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HOUSE CALL WITH DR. SANJAY GUPTA

Organ Donation Celebrates 50th Anniversary

Aired April 24, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


RENAY SAN MIGUEL, ANCHOR: Here's what's happening at this hour.
More deadly violence in Iraq today. A homemade bomb exploded outside the 1st Infantry Division base this morning, killing at least four Iraqis and wounding 16 others. Elsewhere in Iraq, five U.S. soldiers were killed and six wounded in a rocket attack north of Baghdad.

And in the Iraqi city of Karbala coalition troops killed five attackers who fired on their base camp with mortars, AK-47s and rocket-propelled grenades. There were no coalition casualties in the incident.

HOUSE CALL with Dr. Sanjay Gupta begins right now.

DR. SANJAY GUPTA, HOST: Good morning. Welcome to HOUSE CALL.

Well, this year marks the 50th anniversary of the first successful kidney transplant. Since then, organ donation has become a life-saving option for thousands of people. And it's also raised some ethical questions and sometimes fear from the general public.

We're going to be talking about all of that this morning. But first, let's start with a look at the human face of organ donation.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, REPORTER: Barbara Amster and Rodney Rodriguez would love to have children of their own, but first, she needs a kidney transplant. So far she's been waiting three years.

BARBARA AMSTER, WAITING FOR KIDNEY: Because I'm on dialysis, it's a very risky pregnancy. I would have to pretty much be on dialysis every day.

FEIG: She already gets three hours of dialysis every Monday, Wednesday and Friday after work, but her wait for a kidney could be long.

WALTER GRAHAM, UNITED NETWORK FOR ORGAN SHARING: Currently, there are almost 85,000 people waiting in this country for vital organ transplants. The sad thing is that about 6,000 of those people will die this year because there are not enough organs donated.

FEIG: Experts say everyone should sign up to be an organ donor.

GRAHAM: There have been organ recoveries and successful transplants done recently from persons as old as 90, 91 years old. And so it all depends on the person's health. Therefore, let the professionals make that decision after you've died.

FEIG: So when you're asked, "Do you want to be an organ donor," Barbara wants you to see it from her point view.

AMSTER: You have the opportunity to save a life. Do you want to do it?

FEIG: In the meantime, her dream waits.

AMSTER: Hopefully one day, if I get a transplant, I'll have my little pitter-patters running around my house.

FEIG: Christy Feig, CNN, Washington.

(END VIDEOTAPE)

GUPTA: Thanks, Christy.

Organ donation is also called giving the gift of life. A single donor can help or save up to 50 lives. But as you've heard, thousands of people are still on waiting lists.

Let's give you some facts.

On average, more than 100 people are added to those lists every day. That's about one every 13 minutes. In that same 24-hour period, 16 people will die waiting. Last year that equaled about 6,000 deaths.

On the positive side, more than 25,000 organ transplants were done in 2003. That lifesaving transplant can come in many forms: from kidneys and lungs to your heart, liver, pancreas and intestines. Beyond that, there's also various tissues such as bone and corneas that can bring new life to a total stranger.

Here to help us answer all your organ donation questions, Dr. Kenneth Newell. He's a transplant surgeon. He's director of the Living Donor Kidney Transplant Program in Emory University here in Atlanta. He's also listed in the guide of America's top surgeons.

Thanks for joining us.

KENNETH NEWELL, TRANSPLANT SURGEON: Thank you.

GUPTA: Fifty years -- thank you. Fifty years since the first kidney transplant. Does not seem like a long time or not that long?

NEWELL: In the evolution of medicine, I think it's not. And so many changes have happened in transplantation just in the last decade or so that I've been involved that it's really, I think, still a very young field.

GUPTA: You yourself have performed around 700 transplants.

Lots of questions coming in on this topic. You get these all the time. Let's get to one of them.

First one comes from Sarah. This is in San Diego. Writes, "I've heard that physicians do not take as many life-saving measures for a patient that is an organ donor. How can I be sure that my donor status will not result in changes in the treatment that is rendered?"

Seems to be a big fear. We get lots of questions like Sarah's. I mean, this was something people that talked about a few years ago. Do you do as much for a possible donor as in any other patient?

NEWELL: I've -- I've heard this question in various forms, and it's a very good question, for a long time. I think that there are several safeguards here.

First of all, we, as transplant physicians and surgeons, are not involved in taking care of any critically ill patients prior to them being pronounced brain dead. And in fact, the law prohibits that.

So there's a whole separate group of doctors whose entire purpose is to give you the best medical care and give you the best chance for recovery they can. It's only after all that's failed and they have spoken with your family that organ donation would even come up.

So I think that that's really a myth that, you know...

GUPTA: Neurologist and neurosurgeons...

NEWELL: Yes.

GUPTA: ... often responsible for declaring someone brain dead and then you get the call.

NEWELL: And in point of fact, the transplant community has nothing to do, really, with a potential organ donor until such time as their physicians have deemed, you know, that they can't do anymore, that they're brain dead.

GUPTA: It's one of the most emotionally charged situations, though, isn't it?

NEWELL: It is. It's particularly hard for the family. And I think that's one the barriers to organ donation, in that, when you haven't thought about it in advance, it's really hard during such a time of stress to consider these things.

GUPTA: Yes. Let's get to -- keep on that point here. Another common fear involves what happens after the surgery is done. Joe in Pennsylvania wanting to know, "What condition is the body in after organ donation? Is it still possible to have an open casket funeral?"

Again, many people fear that the body will be disfigured after donation. Is this something you hear about a lot?

NEWELL: I don't hear about that as much, but I know it is a concern. And I think it's really important to recognize that these people are treated with great respect. The surgery is done just as carefully, with just as much attention to detail as if we were operating on a person, you know, to put a kidney in or something like -- akin to that.

So I think that there's no disfiguration, you know. An open casket would not be a problem at all.

GUPTA: A judicious operation...

NEWELL: Yes.

GUPTA: ... to try and prevent that from happening. Lots of misconceptions. Hopefully we've cleared some of them up.

Coming up next...

(BEGIN VIDEO CLIP)

ANNOUNCER: Can be too old to donate? What about too young? When HOUSE CALL continues, we'll get to the bottom of who can be a donor.

And later, are all transplant patients treated the same? We'll get some answers.

See if you can answer our "Daily Dose" quiz: "What's the most important step in becoming an organ donor?" The answer when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

ANNOUNCER: Checking the "Daily Dose" health quiz. We asked, "What's the most important step in becoming an organ donor?" The answer? Inform loved ones of your wishes.

(END VIDEO CLIP)

GUPTA: Really important point. We're going to talk more about that.

Welcome back. We are talking about organ donation.

If you want to become a donor, there are some simple steps you can take. First, make sure you're listed as an organ donor on your driver's license and remember to carry an organ donor card as well.

Also, get your name listed on a local donor registry in your area.

And as you saw in our quiz, letting family members know is critical, since many hospitals require them to sign consent forms before transplants. Still, they can refuse, even if you have the donor card.

We're talking with Dr. Kenneth Newell, a transplant surgeon here at Emory University Hospital.

Lots of e-mails coming in on this topic, ethical questions as well as specific ones.

Let's go to Kim in North Carolina. She wants to know, "When you indicate that you are an organ donor, is there a way to indicate the preference of donation for either medical research versus donation for another life?"

There are very different donation procedures on this sort of thing, is that right?

NEWELL: And it's important to remember that you can do both. It's not either or. So you can donate both organs for lifesaving transplants and organs or tissues for research.

I think that the important thing to keep in mind is you can indicate your preference, but the way it works practically is your relatives will be approached. And it's what they say that really determines what happens.

GUPTA: Such a difficult conversation to have with your family, isn't it?

NEWELL: Yes, and it's something that in the past we never thought about. Now as education is better, they're approaching this at the high school and junior high level, and that's when people think about it, when they don't need to.

GUPTA: Right.

NEWELL: You know, that's the approach that will really change donation in the future, I believe.

GUPTA: Really requires someone to confront their mortality, oftentimes at a very young age.

NEWELL: Well, it's easier to confront it as a youngster, I think, than when you're older, and it's certainly easier than when, you know, some tragedy has happened to a loved one.

GUPTA: Certainly. Let's go to another e-mail question, Iris in Pennsylvania asking, "If you decide to become a donor, can you choose which organs to donate or at least be advised on what organs will be removed?"

And the answer in part, Iris, is yes, you can be specific. Take a look at this organ donor card. You can check the box that says any needed or specify what you'd like to donate.

For example, if you only wanted to donate your kidneys and intestines, or you could do something else.

Let's clear something else up, Doctor. If you want specific organs donated, will doctors remove anything else?

NEWELL: No, absolutely not. It's basically prohibited by law. It's very specific and, again, the card, you can list things, but the only way -- it's just like signing a consent for any operation. Your family, in effect, signs the consent for you once you're brain dead, and they list exactly what can be done. And we don't do anything beyond that.

GUPTA: So despite the driver's license, despite the organ donation card, if your family still says no, then nothing will be done?

NEWELL: Yes, that is correct.

GUPTA: That's the way it works. The family has the final say on this sort of thing.

We sent our cameras out to try and get a few more questions. One of the questions came in from Atlanta.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: What is the maximum age at which, for example, eyes, corneas or livers, or whatever, can be used for another person?

(END VIDEO CLIP)

GUPTA: Is there an age? I mean, can someone be too old or too young?

NEWELL: No. Absolutely not. And we learned that. We used to be much more restrictive, even when I started, as far as the age that we would go to. And it's continually being pushed further and further out, and not only can these people donate, but the organs really work very well. So they're really helping someone.

GUPTA: And there's a lot of living related donations now, is that right? A parent or a child donating to someone else?

NEWELL: I think one of the fastest growing aspects of transplantation, particularly in kidney transplantation, is living related donation.

GUPTA: So a family member would actually donate to someone else.

NEWELL: That's typically how it was, maybe a decade ago. Now one of the biggest trends is people who aren't even related donating, people who meet each other through church or work, and that's really a dramatically growing area.

GUPTA: We're going to have some of those stories coming up as well. Ethics and transplants. Is everyone treated the same? Coming up...

(BEGIN VIDEO CLIP)

ANNOUNCER: Pat Summerall, Larry Hagman, Mickey Mantle. Are celebrities given special treatment?

More HOUSE CALL coming up, but first, a tip for staying healthy from our Bod Squad.

At first glance, this may look like just another step class, But this ramp-shaped platform is no step.

You might say it's a whole new direction in fitness. The latest creation of fitness guru Jen Miller simulates the feeling of walking up a ramp, hence the name.

JEN MILLER, FITNESS GURU: Ramping is really more about the upward leg muscles, the higher leg muscles in the hip and the glute muscles. Because those are the muscles that you do these little incline walking on modified lunge movements with.

So it is a little more about hips, legs, and hamstrings.

ANNOUNCER: With a constant interchange of acceleration and deceleration, ramping promises a high-calorie burn in a simplistic workout, so virtually everyone can do it.

And after a decade of encouraging people to step in the name of fitness, Miller's take home message is simple.

MILLER: Get yourself moving 30 minutes a day. If people could feel how much better they would feel in their head and in their heart from exercise, then they would do that. They would do exercise anyway.

Losing weight is the perk, the icing on the cake.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: Welcome back. We're talking about organ donations, from the controversy to the myths surrounding the process.

One of those myths is if you're famous and in need of a transplant you're going to get one sooner than the average person. We're going to check in with our guest in a moment on that.

But first, let's talk about how someone gets picked for a transplant.

First, the blood, tissue type and the size of the donor organ have to match. Your placement on a list is also a factor. How sick you are, how long you've been on the list and lastly, location also important, both of the organ and of the person needing the transplant are taken into consideration.

We're talking with Dr. Kenneth Newell. He's a transplant surgeon at Emory University Hospital. He's an associate professor of surgery at the university medical school.

First, let's get this straight, because a lot of people ask about this. Is there any priority given to celebrities or someone famous?

NEWELL: No, absolutely not. I think maybe we hear more about those cases because they are famous people, but they have no priority in the allocation of organs.

GUPTA: Is there a way to game the system, to fix it?

NEWELL: Not really. You know, I think that there's always issues about access to medical care and that may be different. But once you're into the system, there's really no way to take advantage of it.

GUPTA: All right. We sent our cameras out to get another question from Atlanta.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Is there any central system for prioritizing people who need organs? Or is it just I just go to one hospital and I get on one list; someone else goes somewhere else, and the lists are not at all related to each other?

(END VIDEO CLIP)

GUPTA: That's a good question. A recent study in the "Journal of the American Medical Association" indicates the sickest people on waiting lists for livers aren't necessarily the ones receiving the transplants.

Doctor, you read the study, as well. Do people need to be on multiple lists in order to get a transplant?

NEWELL: No, I don't really believe that that is a practical solution. I think that being on one list is perfectly adequate. There is a national list.

Being on multiple lists allows you the chance to perhaps get an organ from outside our area. But practically speaking if you're -- look, I think people get transplanted about the same rate. And in fact, you can't be on multiple lists in one region.

So if you want to be on multiple lists you have to be willing to be transplanted at a center a long distance from your house.

GUPTA: To have to move. And another big topic, and we talked -- touched a little bit on this. But Larry Hagman, Pat Summerall, various folks, Mickey Mantle. The question about alcoholic livers and transplantation.

Should people who are alcoholics who, in effect, have damaged their livers on their own be candidates for transplantation?

NEWELL: I'm not sure I'd answer should they. That's a bit of an ethical issue, but the way the medical community has decided to deal with it. There are many, as you know, well things that we do that contribute to our own illnesses.

We look at things like alcohol use. If you're actively drinking, almost no center in the United States will transplant you, if it's caused alcoholic liver failure.

However, you're not penalized. If you're willing to stop, go through rehabilitation program, undergo evaluation and not drink anymore, almost every center in the country will transplant.

GUPTA: How many of those come back?

NEWELL: It's really been studied pretty carefully, and it's really quite rare. If you've stopped and you've gone through a careful program to evaluate you, and the center that does the transplant, you know, really adheres to detail in looking at that, it's quite rare to ever resume drinking.

GUPTA: I guess a liver transplant probably a good wake-up call for the drinking.

NEWELL: Yes.

GUPTA: You know, another important point. We've talked mainly about donating after someone has died. But we also touched on the fact that you can be a living donor, as well.

Your kidney, parts of your liver lungs, pancreas can be used to help someone on a waiting list.

Betty from West Virginia writes, "I have a friend that needs a kidney transplant, and I want to be tested to see if I am a match. I am 30 years old, single and have no children. My friends and family are worried that if I later marry and want to start a family, pregnancy would be too hard on me with only one kidney. Am I putting my health at risk by donating to my friend? I don't want to see his quality of life deteriorate more. He's only 37, and I want to give him a second chance at life."

Now living donors have outnumbered deceased donors for kidney transplants for the last few years. Can someone still have a healthy life? You know, Betty's question, go on to marry, have a pregnancy, all that, with one kidney?

NEWELL: Absolutely. And in point of fact, people who get a kidney transplant go on to have children. So you know it can be done.

GUPTA: That's right.

And we're not done with this. There's a lot of issues here. Stay tuned now for more HOUSE CALL.

(BEGIN VIDEO CLIP)

FEIG: When we come back, we'll give you web sites where you can download organ donor cards and learn more about the organ matching process.

Plus, we'll share some success stories.

First, some of this week's medical headlines in today's edition of "The Pulse."

Cholesterol-lowering statin drugs may also keep your eyes healthy. The new study out of U.C. San Francisco found statins may help reduce vision loss due to acute macular degeneration, which is the leading cause of blindness among older adults in the U.S.

Also, heart bypass surgery performed while the heart is beating may be as successful as surgery using a traditional heart/lung bypass machine. The study in the "Journal of the American Medical Association" shows, in addition to requiring shorter hospital stays, the off pump procedure is much cheaper than the traditional operation.

Christy Feig, CNN.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: You can read more about organ transplants and keep up with the waiting list at www.unos.org. That's the United Network for Organ Sharing.

Another option, www.optn.org. Click on "donation and transplantation" and you'll find tons of fact sheets and more information on the ethics surrounding the whole process.

And if you want to become a donor, click onto www.organdonor.gov and download an organ donor card to keep in your wallet.

Along with all the questions that we've been receiving today, you'll be happy to know we've received some inspirational stories, as well, Doctor. We want to share a few of them with you.

The first is from Harry in Maryland, who writes, "In early 1985, after the birth of our last child, my wife developed congestive heart failure. Doctors gave her six months to live, unless she had a heart transplant. Because of the gift of life from a total stranger, my wife received her heart transplant in May 1985. Next month will mark nineteen years of survival."

Unfortunately, Doctor, as you know, "there are many who don't get this opportunity. But obviously, in this case, a different life, a new life for her.

Nate from Pennsylvania also writing, "I had my first heart transplant at the age of 20. Eight years later it failed. I had my second transplant at the age of 29 in 2002. My brother also had a heart transplant in 1997. Thanks to loving people who, in their time of grief, helped our family, we are both living and leading productive lives today."

Pretty impressive. You save lives. You change lives, for sure, what you do.

NEWELL: I think that it's really gratifying to see people with such debilitating chronic medical problems get a new lease on life and go back to enjoying it, and it benefits them and their families.

GUPTA: Yes. Along those lines, do you have a final thought that you'd like to share with our viewers today?

NEWELL: I think the most important thing is to think about organ donation when you're healthy, when it's not a crisis for your family, to share your thoughts with them, and it helps them at the time when, you know, emotions are so distraught and to make a decision that helps other people and honors your wishes.

GUPTA: Really important advice. You've helped us work through some very important, sometimes difficult information.

We are out of time for today. I'd like to thank Dr. Kenneth Newell first of all. I'd also like to thank all of you at home, as well, for asking all your questions. We hope we've inspired some folks to become donors today.

Thanks for all your e-mails. Remember to e-mail your questions to us every week, HouseCall@CNN.com. You can start now by sending us a question on next week's topic. We're going to be talking about caring for new babies and new moms as well, dealing with postpartum depression and losing that baby weight, and trying to get some sleep, and breast feeding. We're going to talk about all of that next week, 8:30 Eastern.

Remember, this is the place where you can ask the experts all of your medical questions.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned for more news on CNN.

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