Dr. Robert G. Gish, MD
Emergency Room Physician
I've worked as an emergency room physician in Northern California for eleven years, and I am sure that my experiences are similar to those of critical care doctors and emergency room doctors throughout the country. Trauma victims make up the majority of organ donors. They are people who one minute are healthy and the next minute have suffered a catastrophic injury. Family members are often in a state of shock after hearing the news and trying to comprehend an overwhelming situation. At some point in the discussions we then try transition to "and there's one more thing I would like to discuss with you." At that point, we ask if the person had ever discussed his wishes regarding organ donation. Usually, the answer is no. In rare instances, the reply is "yes, he definitely wanted to be a donor and wrote it in his will," or "yes he would not have wanted donation." It is not unusual to for the family to say no he never discussed it, and then the victims drivers license is produced with the organ donor designation, unbeknownst to the family. In the majority of cases where is was not both explicitly written and discussed with family members, families will choose not to donate. It is a huge decision for a family member to make in a time or crisis and grief. If you are serious about donating your organs if the situation arose, and also would like to spare your family
a "what would he have wanted" decision, it is crucial to lay down the appropriate groundwork ahead of time. State you wishes in your will or other signed document. Get the designation on your driver's license. Make your thoughts on the subject known to your family. And then, if you yourself have any second thoughts , try to imagine that you have been on a waiting list for a life sustaining transplant for two years, and suddenly got the gift of a lifetime, a call from the regional transplant center saying that it was your turn.
Dr. Howard Schwartz. MD
Chief, Emergency Department
Kaiser Vallejo Hospital
Colonel Maria Sjogren, MD
Veterans Administration Medical Center
Hepatitis C is the leading indication for liver transplantation in veterans, accounting for more than 50% of transplants performed. The outcomes of veterans following liver transplantation are comparable to those of non-veterans. Waiting times for organs at VA liver transplant centers are long, in part due to the referral of these patients from all over the country to 2-3 centers, but in greater part due to the critical national shortage of donors.
There have been two mechanisms for veterans to undergo liver transplantation 1) At one of three VA Medical Centers specializing in liver transplantation (Portland, Pittsburgh and Nashville) or 2) through sharing agreements between the VA and local University hospitals where liver transplantation is performed. Recently, liver transplants at the Pittsburgh VA have been halted, so that Portland and Nashville are the main programs. The patients are then brought to these medical centers for formal evaluation and if considered to be suitable candidates, are placed on the liver transplant waiting list.
Dr. Teresa L. Wright, MD
Heart Transplant Program Director Brooke
Army Medical Center
The military has one heart transplant program at Brooke Army Medical Center (BAMC) in San Antonio, Texas. We also have a liver and kidney transplant program at Walter Reed Army Medical Center (WRAMC) and Bone Marrow Transplant Programs at BAMC, WRAMC and Wilford Hall Air Force Medical Center. All of these programs have been very successful in providing their services to our military family. You may be surprised to learn that half of our heart transplant patients have been young active duty soldiers when they became ill. Cardiomyopathy, which is the leading cause of heart failure requiring transplantation, is a disease of young active people--many of whom develop it as a result of a viral infection. The rest of our patients are dependents of active duty soldiers and retirees.
We are proud, as military physicians, to be able to provide whatever medical care is necessary for our soldiers and their families. In this case, caring for that need requires the unselfish "gift of life" from families at the time of their most profound sadness. It is impossible to express our gratitude for such an act.
David J. Cohen, M.D.