I am - in the UK - and I think that it should be opt out rather than opt in.
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Just so everyone knows, you can't really transplant dead organs (at least not as safely or with the success of live organs).
They can only use your organs if you die in a hospital setting. They will keep pumping blood to your organs after you die to keep them "fresh" and "alive."
Post-death organ transfer exists but is way more risky than an organ that was recently in a living, functioning body.
So if you've ever considered it, keep in mind that you have to die at a hospital for it to happen, and even then, they're still technically forcing your body to be alive to keep these organs alive.
Source: Friend who lost his leg to amputation during a COVID-coma. They didn't think he would make it. He woke up in the donor ward. EDIT: Just to be clear, this happened during peak COVID before the vaccines when bodies were just piling up everywhere. I don't think a coma patient waking up in the donor ward is a normal thing, I think it happened because COVID was a fucked up situation and people were overwhelmed.
What does it even look like when you wake up in a donor ward? Was he a write-off and the doctors were just like 'oh shit, he's awake'? Do non-donors simply get disposed of instead of being brought there?
He's older and it's been tough to get explicit details from him, but yeah it sounds like because it was during COVID and beds for bodies were so scarce, on top of the fact that they didn't have high hopes for him surviving (so many people his age with COVID just never made it), that they were keeping in there for simplicity's sake. Anyway, it spurred me to begin looking into organ donation actually functions, and I mean, it makes sense, I just hadn't really thought about it before that you technically have to have your body being kept alive to be able to donate the organs. A rotting organ probably isn't very useful. That's why it usually happens with terminal patients where the outcome is 100% they are gonna die. During COVID, with bodies piling up, and lack of open beds in hospitals, it at least makes sense to me that he would have ended up there, in case he didn't wake up. It was pandemonium, at the time. Sadly, it seems to have kind of messed with his head to wake up in that situation, he's a lot less trustful of doctors now.
If I'd walk up from coma with one leg less, I might lose my trust in doctors too...
Itβs not the leg amputation, I believe, they considered him βas good as deadβ when he went into coma. He knew he was getting an amputation. What he didnβt expect was that he would wake up to a nightmare of being prepped for his other organs to be removed.
Sorry to hear about your friend.
I don't think knowing this fact should discourage anyone from choosing to be a donor, though. It just means that yeah, it's unlikely that you'll be in a position where they can use your organs when you die, but it doesn't hurt to be put on the list just in case.
Iirc, I think a lot of organ donations end up being from people in motor vehicle accidents.
I did get to see one case where they harvested the person's bones instead of their organs. Didn't even know that was a thing. I'm not sure if they died in a hospital setting or not. Might be you get more time to harvest bones as opposed to organs?
Oh yeah, I hope I don't dissuade anyone. I just hadn't ever really deeply thought about it before, despite being a registered organ donor. It's an interesting conundrum to me, because you need fresh, live organs, but you can't reasonably take those from fresh, live people most of the time, so you need people who are literally on death's door, who aren't going to make it, to have their bodies kept artificially alive for the purpose of organ transfer. COVID was just a fucked up situation all around with not enough beds and so many people dying. My friend had a rough experience, but it's hardly the norm.
I worked as a transplant coordinator for a few years, and you're mostly right, but there qre a few points I would clarify.
Dead is dead. All transplants are post death.
All of your organs need oxygen to keep functioning. When they don't have oxygen, the cells die and the organ stops working, but you can be dead and have functioning organs.
When your brain is deprived of oxygen, the neurons stop firing and you're gone. Dead is the irreversible cessation of brain activity. Sometimes organs can heal, but once your brain is gone, you're dead.
Sometimes that happens because your heart stops beating. The muscle in your heart can also die, and it will stop pumping blood. This heart failure deprives your brain of blood, and then you die. When your heart is failing, you can stimulate the heart to keep beating and continue to live. But if your heart stops beating and you die, that is called a cardiovascular death.
You may also lose oxygen due to a failure of the lungs. Lungs put oxygen in your blood, and if your lungs fail, you don't get oxygen to your brain and you die. This could be related to the lungs, the vasculature between the heart and lungs, or any combination of the three.
The liver and the kidneys work to filter the blood. If either of these fail, your blood can become toxic and poison your heart, your lungs, and/or your brain. The liver and kidneys also need oxygen to live, so if your heart stops beating or your lungs stop providing oxygen, then they will begin to die at the same time as your heart.
Like your organs, your muscles, skin, and nerves also need oxygen to live, and if you have trouble getting oxygen to your peripheral systems, your limbs can begin to die and become necrotic. Necrotic tissue creates a feedback loop of decay in your blood stream, and often requires amputation.
Covid affects both the lungs and the heart. Lung damage reduces oxygen in the blood, and heart failure reduces the flow of blood to the extremities.
Now, in the event of a traumatic brain injury, like a motorcycle accident, the brain can be killed before the other organs begin to die. The heart has a special mechanism that allows it to continue beating without input from the brain. These are ideal circumstances for organ donation, because the donor has died but their transplantable organs are in good condition.
It might be different in other countries, but in the USA, there is a network of transplant professionals that work together to procure and distribute transplants. They work with the hospitals to identify potential donors and talk to the families about donation options.
The hospital would call the local organ procurement organization every time any patient had a traumatic brain injury, even before they died. Patients would continue to receive treatment in the same area of the hospital by the same doctors and nurses. There is no "donor ward" and the only difference in treatment is that additional efforts will be made to keep the transplantable organs alive.
The patient's doctor wants to keep their brain alive along with everything else, and they only stop trying when it becomes impossible to succeed.
So, while I'm sure that your friend really did experience the loss of a limb, and I'm certain the OPO had dispatched a transplant coordinator to evaluate your friend for donation, there's no way the family was approached for possible donation without a dire prognosis (or maybe they asked). The approach would have been in the same conversation where they discuss withdrawing care because there is no hope.
The doctors and the family may have mentioned that they had discussed donation to demonstrate how dire the situation seemed, and how close to death your friend was, but they would not have altered his care at all or moved him to a special section for donors.
Judging by this comment thread I'm not the only one who's like "you can have them, but I don't know if you're going to want them"
Healthcare in the US is run for profit. From 2020 estimates, they charge $1.6 million for a heart transplant. $1.3 million to transplant a pair of lungs, $880 thousand for a liver, and $440 thousand for a kidney. This is what for profit hospitals charge patients while giving your next of kin nothing for the organs that made it possible.
They don't pay you for your organs. They will still bill your estate for any care other than the organ removal despite your generosity.
I would happily be an organ donor in a country with a non-profit healthcare system. But because of how heathcare is run in this country, I would rather my organs be left to rot.
I agree it's horrible, but also I don't see it as a large enough reason to not donate. The person receiving the organs is probably not the cause of this. It's like not working because your labor mostly goes to the elites. It's not a great plan, even if it does feel good.
Thankfully it's opt-out in Slovakia, so yes.
I'll be dead. Do whatever with my body. Take the organs, fuck it, feed it to animals, compost it, use it as shooting target, turn me into soap, I won't care. I literally won't be able to care. Why even decline?
- of course.
- i'll be dead and won't need them while others might. how selfish of me not to give them over
Yes I am registered, because I ride motorcycles and I won't need my organs if I'm dead.
I've been registered for a while now. I really don't see a good reason not to, they only take 'em if I'm dead and what good are they to me then? Better going to someone in need.
No.
My mom got double brain aneurism. Had her head cut open to put clamps on the leaking arteries.
Slipped into a coma, few days later doctor came in to convince us for prepping her for organ donor, dad said it was too early.
Another few days later doctors came in being really rude that all she was good for was organ donor. Had a heated conversation with my dad who got tired and said "fck off doctors".
Few days later she woke up. After revalidation she has a healthy life, this was 37yrs ago, she still lives, she is 71.
My dad told my awake mum and since I was underaged opted me out for organ donor. Needles to say, I am reluctant to opt myself back in.
Optional read: aftermath of the aneurism is that the part of the brain to process visual data was damaged. Other parts of her brain took that role but is not as effective. Her depth perception any further that 10m is gone. She has no vertical peripheral processing, so she has to tilt her head up or down to recognize what she noticed i' her peripheral, one cannot imagine this seeing something but unable to recognize until you point your head at it :) in the end, very good outcome.
Damn that's double fucked. What a disappointing story. I've still got myself down for organ donation because it's more likely to be done in good will than not, but that's a very sad story.
Do people pay for organ transplants where you are? I wonder if it's not necessarily altruism but money that is pushing the doctor's hand to jump the gun.
I like the system in Singapore. Organ donation is mandatory, though you can complete a form to opt out. If you're on the opt-out register, you have a lower priority to receive organ transplants. Fair is fair.
Throwing this post out there for a bit of visibility and discussion.
For me, I just registered 5 minutes ago. Idgaf what they use my body for, as long as someone learns something it's a net positive at no expense to me.
Yep. Pessimistic about anything still being useful at this point, but hoping I am wrong.
Yes I am. As for why, my organs will save peoples lives,
I was already a donor before my sister died but it really solidified my stance when she saved three people's lives with her kidneys and liver. They needed it more than the crematorium needed them.
In Austria you have to register to NOT be an organ donor. So we have about 99% donors (after brain death). I am a donor too, as I neither care about my body once I am dead nor bother to register for anything.
As a very strong believer in Danny DeVito's quote, "When I'm dead, just throw me in the trash!", if any medical party is even remotely interested in dumpster diving for my parts when I'm done with them, they can have 'em. Better than throwing them in a box and taking up land in a cemetary. The less of my remains uselessly taking up space on this planet after death, the better. If I get my way upon my demise, anything they don't take is going into the incinerator anyway.
Here in Belgium everyone is a donor unless you register that you don't want to donate your organs.
Same default settings in France, although your organs can only be used for transplant. Using them for teaching and practicing in medical school still needs your explicit (prior) consent.
Yes, definitely.
I received a live donor kidney transplant over a decade ago, and because of that, my quality of life drastically improved, and I lived long enough to meet my kid and my nieces and nephews.
I've got complex medical issues, so my organs might not be any good, but they're going to be available when I'm gone.
Yes. Probably been registered for more than 10 years now. Iβm in Sweden and it was a super easy online form to fill in.
When I die thereβs probably someone else who needs my organs more than me.
No, I'm one of those weird people that because my family moved to the UK when I was little in the late 80s for work for a year I'm under risk of mad cow disease and none of us can donate blood or organs. Learned that the sad way when trying to give blood in college, like half a dozen random things that can disqualify you that you might not realize.
Up until now here in Germany we had a "system" that was a paper(!) card you put in your wallet if you were ok with donating your organs. That's obvioisly not an ideal system and Germany has far to few donors. We now moved to an online system and being Germany it's (as far as I've heard, I haven't tried it yet - which might be a sign that this is not going to be a great solution) is super complicated and convoluted. So basically even worse than the piece of paper in your wallet (seems impossible but for Germany business as usual when it comes to anything digital).
Personally this would be one of the very few things were I would be ok with something being opt-out instead of opt-in but I don't see that happening.
My spouse and I are registered to donate our bodies to a medical college. If we can advance medicine in even a small way, it is still a move to better life and health.
I'm set to donate my body to science. Maybe I even get to be a skeleton in a class room or sum π
Yes, I don't see why not. What else am I gonna do with my organs when I'm dead?
No, both to receive and give organs. I'm just not comfortable with the idea.
Look to be honest I don't agree with your stance but I respect the fact that you both don't wish to donate and more importantly receive. I fell some people would be quite happy to take but not give.
The real test is how they feel when they actually need the organs.
Not meaning to call anyone out, but it's easy to say no to organs when you're life isn't on the line.
Yeah, why not? Wtf am I going to do with them when I'm dead?
Yes, it just feels like the right thing to do. Why let them go to waste if they can help someone else live.
Yes because why not. I doubt they will be of much use, but feel free to harvest anything you want. It would be the most useful I've been in my existence.
No need to register in Brazil, you just have to tell your family members, as they're asked whether or not they're ok with your organs being donated. I've already told my family to, once I die, donate all of my organs that might still be in good shape