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.