Are You An Organ Donor?


    Dr. Radi Zaki, chairman of the Division of Transplantation at Einstein Medical Center Philadelphia, explains why organ donation is the ultimate mitzvah.

    Why Organ Donation Is The Ultimate Mitzvah with Dr. Radi Zaki, Chairman, Division of Transplantation, Einstein Medical Center Philadelphia

    Physicians aren’t the only ones who save lives; so do organ donors. At Einstein Medical Center, approximately 25 liver transplants and 90 kidney transplants are performed every year. As chairman of Einstein’s transplantation division, Dr. Radi Zaki knows that the death of one person can save the life of another. But he also knows that there are not enough organs to supply the needs of patients who fill waiting lists. In October, 2013, more than 2,330 patients were on the waiting list for livers and more than 13,980 patients were on the waiting list for kidney donations. That’s just in the Philadelphia region; the nationwide need is much greater.

    Which organs are most needed?

    “We look at that two ways: by pure volume and by medical need,” Zaki explains. “By volume, there is more demand for kidney donations. That’s because there are so many Americans – more than 80,000 of them on are on the waiting list – with renal disease caused by high blood pressure, diabetes and a variety of other diseases.” Renal disease is usually not a critical condition because patients can be maintained by dialysis, Zaki says. But dialysis is not a long-term solution because it shortens patients’ lives. It also severely deteriorates the quality of the lives they lead while waiting for donated kidneys.

    When it comes to medical need, hearts, lungs and livers are the most in-demand organs, Zaki says.  There is no option like dialysis for them. Transplants are the only option.

    What should potential donors do to make their wishes known? Is having “organ donor” on your driver’s license enough?

    “The driver’s license is the starting point,” Zaki says. “And it’s amazing that the path to saving someone’s life begins when you’re in line at the DMV. But it is also important to make your wishes known to your family and friends. It’s best if they don’t have to guess about your desire to be an donor.”

    What is the process of finding the right patient for a donated organ?

    Allocation of donated organs is regulated by the United Network for Organ Sharing (UNOS), Zaki explains. Each organ has its own policies to determine patients’ need. For example, a mathematical equation called Model for End-Stage Liver Disease (MELD), results in a number that determines the order in which patients are placed on the waiting list for livers.

    The allocation process for kidneys, hearts and lungs is based on the length of time that patients have been waiting for a donation, Zaki explains. The longer the wait, the higher someone is on the list. Other factors come into play, including blood type, tissue type, the potential recipient’s availability and whether or not he or she is healthy enough for immediate surgery.

    What role does geography play?

    The United States is divided into 11 regions based on population density and, therefore, need and availability of organs, Zaki explains. When an organ becomes available, it is first offered to a patient within the region. The Philadelphia area is in Region 2, which includes Pennsylvania, Delaware, District of Columbia, Maryland, New Jersey, West Virginia and Northern Virginia. Gift Of Life is the organ procurement organization in our immediate area of eastern Pennsylvania, South Jersey and Delaware.

    Do families know who received their loved ones’ organs?

    “Families are told that the organs have been transplanted, but not who received them,” Zaki says. “But the recipient usually writes thank you letters, and sometimes letters are sent back and forth via Gift Of Life. It becomes an incredibly emotional but wonderful kind of communication because it truly is a matter of one person’s death saving the life of another person.”

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