — and this conversation is well outside my sphere of knowledge, so I’m taking it on faith — UNOS and many other groups claim that organ donation is in line with “every major religion.”)

The UK actually has [a bit of a crisis] with families overruling organ donation, and over a thousand lives have been lost because of those decisions.

However, this isn’t the case everywhere. According to [this article in 2006], 45 states in the US have “registries of consent,” meaning that the organ donor’s wishes overrule their families’ when determining whether to donate; that number may have gone up since then. In these states, consent for donation and related testing actually rests with the local organ donation network, and the coordinators there make decisions about their care.

 

For More Facts…

Here are some more awesome FAQs about organ donation and transplantation from:

[The United Network for Organ Sharing (UNOS)]

[The Mayo Clinic]

[Organ Procurement and Transplantation Network — US Dept of Health]

[OrganDonor.gov]

 

Next Time…

Next time on The Writer’s Guide to Organ Donation & Transplantation, we’re going to talk about tissue matching and how recipients are selected. To see the whole series of articles, check out [this link].

xoxo, Aunt Scripty

[disclaimer]

[Maim Your Characters: How Injuries Work in Fiction]

[10 B.S. Medical Tropes that Need to Die Today]

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