BY TONI LAPP
It's a conundrum of modern medicine: Despite having more organ donors than ever before, there are still more patients than ever waiting for life-saving transplants.
According to the Organ Procurement and Transplantation Network, in 1998, 5,900 donors led to transplants in 12,600 individuals from a waiting list of 15,000. In 2001, 12,973 donors furnished transplants for 24,000 individuals. But the waiting list had grown to 80,000.
The best way to encourage patients to become organ donors is to talk about it -- and set an example, says Christine Petty, M.D., of Moline, Ill., vice president of medical management for John Deere Health Care. Petty is a member of the AAFP Commission on Health Care Services.
"Not only do we need to talk to patients about end-of-life issues, but we must communicate the need for organ donations," she says. "We as physicians can be an active piece of that puzzle."
Petty, a past president of the Illinois AFP, felt strongly enough to draft a resolution that the 2002 Congress of Delegates passed last October to encourage more education about the issue.
Says Petty: "I've had patients who've had unfortunate injuries, and I've discussed with those patients the possibility of being an organ donor -- and that's a difficult situation. But it's better to discuss prior to an unfortunate accident or illness."
"The more times people hear about it, the more inclined they'll be to become an organ donor," she says. "Especially when they hear about it from their doctor whom they respect -- and especially if their doctor can say, 'I plan to be an organ donor myself.'"
Perhaps most frustrating are the disparities among minorities. Transplant success rates increase when organs are matched between members of the same ethnic and racial group. Yet at present, for example, 12 percent of the U.S. population is African-American, but 35 percent of all patients waiting for a kidney transplant are African-American.
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For a downloadable organ donor card, go to
http://www.organdonor.gov/ |
Often cultural barriers and health illiteracy make it difficult to disseminate education, says one doctor.
"My patients have a hard enough time grasping the concepts of their current illnesses, let alone the possibility of giving the gift of life," says Edgar Figueroa, M.D., who sees a large Latino population as chief resident at the family practice residency program at New York-Presbyterian Hospital in New York City.
In New York, a 1998 law requires hospital staff to discuss each death with the state organ donor network. Patients are then screened, and if the expired patient could possibly be an organ donor, trained personnel come in and help approach the family about organ donation, Figueroa says.
He sometimes mentions the possibility of organ donation to patients, but the prime audience for this discussion -- younger and middle-age patients -- tend to be "too focused on the here and now," he says. But even elderly patients may be able to donate items such as skin for burn victims.
Kim Yu, M.D., of Novi, Mich., an FP in private practice, educates patients by telling about her own family's experience: "My mother received a kidney transplant that lasted 20 years. Even though she was Chinese, her kidney came from a Caucasian male -- and she would sometimes joke that when she started becoming a little hirsute, it was due to her 'male' kidney!"
Yu says that education should begin at the community level -- in churches, at malls, in the hair salon. "I truly believe it will take concerted community efforts to reach people and tell them about these issues in an informal, nonthreatening situation," she says.
Like in an FP's office.
To reach writer Toni Lapp, e-mail tlapp@aafp.org.
FP Report is published by the
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Copyright © 2003 by
American Academy of Family Physicians.