SUNDAY, June 29 (HealthDay News) -- More than 98,000 Americans
are clinging to life this very second, and their only chance for
survival is a dead person's generosity.
The science of organ transplantation has improved by leaps and
bounds. But despite the advances, almost 7,200 Americans died in
2005, waiting for a replacement organ that never arrived, according
to the U.S. Health Resources and Services Administration.
"The success of the clinical side is phenomenal," said David
Fleming, executive director of Donate Life America, a nonprofit
alliance of national and local organizations dedicated to promoting
organ donation. "Unfortunately, it's not a medical problem we're
looking to solve. It's truly a matter of just not having the supply
that we need."
The waiting list for donated kidneys is longest. Almost 75,000
patients are waiting for a kidney, or about three of every four
people waiting for an organ.
That's generally because a person without a kidney can be kept
alive longer, Fleming said. Dialysis can sustain them, while
patients in need of such vital organs as hearts or lungs often die
quickly.
However, the nation's diabetes epidemic is expected to make
kidney failure much more prevalent in the future, leading to even
greater demand for donated kidneys, Fleming added.
The waiting list for livers is next longest, with more than
16,000 patients awaiting help. More than 2,600 people are waiting
for a heart, while an estimated 2,100 people need a lung, and
around 1,600 patients are waiting for a pancreas.
The main problem with supply is that donors must die in a very
specific way for their organs to be useful to others.
"In order to donate a solid organ, you have to die a brain
death," Fleming said. "It's a very small percentage of the
population that die in a way that leaves them brain dead," he said,
about 1 percent of deaths annually, between 20,000 to 30,000
people.
Of those who die under optimal conditions, only about 60 percent
have consented to donate their organs, he said.
"Realistically, if 100 percent of the people consented to donate
their organs, we still wouldn't be able to save everybody," Fleming
said. "The need continues to outstrip the supply. But if we can get
everyone to consent to transplant, that's nearly twice the number
of people who can be saved."
But supply isn't the only obstacle facing transplant recipients.
To keep their bodies from rejecting donated organs, patients must
take a variety of medications that suppress the immune system.
Unfortunately, those drugs often come with a range of severe side
effects. By suppressing the immune system, they also leave patients
open to infection.
In the latest wave of innovation, researchers have discovered
therapies that allow transplant recipients to stop taking the
powerful drugs that keep their bodies from rejecting the new
organ.
"We hope this will improve the quality of life for someone who
receives a transplant from another human being," said Dr. David
Sachs, director of the Transplantation Biology Research Center at
Massachusetts General Hospital in Boston, who published his
findings in a recent edition of the
New England Journal of Medicine. "We think this tolerance
also will help reduce the amount of chronic rejection of
organs.
"That's the main disadvantage of immunosuppression, that it
increases the risk of a wide range of infections, and even cancer,"
he added.
And that's why the new research -- in which patients can be
taken off the anti-rejection drugs -- is important, said Sachs, who
heads one of the research teams that have had success.
The method being investigated involves a procedure that
partially destroys a transplant recipient's bone marrow. This is
done to reduce the level of T-cells, the part of the immune system
most responsible for organ rejection.
When the bone marrow regenerates, the new T-cells it produces
tend to accept the new organ as part of the body.
"We start the immune system over, so to speak, so the new
T-cells that form are eliminated if they react too strongly to
either the self or the new organ," Sachs said.
The promise of the research doesn't end there. Taking it
further, Sachs believes these methods could end the dire demand for
organs by creating a new supply.
"We believe this same kind of tolerance can be induced for a
xenograft" -- or a grafted organ donated from an animal rather than
a human, Sachs said. "We've been working very hard on that, too,
and we're working on pigs as a potential donor."
"Tolerance can be even more important there, because the amount
of immunosuppression needed is even greater when the donor is from
outside the species," he added.
Such a breakthrough could end the frustration that organ
donation experts feel on a daily basis, as more lives that could
have been saved are instead lost.
Until then, calls for organ donation will continue to ring
out.
"We have lots of national heath-care crises in this country that
we don't have a solution for," Fleming said. "We actually know the
solution for this one, for a big part of it. It's very frustrating
when you know the cure for something, but you can't get someone to
do it."
More information
To learn more about organ donation, visit
Donate Life
America.