Sally Jacobson had about a month to live.<\/p>\n
A few months before, she\u2019d been tired, sure\u2014not feeling so great. But she was bustling along, balancing work and family in Grand Forks, ND. Then she got some great news: a promotion at work.<\/p>\n
Within a week, her health had deteriorated so much that she couldn\u2019t walk and breathe at the same time.<\/p>\n
The diagnosis was autoimmune hepatitis, a disease of undetermined cause that made her body attack her liver as if it were an infection that needed to be destroyed.<\/p>\n
She ended up in a wheelchair, with her husband as her caregiver. She couldn\u2019t get out of bed by herself\u2014couldn\u2019t get off the toilet by herself. And every two to three days, she underwent thoracentesis, a process that involves having a needle stuck in your chest to remove fluid buildup.<\/p>\n
On March 31, 2006, at 61 years of age, Jacobson was placed on the waiting list for a liver transplant. \u201cAnd that\u2019s when the surgeon asked if I would accept an older liver,\u201d she recalls of her Mayo Clinic doctor. \u201cHe said, \u2018It might give you 15 years.\u2019 And when you know you don\u2019t even have a month left to live, that 15 years is a pretty awesome gift.\u201d<\/p>\n
Many older people believe they can\u2019t donate because their organs are worn out. Mostly, they\u2019re wrong. <\/p><\/blockquote>\n
Three-and-a-half weeks later, Jacobson received her liver\u2014from a man who died at 82.<\/p>\n
Today, Jacobson is doing well. In fact, her doctor now believes that her liver will last past those initially predicted 15 years, she says. She spends her days volunteering at an impressive pace, spreading the word about the desperate need for more organ donors\u2014especially the fact that, despite what too many people believe, you\u2019re never too old to be a donor.<\/p>\n
Why Older People Don\u2019t Sign Up as Often to Be Donors<\/strong><\/p>\n
These days, registering to be an organ donor can be accomplished at as mundane a place as the Department of Motor Vehicles. But when today\u2019s older generations were in their formative years, the idea of donating an organ was a profound one.<\/p>\n
The year 1954 marked the first time an organ was successfully transplanted. It was a kidney from a living donor. In the 1960s, organ transplants from deceased donors began\u2014and made a media splash. The surgery was featured on magazine covers and in headlines.<\/p>\n
\u201cSome time ago, organ failure meant certain death,\u201d pioneering transplant surgeon George M. Abouna later reflected. \u201cWith the advent of transplantation came the hope of a second chance of life.\u201d<\/p>\n
During the early years, organs were generally only transplanted from younger people. It was in part because of Abouna\u2019s work that doctors gradually learned that organs from people over 60 could work well too.<\/p>\n
Nowadays, organs from older people are transplanted all the time, usually to people who are of a somewhat similar age. Still, members of older generations are less likely than those of younger ones to register to be organ donors.<\/p>\n
According to a 2012 Gallup survey of more than 3,200 people, 66 percent of Americans ages 18 to 34 have granted permission on their driver\u2019s license, and 52 percent of people 66 and older have done so.<\/p>\n
Sixty-six percent of people on the waiting list for a transplant are 50 and older\u2014prime candidates for an organ of about the same age.<\/p><\/blockquote>\n
This lesser willingness among older people matters because every donor matters. For one thing, not everyone who registers to be a donor can become one in the end\u2014no matter their age and health.<\/p>\n
\u201cYou need to die in a hospital to be considered an organ donor, and the majority of people do not,\u201d says David Klassen, MD, chief medical officer of the United Network for Organ Sharing (UNOS). \u201cMost die at home or in some other place.\u201d<\/p>\n
You also must die in a manner that preserves organ function\u2014usually from an event that causes brain death, such as trauma or a severe stroke.<\/p>\n
But older donors in particular matter because \u201cthe most rapidly growing subgroup of the waiting list is older adults,\u201d says Dorry Segev, MD, a transplant surgeon and associate vice chair for research at Johns Hopkins University School of Medicine. \u201cA 70-year-old waiting for a kidney doesn\u2019t need kidneys from a 20-year-old. They could benefit significantly from kidneys from a 70-year-old.\u201d<\/p>\n
The problem isn\u2019t that older people don\u2019t believe in organ donation. Over 90 percent do, according to the Gallup survey, which was conducted for the US Department of Health and Human Services.<\/p>\n
The first reason they say they\u2019re not signing up is they think they\u2019re too old\u2014that their organs are worn out and undesirable, says Kimberly Downing, PhD, a social behavioral researcher who\u2019s been studying donor registration among older adults for 10 years. <\/p>\n
But that\u2019s just the surface answer. Probe deeper, and you find that the reasons are also health related. Because of a chronic illness, disease or medication, they\u2019ve decided, \u201cI\u2019m not good for anybody,\u201d says Downing, who\u2019s the codirector of the Institute for Policy Research at the University of Cincinnati.<\/p>\n
Experts say they\u2019re often wrong\u2014and it\u2019s costing lives.<\/p>\n
Why Older Organ Donors Are Desperately Needed<\/strong><\/p>\n
If today is an average day, 22 people will die waiting for an organ transplant.<\/p>\n
This minute, over 122,000 people are on the waitlist. Almost 80,000 of them are medically eligible to receive an organ right now. Yet only 29,532 organ transplants were performed in 2014.<\/p>\n
The necessary organs just aren\u2019t available. The number of donors has been pretty stagnant for over a decade, yet the number of people on the waiting list has kept right on growing. (In 2005, there were just 90,526 people on it.)<\/p>\n
And 66 percent of people on the waiting list are 50 and older, according to UNOS, the nonprofit organization that manages the United States organ transplant system. These are prime candidates for similarly aged organs.<\/p>\n
How Health and Age Affect Organ Donation<\/strong><\/p>\n
Both your age and your health can affect what you\u2019re able to donate\u2014but not to the extent many people think.<\/p>\n
Health-wise, what affects one organ doesn\u2019t necessarily affect them all. \u201cIf you die of heart failure, you\u2019re not likely to be eligible as a heart donor, but you might still be acceptable as a liver donor, for instance,\u201d explains Klassen, who was a transplant nephrologist for 28 years at the University of Maryland before he joined UNOS in 2014. \u201cOr a person who has had diabetes for many years might have suboptimal kidney function and therefore not be really a good kidney donor but might be a liver donor.\u201d<\/p>\n
Even if you\u2019ve had cancer or have been told you can\u2019t donate blood, that may not preclude you from being a donor.<\/p>\n
Age has a similar sometimes\/sometimes-not effect.<\/p>\n
When David Coffee\u2019s mother, Christine, died suddenly of a brain hemorrhage in May 2015, he was promptly told that she\u2019d make a great liver donor. \u201cI said, \u2018You\u2019re kidding me! A 90-year-old lady?\u2019\u201d he recalls. She was an active woman\u2014healthy and vigorous\u2014but still, \u201cI was just surprised that they could use an organ from her at that age.\u201d Her match was a 60-year-old man in New York.<\/p>\n
Donated tendons help people move, donated veins prevent amputations and corneas help people see.<\/p><\/blockquote>\n
Coffee would soon learn that his mother had become the second oldest organ donor in the history of LifeGift, the organ procurement organization for north, southeast and west Texas, which was established in 1987.<\/p>\n
The nation\u2019s oldest donor was also a LifeGift donor: in 2006, Carlton Blackburn\u2019s liver went to a 69-year-old a few days before Blackburn would have turned 93.<\/p>\n
To transplant doctors, age really is just a number. \u201cSeventy is the new \u2018we\u2019re not sure,\u2019\u201d says Segev.<\/p>\n
That said, in general, organs are often matched up with people of similar ages. \u201cOne of the latest paradigm shifts in transplantation is to try to match the wear-and-tear of the organs with the wear-and-tear of the patient receiving them,\u201d Segev says. \u201cThe phrase is, \u2018to find organs that look like you.\u2019”<\/p>\n
\u201cTypically, at least for kidney transplants, what we attempt to do is match organs that are expected to last the longest with patients who are expected to live the longest, or require them the longest,\u201d says Klassen. \u201cSo we try to match the expected longest-lasting organs with, say, younger people.\u201d But an organ that has a more limited, predicted lifespan can work well for someone who\u2019s older. Klassen also notes that older people can sometimes be living donors\u2014for example, donating a kidney to a family member.<\/p>\n
How Organs Are Evaluated<\/strong><\/p>\n
Organs are medically evaluated before they\u2019re transplanted. During her research, Downing has found that many older people don\u2019t realize that\u2014and therefore choose not to be donors. Women, especially, often fear they could actually harm a recipient through donation.<\/p>\n
Depending on the organ\u2014kidney, pancreas, liver, intestine, lung or heart\u2014it may go through lab tests, physical tests, examinations or a biopsy, Segev says. Some organs can even undergo a bit of renovation before transplantation. \u201cFor example, kidneys, liver and lungs can go on perfusion machines,\u201d he says. \u201cOnce you\u2019ve taken the organ out of the patient, you can put it on a machine, and that machine can improve the function of the organ.\u201d<\/p>\n
But say it turns out none of the organs are usable after all. There are still many more things people can donate\u2014namely tissues. For example, donated skin can help people with serious burns, reducing pain, scarring and infections. Donated bones can be used for spinal fusion and dental implants, or for filling in around knee or hip replacements\u2014and even to replace bone that was lost to cancer. Donated tendons help people move, veins prevent amputations and corneas help people see.<\/p>\n
At age 71, Robert Kauffman of Arizona died two weeks after he underwent elective surgery for a brain aneurysm. He\u2019d been an athlete all his life, even playing NCAA basketball. \u201cHe was still playing singles tennis,\u201d says his wife, Betsy Kauffman, who volunteers to tell her story through her state\u2019s organ procurement organization, the Donor Network of Arizona. \u201cHe was very active physically.\u201d<\/p>\n
After some of his tissue was donated, Betsy Kauffman received a letter from a recipient\u2019s family to thank her. \u201cIt turned out their daughter was trying to be in the 2016 Olympics and tore her ACL,\u201d Kauffman says, referring to a serious knee injury. \u201cSo we were able to fix that. How cool is that?\u201d<\/p>\n
Other Factors That Keep People from Donating<\/strong><\/p>\n
Though concerns about age and health are the main reasons older people cite for not becoming organ and tissue donors, some other factors do come into play.<\/p>\n
For one thing, organ transplantation is relatively new. It made the news in the \u201960s, but it wasn\u2019t until the1980s that it started becoming more common, thanks to the newly discovered immunosuppressant cyclosporine, which helped prevent people\u2019s bodies from rejecting the organs. Because older generations didn’t grow up knowing anyone who had a transplant or who was a donor, they\u2019re dealing with a learning curve, Downing says.<\/p>\n
Jacobson, who had the liver transplant in 2006 at age 61, experienced some of that learning curve\u2014mostly through relatives. \u201cMy mom had a hard time understanding it,\u201d she says. \u201cShe\u2019d introduce me to people, \u2018This is my daughter, Sally. She had implants.\u2019\u201d<\/p>\n
Another factor that affects older people more than younger ones is concern about how the donation may impact their family, Downing says. One thing they worry about is cost. They needn\u2019t worry, though. Donation costs donor families nothing.<\/p>\n
As far as emotional impact goes, organ donation can actually be a source of comfort. In fact, 83 percent of people believe it helps families cope with their grief, according to the Gallup survey.<\/p>\n
Coffee, whose mother donated her liver at age 90, can testify to that. \u201cThere\u2019s the comfort of knowing that even in that sad situation, good is coming out of it,\u201d he says. \u201cAnd then also it\u2019s that little bit of immortality\u2014to say, oh my gosh, she\u2019s still living on\u2014and it\u2019s kind of amazing.\u201d<\/p>\n
It is a good idea, however, for people to talk to their family about their decision to become a donor, because if the family were to object at the hospital, their wishes would likely be respected. \u201cOrgan procurement organizations do pay very close attention to family wishes,\u201d Klassen says. Though a family\u2019s distressed pleas could legally be ignored, it would be unusual for the organization to go against significant family objections.<\/p>\n
How to Register as an Organ Donor<\/strong><\/p>\n
In the United States, organ donation is completely humanitarian. Buying and selling organs is illegal, and organ procurement is highly regulated by a number of federal agencies. (It\u2019s also overseen by UNOS and carried out according to state laws.)<\/p>\n
So each person on that transplant waiting list is dependent on the charity of their fellow human beings. Signing up to be a donor, therefore, is a profound, potentially lifesaving thing to do. Yet it\u2019s very easy. You can register online<\/a> or when you renew your driver\u2019s license at the Department of Motor Vehicles.<\/p>\n
In 2012, the US Department of Health and Human Services launched the 50+ campaign\u2014complete with a video, brochures and public service announcements\u2014to urge people 50 and older to register as organ donors. More information about donating organs as an older adult, including downloadable materials, is available through that campaign here<\/a>.<\/p>\n
Jacobson, whose liver turned 91 this year, is grateful for the time her donor has given her. She and her husband have now been married 52 years, and since her transplant, they’ve welcomed three new grandchildren into the world.<\/p>\n
Jacobson volunteers tirelessly with LifeSource to spread the word about organ donation. \u201cI believe in paying it forward,\u201d she says, \u201cbecause I\u2019ve received the most awesome gift of all\u2014the gift of life.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
Sally Jacobson had about a month to live. A few months before, she\u2019d been tired, sure\u2014not feeling so great. But she was bustling along, balancing work and family in Grand Forks, ND. Then she got some great news: a promotion…<\/span><\/p>\n