BY TIM BONFIELD
The Cincinnati Enquirer
Beginning today, many more relatives of people who die at Tristate hospitals will be gently asked to donate their loved one's organs or tissues.
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NEW DONOR NOTIFICATION PROCESS
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Hospitals must call the Ohio Valley LifeCenter in advance of an imminent death and about all other deaths once they occur.
The LifeCenter will assess whether the patient is suitable for organ donation or tissue donation. In many cases, people who die of diseases that prevent organ donation can still give corneas, skin and other tissues.
If a patient is a potential organ donor, a LifeCenter staff member will go to the hospital to coordinate the request and handle the necessary paperwork.
For potential tissue donors, LifeCenter staff will train hospital staff to make requests. Source: Ohio Valley LifeCenter
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The change stems from a new federal regulation that requires all hospitals to notify organ procurement organizations -- such as the local Ohio Valley LifeCenter -- about all patient deaths.
The intent is to make sure as many potential organ donors as possible are approached by people trained in how to talk with grieving families.
Supporters predict the new regulation could increase organ donations by 20 percent, significantly reducing waiting times for the 60,000 patients on waiting lists nationwide.
As long as the requests are handled with proper respect, some families who have been through the process see the new regulation as a positive change -- including Brenda Collier, mother of slain Cincinnati police Spc. Ronald Jeter.
Organ donation "wasn't something we ever thought about before," Mrs. Collier said. "They came up to me in the hospital. Knowing Ron and the type of person he was, I just knew that would be the right thing to do."
Spc. Jeter was killed in the line of duty Dec. 5. His liver was donated to a 20-year-old college student who was near death. His kidneys were collected for medical research.
"Because of his liver, that coed went on to live a productive life. My son would be so proud we made that decision for him," Mrs. Collier said.
Mrs. Collier said she was surprised to learn many hospital have not been notifying organ agencies about all potential donors. But that has been the fact in Cincinnati and many cities nationwide.
Of the 2.1 million deaths that occur in hospitals every year, an estimated 15,000 could be suitable for organ donation, according to the LifeCenter. These typically involve brain death cases from car accidents, gun shots and other traumas.
However, only 5,475 such cases last year resulted in donations. Meanwhile, an estimated 4,000 Americans died waiting for an organ transplant.
Previous studies indicate many families say no to organ donation for religious or personal reasons -- which continues to be their absolute right.
However, those studies also show family responses vary widely depending on how they are approached: LifeCenter staff have a 75 percent success rate, clergy 67 percent, nurses 50 percent and treating physicians just 39 percent.
Even worse, up to 27 percent of families of potential donors are simply never asked.
In Greater Cincinnati, 50 people donated their organs in 1997 -- one of the higher annual totals for the area. However, local hospitals notified the LifeCenter in only 68 of the 91 brain death cases that occurred last year.
"With this regulation, we think we could see a 20-percent increase in donations pretty quickly," said Mark Sommerville, the LifeCenter's director of education and development.
So why haven't some hospitals been doing this all along? There are several reasons, said Dr. James Hurst, chief of staff at University Hospital, the area's leading trauma center, transplant center and largest source of donated organs.
In some towns, there is no active organ agency promoting the issue. On some busy shifts, dealing with organ donation seems like too much of a bother. Sometimes, physicians and nurses feel so sorry for families during their bereavement they don't want to bring up the subject.
The new rules will help, Dr. Hurst said, by making the organ donation question totally separate from the efforts of trauma teams to save lives. The result should be more organ donations, especially from patients who die in outlying community hospitals, Dr. Hurst said.
"We want to concentrate on care and leave the donation issue to the professionals," Dr. Hurst said.
The new regulation requires any hospital that accepts Medicare payments to notify organ agencies about potential donors -- including deaths that may be useful only for tissue donations, such as corneas, heart valves and skin for burn victims.
The American Hospital Association tried unsuccessfully to delay the regulation for a year, claiming the rule creates an administrative burden. But locally, few expect compliance to be a problem.
"In Kentucky, we've been doing requests to families for quite some time," said Ruth Henthorn, assistant vice president of nursing at St. Elizabeth Medical Center. "The change for us will be involving the LifeCenter upfront and contacting them prior to making that request."
While national hospital groups have resisted, Tristate hospitals have assumed the rule would take effect. So they've been running workshops with the LifeCenter to bring hospital staffs up to speed, said Lynn Olman, president of the Greater Cincinnati Health Council.
"We have to tweak things a little bit to make sure the calls happen every time, but we have a good relationship with the LifeCenter," Ms. Olman said. "And we certainly need the organs."
