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OCR for page 281
Organ Donation: Opportunities for Action 10 Opportunities for Action The recommendations provided in this report set forth a number of actions that the committee believes can have a positive impact on organ donation (Table 10-1). Together, these recommendations identify a set of actions that in isolation might have only limited results but that in concert should strengthen ongoing efforts and open up new opportunities to increase the supply of transplantable organs, thereby saving the lives and improving the quality of life of many individuals. The committee believes that it is possible to increase the opportunities for organ donation in the two populations of deceased donors: individuals whose deaths have been determined by neurologic criteria and individuals whose deaths have been determined by circulatory criteria. It has been estimated that each year organs are recoverable from approximately 10,500 to 16,800 individuals whose deaths are determined by neurologic criteria. Currently, however, approximately only half of these individuals become organ donors. Nevertheless, more and more organ procurement organizations and hospitals are increasing their donation rates and some are approaching or are achieving 75 percent conversion rates. Increased quality improvement, organ donor registration, education, and research efforts have the potential to sustain these increases and to realize similar increases in other institutions. Additionally, the committee estimates that each year in the United States organs are potentially recoverable from 22,000 individuals whose deaths are determined by circulatory criteria. This population of potential donors is only beginning to be recognized. In 2004, there were 391 dona-
OCR for page 282
Organ Donation: Opportunities for Action TABLE 10-1 Actions to Increase Organ Donation Individuals Register as an organ donor through driver’s license, donor card, or donor registry Inform family members of organ donation decisions Families Discuss organ donation decisions Honor prior donation decisions made by the deceased family member Provide consent for donation if the deceased family member did not make a decision regarding donation Healthcare, emergency care, and transplantation systems Implement system changes Sustain mechanisms and support for continuous quality improvement Integrate organ donation and end-of-life care practices and services Expand donation opportunities Increase opportunities for donation after circulatory determination of death Expand and enhance professional education about organ donation and end-of-life care Nonprofit organizations, academia, government, media, employers Provide multiple opportunities for donor registration and education Encourage registration through donor cards, driver’s licenses, or donor registries Promote programs to increase donor awareness Improve media coverage to increase public awareness and reduce misperceptions Increase public education Coordinate efforts through the use of Donor registries Uniform state laws Fund research on innovative approaches to increasing rates of organ donation and enhancing organ viability tions after circulatory determination of death (DCDD). Although the committee recognizes the challenges in developing and implementing DCDD programs, the opportunity to save lives necessitates a careful effort to fully explore the recovery of organs after the circulatory determination of death. It is the committee’s hope that this report will contribute to the development and implementation of new efforts to increase the rates of organ donation. In addition, the committee hopes that these efforts, along with concurrent actions focused on the prevention of health conditions that lead to the need for transplantation and research to explore alternatives to transplantation, will significantly reduce the size of the organ transplant waiting list in the near future.
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