Organ Donating

I’m an organ donor; in the event of my death, take whatever’s good and give it to someone who can use the organs. I signed up as part of a big drive a few years ago, when I was giving blood. There was a box to tick, and I didn’t need to think about it. A few days later, I was sent a card in the post that I could keep in my wallet. I’ve long since lost that card, but I’m still registered on the database (I’ve checked), so I know I’ll do some good with whatever is in vaguely working shape when I’ve croaked.

I will confess, until that moment in the blood bank when I was in my very early twenties, I’d not given the concept very much thought. It wasn’t something that really crossed my radar, and certainly wasn’t something that was very often discussed in polite society – if there is such a thing.

Why isn’t it? Is it because we’re squeamish? Do we somehow want to keep hold of our previous organs, even in death? Do we think we might need them again one day if we’re bodily resurrected like the Egyptians thought we might be? The death rites of the ancient Egyptians, at least for people thought important enough, involved removing all the person’s organs and storing them in canoptic jars near to the body until needed. Why that was important, I’m not entirely sure, but apparently there was a logic there somewhere.

There are over 6,500 people in the UK and over 120,000 in the US who are waiting for life-saving organ transplants (over 96,000 of these in the States are awaiting kidney transplants). Over 400 people in the UK died whilst on the waiting list. This is because, despite more than 500,000 people dying each year in this county, fewer than 6,000 people die in circumstances where they can become a donor.

Common transplantations include: kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Some organs and tissues can be donated by living donors, such as a kidney or part of the liver, but most donations occur after the donor has died.

The first living organ donor in a successful transplant was Ronald Lee Herrick (1931–2010), who donated a kidney to his identical twin brother in 1954. The lead surgeon, Joseph Murray, won the Nobel Prize in Physiology or Medicine in 2010 for advances in organ transplantation.

A few facts for you:

  • The youngest organ donor was a baby with anencephaly, born in 2015, who lived for only 100 minutes and donated his kidneys to an adult with renal failure.
  • The oldest known organ donor was a 107-year-old Scottish woman, whose corneas were donated after her death in 2016.
  • The oldest known organ donor for an internal organ was a 92-year-old Texas man, whose family chose to donate his liver after he died of a brain hemorrhage.
  • The oldest altruistic living organ donor was an 85-year-old woman in Britain, who donated her kidney to a stranger in 2014 after hearing how many people needed to receive a transplant.

Religion, which is incredibly vocal on most matters relating to the body, has a variety of different opinions on organ donation. Islam is split, with half believing that it’s against the faith. However, Muhammed stated that his believers should seek medical attention when in need, and saving life is a very important factor of the Islamic religion. Buddhism is mostly against the practice, because it disrespects the bodies of ancestors and nature. Christianity is the most lenient on the topic of organ donation, and believe it is a service of life.

All major religions accept organ donation in at least some form, either because of its life-saving capabilities because of the right of an individual believer to make his or her own decision. Most religions support organ donation on the grounds that it constitutes an act of charity and provides a means of saving a life; Pope Francis is an organ donor. One religious group, The Jesus Christians, became known as “The Kidney Cult” because more than half its members had donated their kidneys altruistically. Jesus Christians claim altruistic kidney donation is a great way to “Do unto others what they would want you to do unto them.” Some religions impose certain restrictions on the types of organs that may be donated and/or on the means by which organs may be harvested / transplanted. For example, Jehovah’s Witnesses require that organs be drained of any blood due to their interpretation of the  Old Testament as prohibiting blood transfusion, and Muslims require that the donor have provided written consent in advance. A few groups don’t favour organ donation; notably, these include Shinto and those who follow the customs of the Gypsies

Orthodox Judaism considers organ donation obligatory if it will save a life, as long as the donor is considered dead as defined by Jewish law.

The concept of consent in organ donation is an interesting one. There are two types of consent; explicit and presumed. Explicit consent consists of the donor giving direct consent through registration – like I did when ticking that box. Presumed consent doesn’t need direct consent from the donor or the next of kin; instead, it assumes that donation would have been permitted by the potential donor if permission was sought. Of possible donors, an estimated twenty-five percent of families refuse to donate a loved one’s organs.

As medical science advances, the number of people who could be helped by organ donors increases continuously. As opportunities to save lives increase with new technologies and procedures, the number of people willing to donate organs needs to increase as well. In order to respect individual rights, voluntary consent is key, to allow individuals to make up their own mind about what happens to their remains after death. Consent is then sought in one of two ways; “opt in” (only those who have given explicit consent are donors) and “opt out” (anyone who has not refused consent to donate is a donor). Opt-out systems dramatically increase effective rates of consent for donation (the so-called default effect, where people just go along with the norm and don’t really give it any thought). Germany, which uses an opt-in system, has an organ donation consent rate of 12% among its population, while Austria, a country with a very similar culture and economic development, but which uses an opt-out system, has a consent rate of 99.98%.

France and Wales have both introduced opt-out laws recently, and it’s changed their rates of organ donation dramatically.

In France, those who don’t want all or any of their organs to be used must now put their name on a “refusal register” – so far 150,000 people have signed up. The authorities have promised to make it easier for those who wish to refuse by allowing them to join the register online instead of by registered post.

Alternatively, those vehemently opposed to their organs being used can leave a signed document with their next-of-kin or transmit their wish orally to relatives who must make a written declaration of non-consent to doctors at the time of death.

According to the latest figures, only eight per cent of eligible adults in Wales have decided to opt out ahead of the new law coming into effect. Those over 18 will become potential donors either by registering their decision to opt in – as they do currently – or by doing nothing at all. It will apply to adults who have lived in the country for more than 12 months.

Brilliant; an opt-out easily satisfies those who have concerns, and it also allows the majority of people who, like me, don’t often give it much thought until prompted.

One last point I wanted to mention here; the prospect of people taking on personality traits of the people whose organs they have received. Sound far-fetched?

It’s certainly an intriguing theory, one that has been explored in literature, in music and on screen. From the Gothic horror of Mary Shelley’s Frankenstein to Homer Simpson turning into a murderous psychopath after undergoing a hair transplant, the idea that a medical procedure can somehow graft one person’s characteristics or traits onto another holds powerful resonance. There are claimed to be more than 70 documented cases of transplant patients taking on aspects of their donors. Some are more cheery than others.

In the US State of Georgia, a heart transplant recipient – Sonny Graham – married the former wife of his donor. Then in 2008, 12 years after the operation, he killed himself with a shotgun; exactly as his donor had done. Such a tragedy evokes the Twenties silent film the Hands of Orlac, in which a concert pianist loses both hands in a railway accident but a surgeon grafts on those belonging to a recently executed murderer. The pianist, needless to say, inherits the killer’s blood-lust along with his hands.

More prosaic, although none the less interesting for it, was a few years ago when an Australian heart transplant patient David Waters, then 24, developed an insatiable appetite for a particular type of crisp following his operation. After tracking his donor’s family down, he was told the 18-year-old donor had consumed the interestingly-named “Burger Rings” on a daily basis prior to his death.

Medical professionals remain less than convinced. Although we regard transplant surgery as routine now, organ donation remains a relatively new science. The first successful human heart transplant in the UK was in 1968 and the NHS Organ Donor Register – which more than 20 million people are signed up to – was established just two decades ago. There has been little to no research done on what else may be being transmitted alongside human cells.

Much of this is down to the fact that monitoring shared personalities is hardly an exact science. Also, due to the anonymity of organ donors, it is almost impossible to track behavioural patterns between them and recipients. Mr Mashford only found out that his donor was a cyclist after pleading for additional information.

A more likely explanation for any personality change following an operation, scientists suggests, is the zest for life that a new organ brings. A grandfather from Massachussetts, Richard Mangino is a case in point. The quadruple amputee underwent a double hand transplant at the age of 65 in 2011 and his recovery has led to him drawing, painting, and re-learning the piano. He has also – in between doing chores around the home – applied his new limbs to learning Pretty Woman on the guitar.

I think I’d be inspired too, if I received something so precious to life; I just hope I’d be inspired to make the most of my new-found freedom.

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