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From “OGGI” magazine – Italy – March 8 2019
“Reginald Green campaigns to change the law on transplantation in Italy. I would like that also in your Country the donor family and the recipients could meet.”
In February 2014, a drunk driver in the American city of Lumberton, Texas, hit a car in which Dawn Sterling and her two daughters were riding. The adult daughter was pregnant and died instantly. The other daughter, a 15-year-old, died of head injuries and was an organ donor. Dawn was unconscious for over a month. She woke to find both her children and the expected grandchild gone. She recovered only to plan her suicide. “The very gifts that gave me life and purpose for the last twenty years were gone and I felt empty,” she says. At that point, she received a letter of such gratitude and hope from Lisa Barker, the 25-year old recipient of her daughter’s liver, that she could no longer face the thought of suicide. “Lisa saved my life,” she says. Dawn and her husband, Reid, have become close friends of Lisa and her family, who are planning to add to the good that came out of the transplant by adopting two children, siblings, from Ghana.
Few stories of the two sides communicating have such obvious momentous consequences as Dawn’s, which comes from Patricia Niles, CEO of Southwest Transplant Alliance, the organ procurement organization responsible to the US Government for organ donation in much of Texas and its 280 hospitals, one of which is Baylor, which recently delivered the first baby born in the US following a uterus transplant. “But the 58 American OPOs that cover every US state and work closely with many of the world’s best-known hospitals say that out of the tens of thousands of cases where both sides have communicated with each other, either by anonymous letter or face-to-face meetings, the results are helpful to both sides in the great majority of cases and in some cases dramatically so,” Reg Green says. “These communications also help boost organ donation rates because the two sides often decide to tell their stories in local schools, hospitals and churches so that other families will see for themselves how a simple decision can save multiple lives.”
Press release from Reg Green (first published in December 2017)
Four-year old Grant Thompson plays with Micki Parker, whose daughter Addie died when she too was four years old from complications of juvenile diabetes. Addie’s organs were donated and her liver saved Grant’s life. Says Micki: “I wanted to know everything about her recipients: did they like pets, were they funny like Addie was, did they like to snuggle up to their Mom after bath-time? Grant’s parents wanted to meet me too and reached out first. Amazingly, I was able to meet him in what was one of the most fulfilling events of my life. Knowing he is so healthy and happy has helped me deal better with the pain of losing Addie.”
(Photo by Alexa Citro)
In the United States communication between the two sides under the supervision of the patients’ medical advisers is strongly encouraged because it is therapeutic for both sides in the large majority of cases. Communication can be anything from the exchange of anonymous letters to face-to-face meetings,
The meeting was arranged by the Donor Network of Arizona, the organization chosen by the US Government to oversee organ donation throughout the state of Arizona.
Connections are now routine in every State and the large majority of them have a positive outcome, according to the 58 organ procurement organizations (OPOs) designated by the US government to oversee organ donation.
These connections, which only happen if both sides want them, generally start with an exchange of anonymous letters under the supervision of doctors. Some get no further than that. If, however, all goes well, the families can move to signed letters and then, but again only if everyone approves, to actual meetings. Against the rare occasions when something goes wrong in this carefully-planned system is the incomparable satisfaction of learning, for example, that the boy who received your son’s heart, who could scarcely walk to the door of his apartment, is playing soccer again or that the girl who had been given only a few hours to live but received his liver now has a baby.
These are not dreamed-up examples. Both happened to us when my seven-year old son, Nicholas, was shot on the Salerno-Reggio Calabria highway in 1994 and his organs donated to seven very sick people. (The boy who got the heart is now dead but his family is profoundly grateful for the extra 22 years of good health the transplant gave him. The girl is now a sturdy woman of 42 with two children, one of whom she called Nicholas in honor of her little donor).
But anecdotes are unrepresentative and can be very misleading, so for an overall view I asked leaders in the American transplant community about their experience. This is what some of them told me:
1) “A recent review of our data indicates that about 52% of donor families will connect with a recipient (either by receiving a communication from or sending a communication to) within the first two years of their loved one’s organ donation,” says Alexandra K. Glazier, President & CEO, New England Donor Services, the OPO which covers the six New England states, home of one of the greatest concentrations of top-class hospitals in the world. “Many donor families and recipients have a natural interest in connecting with one another and that is experienced as a positive aspect of the donation and transplant process.”
2) Tom Mone, CEO of OneLegacy, the largest of the 58 organ procurement organizations, whose area covers twenty million people and two hundred hospitals in California, points out that actual meetings are only a small percentage of the total connections and the risk of something going wrong is the greatest but even there he says that in more than twenty years “we have no cases where families regretted meeting.”
3) “I am not aware of a single instance of physicians in the United States being philosophically opposed to donor families and recipients meeting.” Bryan Stewart, for 12 years communications director of OneLegacy.
4) Elling Eidbo, CEO of the Association of Organ Procurement Organizations, which represents all 58 OPOs, adds another crucial reason. “Every day, all over the United States, transplant physicians and their teams work closely with all organ procurement organizations to provide recipient outcomes and information that is shared with donor families. This happens because across the country, both transplant physicians and donation professionals understand and appreciate how important and significant these communications and connections are, including face-to-face meetings, to maintaining the critical trust and faith of their communities and society in donation and transplant. It is this trust and faith in our system that gives people the confidence to donate, and knowledge that the generous gift of life to others will be appreciated and respected with grace, dignity and sincerity”.
5) Rob Linderer, who retired a few weeks ago as CEO of MidWest Transplant Network said that in 38 years in his area, which covers several million people, he could recall only two cases where meetings between the two sides caused a problem. Two in 38 years! In one of those cases, a donor mother wanted to pay more attention to the heart recipient than the doctors thought desirable. She was told quietly but firmly she had to be less insistent and that was the end of the problem.
6) Opponents of change say there is little interest because families want to put a transplant behind them and get on with a new life. Certainly, that is true of many families and no responsible person would put any pressure on them. But families are hungry for information. Nearly 1,200 letters are exchanged between donor families and organs and tissue recipients every year through another leading American OPO, the Gift of Life Donor Program, based in Philadelphia, according to its CEO, Howard Nathan.
Other Countries Say Communication Between Organ Donors And Recipients Is Beneficial In The “Vast Majority Of Cases.”
Evidence is coming in from widely different parts of the world that communication between organ donor families and their recipients is therapeutic for both sides, says Reg Green, father of Nicholas Green the seven-year old American boy who was shot on the Salerno-Reggio Calabria autostrada, who is leading a campaign for a public discussion of the application of Italy’s privacy policies that prevents any communication between the two sides. He cites remarks by Anthony Clarkson, Assistant Director for Organ Donation and Nursing at United Kingdom’s National Health Service Blood and Transplant, who says communication “is a positive and beneficial experience in the vast majority of cases.”
Mr. Clarkson adds: “When asked, nine out of 10 donor families indicated they would like to hear from the recipients of their loved one’s organs. Donor families who are contacted tell us it brings them great comfort and are grateful that their precious gift of donation has been acknowledged.”
In Italy, the law enacted in 1999 forbids health service personnel from giving any information about patients donating or receiving an organ. Mr. Clarkson did not make his remarks in reference to Italy. They are the United Kingdom’s conclusions from its own experience.
They were quoted in a statement sent to the British newspaper, The Guardian, on September 29 by Dave Marteau, father of a 21-year old Englishman killed in a road accident in Palermo whose organs were donated to four Italians but whose family was unable to find out anything about them for eight years.
“It is clear that the way Italian privacy laws are applied is causing pain to many donor families, despite the selfless decision of those families to save the lives of complete strangers,” Mr Green says.
Mr. Marteau also cites a survey at a university hospital in Brazil that found 67% of organ donation families wanted to meet recipients while 82% of transplanted patients expressed a desire to meet with donor families. “A large Californian study came up with similar findings, with 70% of donor families and 75% of organ recipients saying they would like to have phone or letter contact with their counterparts,” he adds.
In the United States, the 58 organ procurement organizations that oversee organ donation in all fifty states are unanimous in encouraging communication, according to Mr. Green, which can range from the exchange of anonymous letters to face-to-face meetings.
One of them, Lifebanc, based in Cleveland, home of the world-renowned Cleveland Clinic and University Hospitals of Cleveland, with whom it works closely, adds another dimension. “The healing power of donation and transplantation is perhaps never more powerful than when a donor family meets the recipients of their loved one’s life-saving gifts,” says its CEO, Gordon Bowen.
From a press release of The Nicholas Green Foundation – October 2017