Organ Donation and Transplantation
Organ transplantation in Georgia is performed at five transplant centers: Children's Healthcare of Atlanta at Egleston Hospital, Emory University Hospital in Atlanta, Georgia Health Sciences University in Augusta, Piedmont Hospital in Atlanta, and Saint Joseph's Hospital of Atlanta. These centers are designated by the National Organ Procurement and Transplantation Network, an agency established by federal law for matching donor organs to waiting recipients. This network is operated by the United Network for Organ Sharing (UNOS) under contract with the U.S. Department of Health and Human Services. UNOS, based in Richmond, Virginia, maintains a centralized computer network, available twenty-four hours a day, linking all organ procurement organizations and transplant centers. In fall 2003 nearly 83,000 people were waiting for organ transplants nationwide, with more than 1,400 of those in Georgia.
LifeLink of Georgia, an independent, nonprofit organization, is the state's organ and tissue procurement organization and one of fifty-nine similar organ procurement programs in the United States. LifeLink medical professionals are on call twenty-four hours daily. Donated eyes are recovered by the Georgia Eye Bank.
By federal mandate, hospitals must have protocols for discussing organ donation with the families of deceased patients. By signing a Uniform Donor Card, an individual indicates his or her wish to be a donor. When the individual dies, however, the family must still sign a donation consent form.
Physicians within designated transplant centers evaluate potential transplant candidates and add them to the national patient waiting list. When a deceased organ donor is identified, a LifeLink transplant coordinator uses the UNOS computer to match patients in the donor pool against the available organ and generates a ranked list of patients for each organ. The organ is offered to the transplant team of the first person on the list, then the patient is reevaluated before receiving the transplant.
Organs and tissues that can be donated include the heart, kidneys, lungs, pancreas, liver, intestines, corneas, skin, tendons, bone, heart valves, and eyes. One donor can potentially benefit 60 or more people. In 2000 there were 137 organ donors in LifeLink Georgia's service area, resulting in more than 390 life-saving organ transplants; in 2001 there were 205 organ donors, resulting in more than 650 transplants. During 2001 there were 437 bone donors. Many lives are saved or improved as a result of donations, but the need for transplantable organs is much greater than the supply.
Children's Healthcare of Atlanta at Egleston is the highest-volume pediatric transplant center in the Southeast, providing heart, liver, kidney, and bone-marrow transplants to patients from birth to age twenty-one. Between 1997 and 2003 Emory University transplant teams at Egleston performed 80 heart transplants, 106 kidney transplants, and 128 liver transplants. Emory teams at Egleston performed Georgia's first pediatric heart transplant in 1988, Georgia's first pediatric split-liver transplant in 1997, and the world's first transplant of umbilical cord blood from an unrelated donor for sickle cell anemia in 1998.
Emory University Hospital, through its Center for Transplantation, is among the busiest solid-organ transplant centers in the country, performing approximately 1,000 transplant evaluations and 300 transplants annually. From 1993 to 2003 more than 3,000 patients received transplanted organs at Emory. Transplantation at Emory began in 1947 with the first corneal transplant in Georgia and continued with Georgia's first kidney transplant in 1966. Emory's bone-marrow transplant program was initiated in 1979. The first heart transplant in Atlanta was performed at Emory in 1985. Emory began its liver transplant service in 1987 and performed Georgia's first simultaneous kidney-pancreas operation in 1989.
In 2001 U.S. News and World Report magazine ranked Emory University Hospital as the nation's seventh busiest in kidney-pancreas transplants. Emory surgeons have performed more than 400 heart transplants. Emory's liver transplant program performs more than 60 adult liver transplants annually. Its split-liver transplant program, in which part of the liver is removed from a living donor and transplanted, is the only program of its kind in the state of Georgia. Emory Eye Center's pediatric cornea transplant program is also the only such program in Georgia.
In early 2003 Emory transplant surgeons performed Georgia's first islet cell transplant to treat type 1 diabetes, with the goal of eliminating the need for insulin injections. In patients with this type of diabetes, the insulin-producing islets in the pancreas do not function properly, causing excessively high blood sugar levels that lead to a variety of serious medical complications.
Transplant surgeons at Emory are scientific leaders in developing innovative strategies for eliminating the need for long-term immunosuppressive drugs for transplant patients and creating true immune tolerance. Although immunosuppressant drugs prevent rejection of donated organs, they affect the entire immune response and leave patients vulnerable to infections and to cancer.
Saint Joseph's Hospital of Atlanta began its Cardiac Transplant Program in 1987 and has transplanted more than 318 donor hearts as of 2003.
Piedmont Hospital established its Organ Transplant Services in 1986. More than 700 kidney transplants were performed between 1986 and 2003. Piedmont also performs pancreas transplants. Piedmont was the first hospital in Georgia to perform laparoscopic nephrectomy—a kidney-removal procedure that is less invasive and less painful than the traditional procedure and requires a smaller incision with less scarring, a shorter hospital stay, and a more rapid return to normal activity.
Medical College of Georgia (later Georgia Health Sciences University) established its Transplant Surgery Service in 1968 and performs both kidney and kidney-pancreas transplants. The university's Tissue Donor Services (TDS) is a hospital-based tissue procurement agency responsible for coordinating procurement of transplantable tissues from hospitals in eastern and southern Georgia and in Aiken County, South Carolina. Any potential organ donor identified by TDS is referred to LifeLink of Georgia.
Generous support for transplantation programs in Georgia has been provided by the Carlos and Marguerite Mason Trust, a private foundation administered by Wachovia Bank. Grants from the Mason Trust are awarded to Georgia nonprofit organizations to improve the care of Georgians receiving organ transplants and to improve the process of organ transplantation.
The Georgia Transplant Foundation, founded in 1992 by a Georgia kidney transplant recipient, provides financial and educational assistance for patients undergoing or awaiting transplants. The foundation's board consists of professionals from the five Georgia transplant centers, community business leaders, transplant recipients, and volunteers working together to improve the quality of life for those affected by transplantation.
Two Ronald McDonald Houses and the Mason House, funded by the Mason Trust, are available to help transplant patients and their families from Emory University Hospital and Children's Healthcare of Atlanta.
Holly Korschun, Emory University
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