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How organ donations broke records even during the pandemic

By Helena Oliviero, The Atlanta Journal-Constitution

Last fall, Jeff Hackman’s kidney disease turned serious. He felt tired all the time, got winded easily. Years earlier, his older sister, Dawn Martin of Marietta, made a promise: when the time comes, she would gladly donate one of hers. Within a few months, the siblings, who were a good match, passed a battery of tests, and a surgery date was set for Dec. 8.

But with omicron sweeping through the country at a dizzying pace, the siblings were filled with worry about the timing for this life-saving procedure, concerned the pandemic could delay the surgery or even thwart the procedure indefinitely. “Absolutely it was the forefront of our minds,” said Hackman, a Miami-based firefighter and first responder, said about COVID-19.

In the end, the surgery went off without a hitch. Hackman, who is 46, married and father to two teenagers, got a new lease on life. He was part of a remarkable trend: last year, in the throes of the COVID pandemic, a record-breaking number of organ donations took place in the U.S., particularly in Georgia.

Across the country, 41,354 organ transplants took place in 2021, a 6% increase from the previous year. In Georgia, the increase was sharper with 1,243 organ transplants taking place — marking an 18% increase from 2020.

Despite challenges posed during the pandemic, major advances in medicine and technology surrounding the preservation and matching of organs combined with outreach efforts to fight the stigma of organ donation have helped keep donations steadily rising year after year.

Credit: HYOSUB SHIN / AJC A new organ recovery center at Piedmont Atlanta Hospital opened up a year ago with its own dedicated care team of nurses and doctors. Using innovative organ preservation techniques, the center has improved the number and viability of organs available in Georgia. Demand for organs continues to outstrip supply by a wide margin. According to LifeLink of Georgia, a local not-for-profit organization dedicated to recovering organs from deceased donors for transplantation, 3,891 Georgia residents are waiting for a transplant. Wait time can vary from months for a lung or heart transplant to three to five years for a kidney. Last year, 237 died without getting one, and another 156 were removed from the waiting list because they became too sick to undergo surgery.

But there are new strategies and resources in Georgia that could increase the supply of organs to better meet that demand.

“We have worked really hard to make Georgia a donation-friendly community and our job is in public education. We don’t want to force people to make a decision, but we want to give people the correct information and dispel myths,” said Tracy Ide, a project manager for LifeLink of Georgia.

Credit: HYOSUB SHIN / AJC One of the biggest myths surrounding organ donation is that patients who might otherwise be saved are sometimes left to die so their organs can be taken. Strict regulations are in place to prevent this from happening. Doctors don’t typically know whether a patient is an organ donor. Procurement organizations are not notified until all lifesaving efforts have failed.

There’s no age limit on organ donation, and there is no medical condition that “absolutely” rules out organ donation, according to Ide.

Organ donation, with the primary exception of living kidney donation, occurs after someone has died from an injury, such as a car accident, gunshot wound, or accidental drug overdose, that results in brain death. Hospitals are required by law to contact their local organ recovery organization any time someone dies so that donation may be considered as a possibility. It’s only at this point the local organ procurement organization (In Georgia, it’s LifeLink of Georgia) looks up the registry to determine whether the patient had signed up to be a donor.

Credit: HYOSUB SHIN / AJC The pandemic has created new challenges for organ donations. Medical staff already stretched thin have been less able to coordinate donations. Thorny questions emerged, particularly around whether the organs of someone who has had COVID-19 are safe to be transplanted.

There is no universally accepted set of recommendations regarding when organs can be safely recovered from patients who are COVID positive. Doctors, less conservative than earlier in the pandemic, are more open to using organs from a patient with COVID who was hospitalized for another reason, such as a serious car accident. Abdominal organs below the diaphragm, like kidneys or livers, are considered for transplantation even if donors test positive, according to Dr. Clark Kensinger, a transplant surgeon at Piedmont Atlanta and associate medical director for LifeLink of Georgia.

However, Kensinger added surgeons have avoided transplanting the lungs of patients who died of COVID.

‘Means a lot’

In January 2020, Charmon Shelnutt of Cartersville returned home from an errand to find her 29-year-old daughter, Brooke, collapsed on the floor in her bedroom. Brooke had accidentally overdosed from a fentanyl-laced drug.Brooke, who had a faint heartbeat, was rushed to the hospital. There was no brain activity, and Brooke was not going to survive.

Credit: Contributed Shelnutt thought back to a conversation the two had just days earlier. The topic of organ donation had come up. Two decades earlier, Shelnutt’s husband – and Brooke’s father – died in a car accident. Shelnutt was asked about donating her husband’s organs, but she said, “at the time, it just wasn’t something I was comfortable with.”

Brooke had signed up to be an organ donor through her driver’s license, but also she told her mom she wanted her to know, should anything happen, she wanted to be an organ donor.

The pain is still deep, but Shelnutt said she takes some comfort in knowing her daughter saved a woman’s life. She recently connected with the woman who received one of her daughter’s kidneys. Shelnutt said her views on organ donation have changed. “Brooke was my everything. Knowing there is a part of my daughter that is still alive,” Shelnutt said, “that means a lot.”

New Recovery Center

The new LifeLink Organ Recovery Center at Piedmont Atlanta Hospital is a partnership between LifeLink of Georgia and Piedmont Atlanta. The centralized organ procurement center, opened a year ago during the pandemic, is the first of its kind in the state and one of only a few like it in the country.

“It’s what we have been able to do despite the pandemic, not like within the pandemic,” said Kensinger. Organ donations fell during surges, he said, adding, “We were doing this in between peaks.”

Since its opening, close to 80% of deceased adult organ donors from across the state are brought to Piedmont’s center.

Organ transplants by the numbers 1,049 - number of organ transplants in Georgia in 2020 1,243 - number of organ transplants in Georgia in 2021 3,813,385 - The number of Georgia residents who have registered to be organ donors. 93% - Percentage of Georgia organ donors who have signed up through the state Department of Driver Services. Q: What organs can a living donor provide? A: A kidney is the most commonly transplanted organ from a living donor, according to the United Network for Organ Sharing, or UNOS, the nonprofit group that manages the nation’s transplant system. (LifeLink of Georgia is one of 57 local organ procurement organizations that partners with UNOS).One entire kidney is removed and transplanted. Living liver donation, where a segment of the donor’s liver is transplanted, occurs less often, and the donor is usually related to the recipient. Also, in rare cases, a uterus or a segment of other organs such as a lung, can be transplanted from a living donor. Q: What organs can a deceased donor provide? A: One donor can donate and save up to eight lives by donating organs after death. The organs that can be donated include the heart, intestines, kidneys, liver, lungs an d the pancreas. Q: What organ is most in demand? A: Kidneys are most needed and livers are second. About 83% of the people on a transplant waiting list in the U.S. are waiting for kidney transplants, and about 12% are waiting for liver transplants, according to UNOS. Since its opening, 517 organs have been recovered from 175 donors. Already, the organ recovery center is averaging close to one more organ per donor compared to the average of organ donors who stay at local hospitals around the state.

The center receives patients from around Georgia who had made plans to be an organ donor and due to an accident or illness have been declared deceased. They are cared for and kept on mechanical support with blood and oxygen flowing, keeping organs viable until they can be transplanted. The machine is not keeping the patient alive — brain death is irreversible and is legally and medically recognized as death.

The space includes six ICU bays, two operating rooms, and private rooms for donor families. Grief and spiritual counseling are provided.

Credit: HYOSUB SHIN / AJC On a recent morning, there was a single donor inside the organ recovery center. “Our focus is the donors, and that’s the mission that is driving us: making sure we are being stewards of their gifts,” said Kensinger. “When donors aren’t being transported to the organ recovery center, there are times when the shift of attention moves away from the donor to the other patients (at the local hospital). So what we are able to do is to provide really, really focused care that is looking to optimize organ recovery.”

‘Eternally grateful’

Elizabeth “Libby” Grimland of Marietta knows what a profound gift an organ donation is. About five years ago, Grimland, now 64, was weak and was having trouble breathing. She was eventually diagnosed with liver disease, caused by hemochromatosis, a hereditary condition that causes the body to absorb too much iron. Home-bound and hooked up to an oxygen tank, she was placed on a transplant list in the fall of 2020.

“It was not a life for anyone to live, it was the worst of the worst,” said Grimland. “I couldn’t really do anything and I had come to terms there was a very high possibility I would die before I would get a transplant.”

Credit: Contributed On Jan. 13, 2021, Grimland got the call to go to the hospital right away. She was getting a new liver.

“I am doing everything I wanted to do for so long,” she said. She is making new friends and enjoying hikes to the top of Kennesaw Mountain again. She’s able to actively volunteer again at her church and with an organization that helps homeless veterans. “There is no stopping me.”

Meanwhile, Hackman has returned to work with an in-office role, but he hopes to return to his previous work as a firefighter soon. He recently went on a family camping trip and he’s starting a new Cuban coffee business.

“This has been eye-opening for me,” he said. “You live your life and then you see how people respond in a critical situation like this. I don’t know the right words but to be able to look at a person and to be eternally grateful for my sister to do this for me when my life was on the line, without any hesitation... I am going to show her how grateful I am by taking care of myself and the gift she has given me.”
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