Donate Life: An Overview of Organ, Tissue and Eye Donation University of Wisconsin Organ Procurement Organization

Why is donation so important?

The numbers speak for themselves: More than 112,000 people in the United States are waiting for a transplant More than 2,500 on the list are children Every 11 minutes – another name is added to the waiting list 19 people die every day because they didn’t get the organ they needed in time 3

U.S. Transplant Waiting List Type of Transplant # of Patients Waiting Kidney 90,023 Liver 16,181 Heart 3,141 Kidney-pancreas 2,121 Lung 1,755 Pancreas 1,353 Intestines 263 Heart-lung 74 Total people waiting 112,414 Source: Organ Procurement and Transplant Network Updated 10/13/11

Wisconsin Transplant Waiting List Type of Transplant # of Patients Waiting Kidney 1,495 Liver 207 Heart 82 Lung 55 Kidney-pancreas 45 Pancreas 15 Intestine 3 Heart-lung 0 Total people waiting 1,859 Source: Organ Procurement and Transplant Network Updated 10/13/2011

Challenges Across the Nation We need to close this gap! 1988 16,026 12,262 5,907 Patients Waiting Transplants Performed Organ Donors 2010 110,375 28,662 14,508 Increase +94,349 (589%) +16,400 (134%) +8,601 (146%) 22 Year Span OPTN data: 8/25/2011 YesIWillWisconsin.com

Why are we learning this in driver’s education class?

Kelly Nachreiner Law (Wisconsin Act 124) Signed by Governor Tommy Thompson on May 9, 2000 Requires all driver’s education programs in Wisconsin to give at least thirty minutes of instruction on organ and tissue donation The law was the first of its kind in the U.S. There are now more than 12 other similar educational mandates Kelly Nachreiner, Sauk City, WI Organ donor on January 4, 2000

What organs can be donated?

Kidneys We have two kidneys that can be given to two different recipients for conditions such as: End stage renal disease Diabetes with renal disease High blood pressure Polycystic kidney disease

Heart For conditions such as: Cardiomyopathy Coronary artery disease Congenital heart disease Valvular heart diseases

Lungs For conditions such as: Emphysema/COPD Cystic fibrosis Pulmonary fibrosis Primary pulmonary hypertension Congenital defects

Liver For conditions such as: Hepatitis A,B,C Cirrhosis Alcohol Medications Biliary disease Metabolic Neoplasms

Isolated pancreas For conditions such as: Diabetes Type I without renal disease Hypoglycemic unawareness Pancreas after kidney transplant

Simultaneous kidney-pancreas For conditions such as: Diabetes Type I with end-stage renal disease

Small intestine For conditions such as: Short gut syndrome Severe vascular disease Small intestine is frequently transplanted in children

What tissues can be donated?

Eyes (corneas) Skin Bone Connective tissue Ligaments Tendons Heart for valves/pericardium Arteries and veins

Eye Donation Cornea transplants become necessary when the cornea becomes cloudy or damaged due to disease, injury or hereditary conditions Other eye tissue can be used for transplant, research and/or education Almost anyone can be an eye donor, even patients with poor eyesight, those who wear glasses or contacts and patients with diseases like diabetes and cancer More than 45,000 cornea transplant surgeries are performed each year in the U.S.

The difference between organ donation and tissue/eye donation Occurs in the first 24 hours after the heart has stopped beating The tissues can be preserved and used at a later date This is a life-enhancing procedure Organ Donation The patient must be in a hospital on a ventilator The organs must be properly preserved and transplanted quickly This is a life-saving procedure

Through organ, eye and tissue donation... 1 person can: Save 8 lives (organ donation) Improve >50 lives (tissue and eye donation)

Common Questions about Donation

Who can be a donor? Anyone can sign up/register People should base their decision on how they feel about donation. Pre-existing medical conditions won’t necessarily exclude anyone from being a donor People of all ages should make their decision and let the medical professionals determine if they’re eligible at the time of their death

Will the doctors do everything they can to try and save me if they know my wishes to be a donor? Yes. The organ procurement professionals are a separate team of people from the medical team that is treating the patient. This ensures that there is no conflict of interest Donation is only considered after all efforts to save a patient’s life have been exhausted by the medical team Organ recovery only occurs after death has been declared

How does religion relate to organ donation? The majority of religions support organ donation Most religions view organ and tissue donation as a charitable act People should talk to their religious leader about donation if they need clarification

Will donation disfigure the body? No. Organs are removed through a surgical procedure, in an operating room Areas where tissue donation occurs are reconstructed and can be concealed by clothing Open casket funerals can occur following donation 26

Does donation cost a family money? No. Each recovering agency pays for all expenses associated with the donation process Those costs are passed on to the recipients and their insurance companies The donor’s family is responsible for the funeral expenses 27

Will donation cause any delays with funeral arrangements? No. The recovering agency will make certain the donor’s body is released to the funeral home on time No extra planning is required by families of organ and tissue donors 28

Can you pay to get an organ? Organ allocation is strictly regulated by the federal government. Donated organs are matched to the recipients according to these criteria: Blood type Medical urgency Tissue match Waiting time Organ size Immune status Geographic distance

Will the organs be transplanted locally? Yes, if: There are local recipients who match the organ There are no status one* patients in our region. (This rule applies to livers only.) There are no wait list patients in the U.S. who are a perfect tissue type match. (This rule applies to kidneys only.) * A status one liver transplant candidate is the most medically urgent patient on the list and is likely to die within one week without a transplant. Approximately 85-90 percent of all organs donated in the our state are used for transplants here in Wisconsin

Can the donor family and recipients meet each other? Yes. Initial contact is coordinated by the OPO, due to federal privacy regulations All recipients are encouraged to write to their donor families Meetings can be arranged if both parties sign a consent/ release of information form

Who will decide if I become a donor? Your legal next of kin. If a person’s donation decision isn’t documented (such as being on the Donor Registry), the legal next of kin hierarchy is the order in which consent for donation is pursued: Healthcare Agent Spouse Adult Children Parents Adult Siblings Adult Grandchildren Grandparents An adult who exhibited special care & concern Legal Guardian Coroner or Medical Examiner 32

What is the Wisconsin Donor Registry? Launched on March 29, 2010, the registry allows anyone with a Wisconsin Driver’s License or State ID card to legally register to become a donor online at any time at: YesIWillWisconsin.com Registering to be a donor now is legally binding and cannot be overruled at the time of your death by a family member or legal next of kin if you are over the age of 18.

What if I already have an orange DONOR dot? Even if someone already has an orange DONOR dot on their license – if their last license was issued or renewed before March 29, 2010 – they still need to visit the registry website once in order to be entered into the new Wisconsin Donor Registry Each time you sign up for a new license/ID card or renew your existing license/ID card – you need to continue to answer YES to the donation question on the application form in order to remain on the Wisconsin Donor Registry If you decide later that you want to remove yourself from the registry – you can do so online at the same website.

You Can Make a Difference On October 13, 2011, the Wisconsin Donor Registry reached 1 million registered donors, but: Here in Wisconsin, more than 77 percent of all licensed drivers and/or state ID card holders still aren’t listed on the Wisconsin Donor Registry Nationally, the U.S. had registered 100 million donors by this same date. The national goal is to register 20 million more donors before the end of 2012

Why is it so important to register? Less than five percent of people die in a hospital on a ventilator. We need everyone who wishes to donate to register, so more people will receive a transplant.

What should I do now? The Two D’s: Decide Take action and sign up to be a donor at any time by going to: YesIWillWisconsin.com and clicking on the orange DONATE button. You can also sign-up to be a donor at the DMV office where you get your license. 2. Discuss Talk to your family about your decision to be a donor – until you turn 18 – your family can overrule your donation decision.

lives are changed forever Through donation lives are changed forever

Take Action! Register online at YesIWillWisconsin.com and Talk your family about your decision