A tough medical assignment

5/27/2003

FEW tasks require more sensitivity and acumen than approaching relatives of a person on life support, a patient with no brain activity and no hope of recovery, for permission to harvest the loved one's organs for transplantation.

And few jobs are more critical. About 81,600 people are awaiting organ transplants nationally, and 6,000 die each year because organs are not available. In Ohio alone, the waiting list is 2,500 names long.

A botched request for organs means a longer wait for some patient who already is seriously ill, and a greater risk of death.

The natural assumption is that individuals responsible for this task, staff members at the 59 “organ procurement agencies” nationwide, are prepared with careful classroom instruction, perhaps at the graduate level. Surprisingly enough, that's not quite true.

So the Medical College of Ohio deserves praise and the national recognition now accruing for its decision to remedy that situation by starting the first such training program in the United States.

Scheduled to begin in September, the one-year graduate certificate program will train nurses and other individuals who staff organ procurement agencies.

These critical links in the organ transplantation system work with donors, including families of terminal patients on life support, to obtain permission for doctors to remove and transplant organs.

Life Connection of Ohio, the local organ procurement agency with offices in Maumee and Dayton, which serve 23 counties in northwest and north-central Ohio, urged MCO to establish the program. And it generously provided cash-strapped MCO with $50,000 to help fund the program.

Organ procurement agency staff often seek permission from families who have just been informed of a loved one's death, or told there's no hope of recovery from a coma. In death, a beloved child or spouse can give life to another person - but only if the family consents.

There's little time to make such points in a sensitive, effective way, since the organs remain viable for just a brief period. And they seek this gift of life at a time when relatives may be struggling in the cold embrace of shock, vulnerability, anger, and other emotional turmoil.

Despite those demands, it has been a learn-as-you-go matter for the 3,000 individuals engaged in this activity. Frustration is common, as relatives all-too-often pass up the opportunity to find more meaning in death.

As the first in the United States, MCO's program already has attracted wide attention. For instance, the Center for Organ Recovery and Education in Pittsburgh, a city with renowned transplant facilities, donated $25,000 to help start the MCO program.

This innovative effort is bound to have a positive impact locally and nationally in increasing the supply of organs for transplantation, shortening waiting lists, and saving lives.