Questions for Dr. Bhargav Mistry

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In Fall 2006 Dr. Bhargav Mistry answered visitors' questions about organ donation.

Your Comments, Thoughts, Questions, Ideas

Anonymous's picture
Anonymous says:

Do you think it is ethical to receive an organ or tissue transplant if you're not willing to donate yourself?

posted on Tue, 10/24/2006 - 3:08pm
Bhargav Mistry's picture

We have to be careful not to assume that people who haven't designated themselves as donors don't want to donate. In fact, research shows that nine out of ten Americans support organ and tissue donation, but only 34 percent know how to make a legal commitment to do so. Minnesota residents can document their wishes online by going to www.DonateLifeMN.org; residents from other states can visit www.DonateLife.net to find out how to document their wishes in their state.

The organ allocation system is based on fairness and equity; the
system is designed to ensure those most in need receive a transplant first. It would be simply unfair to punish individuals and their families facing dire illness because of their past personal beliefs or lack of understanding. Additionally, you'll see in the previous question that I talked about donation as a GIFT and, in our society, we give gifts without the expectation of a gift in return.

posted on Wed, 11/01/2006 - 4:13pm
Anonymous's picture
Anonymous says:

Why are "opt-in" donation programs (i.e. you tell your family and health care providers that you want to donate) considered more ethical than "opt-out" programs (i.e. it's assumed that you want to donate unless you specifically tell someone that you don't)?

posted on Tue, 10/24/2006 - 3:08pm
Bhargav Mistry's picture

Our society views organ and tissue donation as a gift given with
thought, love, and compassion for fellow man. It is this act of giving and helping others that motivates people to say yes to donation. It is also something that provides great comfort to donor families knowing that their loved was able to help those in need.

The act of gifting (monetary or otherwise) has always been driven by the person who wants to GIVE a gift. This notion extends through time and includes wills, birthdays, holidays and the like.

Ethically, we all know you should never TAKE a gift that wasn't meant for you. With the current "opt-in" system, we can all be assured that the person meant to give the gift of life to someone else who is in desperate need of a transplant.

posted on Wed, 11/01/2006 - 4:06pm
Anonymous's picture
Anonymous says:

Why don't more people become donors? It seems like an easy choice to make.

posted on Tue, 10/24/2006 - 3:12pm
Bhargav Mistry's picture

It does seem like an easy choice to make, and for many people it is; organ donation rates in Minnesota and across the country continue to increase at a rate we've never seen before. However, there is still a long way to go until we no longer have people dying on the transplant waiting list. There are currently more than 93,000 people waiting for a transplant in the US, including more than 2,200 in Minnesota. Each day 100 people are added to the national waiting list and there are 17 preventable deaths simply because not enough people have said yes to donation.

We want to move to a day when everyone says yes to donation because it's the right thing to do. Analysts who have studied public attitudes about donation have reported that 9 out of 10 Americans support donation as a generous and noble act, so we can safely say that it's not because people don't want to help their fellow citizens.

The most often cited reasons we hear as to why people haven't documented their wish to donate is simply because they haven't gotten around to it; they haven't thought about it before; they didn't understand the process of donation and the benefits to recipients. Additionally, many people assume they can't donate due to age or medical conditions when in fact that is usually not the case. These statements of misinformation or misunderstanding is why it is so important that there continue to be a public dialogue about this important health issue and that LifeSource continue to educate the public about donation so that Minnesotans can make an informed, positive decision about donation.

posted on Wed, 11/01/2006 - 4:01pm
Anonymous's picture
Anonymous says:

On my drivers license it states that I am a donor but if my family is against it could they change it? Thank You.

posted on Sun, 11/05/2006 - 10:10am
Bhargav Mistry's picture

We believe in the right of every individual to make their own decisions about their healthcare, and the option of donation is no different. If you have the right to make decisions about your body during your lifetime, that right should extend to what happens to your body after death.

In Minnesota, the donor designation on your driver’s license or in the online donor registry is legal authorization for donation and will ensure that your wish to save lives is fulfilled. At the time of donation, a LifeSource Donation Coordinator explains to your loved ones that it was your wish to help save lives through organ and tissue donation, walks through the process and answers any questions your family may have. We often find that families who know that it was their loved one’s wish to help others are happy to help make that wish a reality.

LifeSource also has a comprehensive family services program. Donor families are supported both at the time of donation and afterward. For as long as families would like, they are able to participate in our program of support from two dedicated Family Services Coordinators, remembrance events, support literature and referrals to more intensive grief counseling and support groups.

posted on Sun, 11/12/2006 - 9:39am
Anonymous's picture
Anonymous says:

i was wondering. . . i have donor on my drivers licence. i heard that if you are almost dead, but not quite they sometimes dont try to save you because someone else needs a body part of theirs. is that true. . . could that really happen?

posted on Sun, 11/05/2006 - 10:10am
Bhargav Mistry's picture

This is a very common misconception that we often get asked. The truth is that medical professionals will do everything they can to save your life; they took an oath to save lives. Organ and tissue donation is offered to your family only after all life-saving measures have failed and there is no chance for survival. Additionally, the doctors and nurses who would be treating you at the hospital are completely separate from the transplant team so that there is no conflict of interest.

posted on Sun, 11/12/2006 - 9:40am
Anonymous's picture
Anonymous says:

How old do you have to be to be an organ donor?

posted on Sun, 11/05/2006 - 10:11am
Bhargav Mistry's picture

People of all ages can be organ donors, from the very young to the elderly. Earlier this year in our region, two very generous parents who lost their child at birth were able to look past their grief and donate their child’s organs and tissues. Because of that decision, another set of parents were able to avoid the same fate because their child received the gift of life.

On the other end of the spectrum, we are now able to transplant organs from older individuals and have successful outcomes. Recently a generous man from Texas set the record for the oldest organ donor in United States history. At 93 years old, he was able to give the gift of a liver transplant to a 69 year old woman who now has renewed hope and life.

If you are interested in becoming an organ and tissue donor, simply put it on your driver’s license or register online at www.DonateLifeMN.org. If you are under the age of 18, your parents or legal guardian will be asked to consent to donation on your behalf. For Minnesotans 18 years of age and older, the donor document of gift serves as legal authorization for donation and we have an obligation to help ensure your wish is fulfilled.

posted on Sun, 11/12/2006 - 9:40am
Anonymous's picture
Anonymous says:

Are organs from unclaimed bodies used for donation purposes?

posted on Sun, 11/05/2006 - 10:11am
Bhargav Mistry's picture

I am not sure what you mean by “unclaimed bodies.” In order for someone to be a solid-organ donor, they must have a devastating neurological injury and be maintained on a ventilator in a hospital. In order for donation to move forward after someone has died, we need to either know that they had made the decision to be an organ and tissue donor on their driver’s license or through the online registry or we need to have a conversation with their next-of-kin to obtain consent for donation. If we did not know the identity of the potential donor, we would not be able to verify their wishes or speak with their family. So, in this case, donation would not occur.

posted on Sun, 11/12/2006 - 9:41am
Anonymous's picture
Anonymous says:

If I have a heart defect ISVD - would my body still be of use?

posted on Sun, 11/05/2006 - 2:54pm
Bhargav Mistry's picture

While medical history is a factor for organ and tissue donation, most people CAN help save lives through donation. The only individuals who cannot donate at this time are those who test positive for the HIV virus.

If there is something that would prevent the donation of your heart, that doesn’t automatically rule out the gifts of your lungs, kidneys, liver, pancreas, intestine and many tissues. If you believe in helping others through the gift of organ and tissue donation you can put it on your driver’s license or sign up online. At the time of death, medical professionals assess the health of each organ prior to transplant to help ensure the best possible outcomes for the recipients.

posted on Sun, 11/12/2006 - 9:42am
Anonymous's picture
Anonymous says:

I've heard that minorities should be particularly concerned about and interested in organ donation. Why is that? Is organ donation race specific? Why?

posted on Thu, 11/16/2006 - 3:17pm
Bhargav Mistry's picture

You are correct that minorities should be particularly concerned about organ donation. Some diseases of the kidneys, heart, lung, pancreas and liver are found more frequently in racial and ethnic minority populations; approximately 50% of the people on the national waiting list for a solid organ transplant are minorities. Transplantation is more likely to be successful if there is a strong genetic match between donor and recipient, and stronger genetic matches can many times be found between people of the same racial or ethnic group. Currently, only about 25% of organ donors are minorities, which is disproportionate from the number of minorities waiting for transplant. If more people from racial and ethnic minority populations became donors, it would likely shorten the waiting time not only for minorities, but for everyone on the list.

However, I want to be clear that organ donation is NOT race specific. It is true, as I stated above, that individuals are more likely to find a genetic match within their own racial or ethnic group. However, race and ethnicity are not used as part of the matching process, and individuals who are waiting for a transplant can receive an organ from anyone of any race, so long as they are a match.

posted on Tue, 11/28/2006 - 3:00pm
Anonymous's picture
Anonymous says:

When was the first organ transplant?

posted on Thu, 11/16/2006 - 3:19pm
Bhargav Mistry's picture

The first successful organ transplant was in 1954 in Boston between identical twin brothers Ronald and Richard Herrick. Dr. Joseph Murray performed the kidney transplant, removing one of Ronald’s kidneys and transplanting it into Richard. At that time, doctors hadn’t yet discovered how to trick the immune system of the recipient so it was necessary that the donor and recipient be identical twins. Now, of course, transplant recipients are on a regimen of immunosuppressant drugs that keep their body from rejecting their new organ. In the time since this first transplant, science has reached many milestones and organ transplantation is an effective cure for many diseases of the heart, lungs, liver, kidneys, pancreas and intestine.

posted on Tue, 11/28/2006 - 3:01pm
Anonymous's picture
Anonymous says:

Does being a donor cause delays to funeral arrangements?

posted on Thu, 11/16/2006 - 3:21pm
Bhargav Mistry's picture

No, donation shouldn’t cause a delay for funeral arrangements. The donation coordinator will work with your family and the funeral director so that you are able to save lives through donation and your family can celebrate your life in the manner that they choose.

posted on Tue, 11/28/2006 - 3:01pm
Anonymous's picture
Anonymous says:

Does donation leave the body disfigured preventing an open casket cermony at the funeral?

posted on Thu, 11/16/2006 - 3:22pm
Bhargav Mistry's picture

No, donation does not prevent an open casket funeral. The recovery of organs and tissues is a surgical procedure that takes place with great care, dignity and respect for the body.

posted on Tue, 11/28/2006 - 3:01pm
Anonymous's picture
Anonymous says:

What sort of organs are the most valuable for donation, or the most vital organs in the body?

posted on Sat, 11/18/2006 - 4:58pm
Bhargav Mistry's picture

Every organ in the body is vital in order for a person to be healthy. If you are asking which organ is most in need, the answer is kidney. 63,000 of the more than 93,000 patients awaiting a solid organ transplant are waiting for a kidney. However, individuals waiting for a kidney transplant are able to be sustained on dialysis – a process of cleansing the blood – until they can receive their transplant. Also, because everyone has two kidneys, people with kidney disease are able to receive their gift from a living donor as well as a deceased donor. Liver and lungs are also able to be transplanted from a living donor, although they are much more rare (especially living lung transplants, where you need two donors for each recipient and each donor contributes a lobe of their lung to the recipient).

However, there are fewer treatments for diseases of the heart and many diseases of the lungs. All heart transplants must come from a deceased donor, as must most lung transplants. So, if you are asking for which organs are transplant from a deceased donor the only option, the most critical ones would be heart and lung.

posted on Tue, 11/28/2006 - 3:02pm