Die And Let Live; Captioned -- National PBS Version

Funding for Die and Let Live has been made possible by the million dollar roundtable foundation, a foundation supported by major insurance agents worldwide. Additional funding has been made possible by a grant from Anthem Life, providing employee benefit products and programs to employers across the nation, and by a grant from ortho-biotech incorporated. This program contains graphic scenes of life-saving surgery. Viewer discretion is advised. Medical science has given us the ability to fight death, but even with impressive technological powers on the side of the living, sometimes death prevails.

But life can flow from death. You're about to see why organ transplants are often called the gift of life. I felt so much gratitude, but at the same time I felt a great deal sorrow because I knew someone had died. If you need a hard transplant or a liver transplant and you have no insurance and you don't have the down payment, you don't get the organ. You're not going to be abused, you're not going to be used as a guinea pig. What you're going to do is help others live. Most people who are asked to donate the organs of family members say no. That's what I said when I was asked several years ago. I didn't know anything about organ transplants, and my grief over the loss of a loved one

that was the last thing I wanted to hear about. I'm Sheila Cooper. I've learned in reporting this story that my reaction was not unique. Organ transplants raise religious, racial, financial, and ethical questions that aren't easy to answer. It's their questions about who lives and who dies. It's a Saturday morning in Dallas. A team at Baylor Medical Center ready to perform a series of organ transplants. The parents of an 18-year-old car accident victim have granted permission to donate their daughter's heart, lungs, liver, and kidneys. Within the next seven hours, two men and a woman who have been waiting at Baylor will receive those organs and a new lease on life. The accident victim is prepared in operating room number three. Her body is connected to a heart bypass machine, which takes over the functions of her heart,

pumping blood throughout her body. Doctors cut through her sternum to reveal the vital organs. Soon afterward, 47-year-old Jean Gilliard is wheeled into operating room number five. He has infosima and needs a new lung. This is the anniversary, isn't it, Jean? The first day he's been here one year waiting for us. 34-year-old Brenda Strawbridge recently suffered two heart attacks. She is brought into operating room number two. Transplant physicians coordinate the upcoming procedures with members of the Southwest organ bank. The organ bank works with hospitals and retrieving and transplanting organs in addition to assisting donor families. Meanwhile, the transplant team makes progress on removing organs from the donor.

The man to receive that liver has been brought up to the operating rooms. 61-year-old Shim Park has cancer and waits to begin his surgery in operating room number four. It's not that he would skid, because I've tested these guys. Right here, it's going to be a really unique opportunity because we have local recipients on our local waiting list who were in the hospital and very, very ill waiting for these specific organs in it. I mean, I hate to say that it's a stroke a lot for them that the situation came up like it did. Oh, I'm so grateful, you know, I am originally from Korea, and in Korea and Japan, they don't have this donor kind of thing, and therefore, because of the availability of donors, they think if they get by kind of a disease, it is really fatal.

About an hour after the procedure begins, the donor's heart and lungs come into full view. The work begins to stop the heart from beating and cool it down. Buckets of icy slush are poured into the chest. Doctors work patiently until the heart has dipped to a temperature of 10 degrees Celsius. 20 minutes later, the heart has cooled, and it is time for the heart and lungs to be removed together. The organs are quickly lifted into a nearby stainless steel bowl. Dr. Peter Alvazados heads to the operating room down the hall where the heart and lungs will be separated.

Unfortunately only one of the donor's lungs can be salvaged. Her left lung was damaged in the car accident. Although gene gillier needs a left lung the most, doctors decide he can benefit by receiving the donor's undamaged right lung instead. Using careful, precise SNPs, the heart transplant team takes 15 minutes to separate the heart and lungs. Once again Dr. Alvazados is on the move. His last run down the hall is to the operating room where brinda straw bridge waits for

the healthy heart of an 18-year-old. The donor heart is now ready to be transplanted. Next door the donor's liver has been removed, so have her kidneys which are measured and prepared for transplantation later in the weekend. As the transplants get underway the donor's surgery has been completed. The body of an 18-year-old who wasn't wearing a seatbelt the night before is stitched closed. The routine conclusion to a procedure that was anything but routine. On this day three lives have been prolonged thanks to a single donor. After in the weekend, when the donor's kidneys are transplanted, the life count will rise to five.

Although transplants save thousands of lives every year, many people choose not to donate organs because of the misunderstanding and confusion associated with brinda. In order to donate organs the person must be the victim of a severe enough head injury to be declared brain dead. Dr. Clive Calendar is director of transplantation at Howard University Hospital in Washington, DC. He says many people don't believe brain death is death. One is dead when either the heart sees the brain sees the function and that the integral part of you and me is our brain. And when that's gone we are gone and so when you talk about when is the soul leave when the brain is dead. As director of transplantation for the method is hospitals of Dallas, Dr. Richard Dickerman has had to explain brain death to grieving families. Most people believe death occurs when the heart stops beating.

Their relative looks alive to them. I mean he's lying in the bed warm there with the heart monitor showing the heartbeat and it's very difficult for them to understand the concept of brain death. It was grossly unfair that he should die. Fred and Kim Carney learned about brain death in 1987 when their son Paul was murdered. After lying in a coma at Baylor Hospital for 12 days, doctors told Paul's family he was brain dead. We're anticipating during these 12 days the overwhelming probability of his death and therefore we did have time to give consideration in our depths of our own feelings and mind to the question of possible transplants, saving of somebody else's life in the death of our son Paul. And two people's lives were saved basically. One with a liver transplant and the other with a heart transplant.

And we were very happy that that was the case, said, very sad about the death of our son. But very happy that somebody's life, two people's lives could be saved and it's the death of our son. And if Paul had been consulted on it, he would have said yes, I'm sure. The reasons people say no to organ donation vary. Few people have actually thought about their own deaths and don't plan for it. Many members often haven't discussed their wishes about organ donation ahead of time. At a time of crisis, the decision can be too traumatic. I have had all kinds of responses in my 15 years of doing this from a family member saying that if I touched their relative, they would come after me with a gun to a wife saying that she was in the process of getting divorced and he was no good one. He was her husband so I could take anything I wanted anyway, she couldn't care less. I mean that's the range of responses that you get. And I've had to do things such as go down to the courthouse here in Dallas and get the

permission from a mother who had beaten her two year old to death to give me the organs even though she had beaten him to death, she was the only next of kin so that I had to get her permission to retrieve the organs. My style has never been to push anybody. My style has been to let you know your loved one is dead. You have the opportunity so that your grief can be asswaged by the fact that his or her death has not been in vain. By federal law, hospitals must ask the families of suitable donors if their loved ones organs can be used for transplant. Some in the medical community believe organ donation should become mandatory. There should be a law in this country like there is in many countries in Europe that once your relative is pronounced brain dead that you should not be given the option of donating the organs, that it should become a law, that you should have to donate these organs. It is, in point of fact, a way to increase the number of organ tissue donors but right

now, as I've gone across the country in black communities and white communities, the community at large is not, doesn't trust us that much yet. So you have two miracles. You got a kidney transplant and you had open heart surgery. It's been nearly 40 years since the first transplant in the United States. New drugs and new technology have made transplants more common and more successful. But donations only supply about a third of the organs required. Because of the critical shortage of organs, doctors must often help decide who gets a second chance to live. She has no history of substance abuse or smoking. Transplant centers across the country hold regular evaluation meetings to determine which patients qualify medically for transplants. During this meeting at Baylor Hospital in Dallas, physicians and social workers discuss the case of a 54-year-old woman.

She right now is feeling a little better, but she's also very anxious about the whole thing, and her own mind wonders if she's psychologically ready for such a major commitment. The committee's decision is based solely on medical reasons. Social status and financial status do not come into play. Everyone agree she's a good candidate for transplant? Social financial status isn't considered by the evaluation team, a potential candidate must be able to pay for the transplant procedure in order to be entered on the nationwide computerized waiting list. Every transplant in the United States has roots in a Richmond, Virginia, computer center. This is the home of UNOS, the United Network for Organ Sharing. The nonprofit agency is responsible for maintaining a nationwide patient waiting list and ranking

those patients based on medical criteria. In a typical year, about 40,000 people get on the list, many will never get their transplants. Gene Pierce is director of UNOS. No one should have to die while waiting for a transplant. When every day people die, it would perfectly help the organs that could be used to save the life of someone. But the scarcity of organs isn't the only obstacle. Some patients who are approved by medical evaluation committees are rejected by hospital financial departments, although they are medically eligible without insurance or the ability to pay, hospitals won't put them on the waiting list. These are the hospitals' prerogatives. They have, after all, it is a business and they have to be careful about how many patients they can absorb if they are non-paying patients because transplantation is not an inexpensive procedure.

The cost of a transplant varies depending on the organ. Kidney transplants range from $25,000 to $30,000. A heart transplant can cost from $57,000 to $110,000, while a heart-long transplant ranges from $130,000 to $200,000. A liver transplant is the most expensive, costing from $135,000 to $230,000. If you need a heart transplant or a liver transplant and you have no insurance and you don't have the down payment, you don't get the organ, and I don't feel that's right. I think that all patients in this country should be afforded the equal opportunity to obtain an organ if they need it. Jimmy Regan needs a liver transplant and doesn't have insurance or enough money to pay for it. The Texas hairstylist watched his brother die without getting a liver transplant because the family couldn't raise the money in time. Now Jimmy has contracted the same liver disease that claimed his brother's life.

When my brother was diagnosed, he was approximately in a physical condition now and six months later he was not marriage-conditioned, unbelievable. And yet a transplant could have made all the difference? If he'd received a transplant by some people that could possibly just say, let's do this for this kid, he'd be alive today. To get on the waiting list, Regan needs $150,000 up front. With help from his church, his friends, and from strangers, he's attempting to raise the money $1 at a time. When you turn around and get right back to that $150,000 up front, it just sets you back. I've never imagined that type of money, you know, to take me a lot of time to work, you

know, and make that much money. But you don't have a lot of time, right? No, I have very little time. Hey Fox, what's up? Most transplant recipients learn how to play the waiting game. A support group at Howard University Hospital meets weekly to bring together transplant recipients and those who wait. When they read Regis, the night for this month was my year for my second transplant. How long did you wait for your first one? I wait five years for my first one. I'm glad to be here with you this morning and able to do some of the things I haven't done in years. How long did you wait, by the way? One month. Geez, what? Are you ashamed and admit that in front of these people? We're not ashamed at all. The meetings begin as each person tells three things they feel positive about. This morning Arlene Holden doesn't feel positive about anything.

Sometimes I tell y'all the truth, I get really upset when I hear a lot of people. One month, you know, six months, I'm, you know, being truthful. I get angry because my husband has been waiting for some time. How long has been waiting? Over a year now. It's been about a year and it's been three or four times that he's almost didn't make it. But you never wavered. And you always had faith. There's anything you can tell her as she waits in it. She cries with the fear that her husband will get one in time, anything that you... No, really. The only thing I can say about all that there was just trusting a good Lord, that's all there. But I didn't allow myself to be depressed. I just kept on, you know, keeping the faith and hoping that one day a kidney would be mine. While her husband sits quietly, Arlene Holden finally tells her three positive things. That's my family's alive and having faith in a kidney will come. I don't need any benefit on the name of Mr. Holden.

While he waits for a kidney, Arlene's husband waverly spends time on dialysis. For hours a day, three times a week, Holden is hooked up to the life-saving dialysis machine that does for him what his failing kidneys can no longer do. Waverly Holden isn't as worried as his wife. Well, upsets, but, you know, like I said, it doesn't bother me. I know that one would be there, one way or another, you know, sooner or later. So, you know, my time just haven't come up yet. Holden has been on dialysis for 17 months. Many patients live out their lives on these machines. In dialysis centers across the country, most of the patients are African-American. Let me see, how long has it been since you had your transplant? Because African-Americans are so susceptible to high blood pressure and kidney disease, they need kidney transplants more often than whites. But for those who get them, the success rate is significantly lower.

Blacks do, half as good as whites do. The kidney survive half as long and rejection occurs more often. And I think that the major reason is because we have so few black organ and tissue donors. The lack of African-American donors is critical when it comes to kidneys. A kidney transplant requires a near-perfect match. There are genetic differences in the immune systems of people from different races. For most racial groups, those differences don't affect the success of a kidney transplant. But for black patients, many doctors believe the chance for success is much greater if the kidney comes from a black donor. Still, many blacks refuse to donate organs for religious reasons, as well as fears about exploitation.

It really has to do with the tradition of blacks being abused by the medical system and a basic distrust of the medical community, which I think is addressed by having people who are waiting for organs and tissues going to the community and bespoke persons, people who have received successful transplants to take the message that, hey, it's okay. You're not going to be abused. You're not going to be used as a kidney pig. What you're going to do is help others live. How many of you have signed organ donor cards? Since most donated organs come from whites, and blacks wait twice as long as whites on the national waiting list, Dr. Calendar goes outside the operating room to get more black donors. So this, I have to remind once again that at Howard University Hospital, where blacks are in desperate need of organs, that 80% of the organs that are provided for transplantation are from whites, so that while that is a concern, we got to balance it with the reality.

And the reality is that we as a group have not been doing our share, at least up to this point. Calendar's recent efforts have been on black college campuses, where he not only urges students to consider signing organ donor cards, but also asks them to talk to others about organ donation. And well, good luck to you, sign an organ donor card and have a family discussion, start a family tradition. All right. Okay. Good. Coffee's very good. Yeah, it is good. When you like it. Oh, thank you. Transplant recipients dream of the moment they can resume their lives. Less than three weeks after receiving the liver from the 18-year-old donor at Baylor, Shim Park is enjoying daily strolls with his wife. So, dear dear, great. Now, I have a second chance of my life. Park's second chance lasted only a year, 13 months after his transplant cancer claimed his new liver.

The other transplant recipients who started their second chance along with Shim Park have been luckier, although there were complications for both of them. Brenda Strawbridge and Gene Gileard have survived and are doing well. I enjoy life a lot more. You ready? And Jimmy Regan finally raised enough money for his liver transplant. An anonymous woman contributed the final $70,000 he needed to live longer. It has definitely made me sit back and realize just how much I have taken for granted all my life. Yes. Now, one year later, Regan says he thinks daily about the people that made it possible. I think more about the donor's family. I hope they're, you know, their heart and their mind is at peace. And I pray that, you know, that they, every time they think about their son, they think about the miracle that their son has provided in life and me.

So, thank you. Funding for Die and Let Live has been made possible by the Million Dollar Roundtable Foundation, a foundation supported by major insurance agents worldwide. Additional funding has been made possible by a grant from Anthem Life, providing employee benefit products and programs to employers across the nation, and by a grant from Ortho Biotech Incorporated.

For a copy of Die and Let Live, call 214-740-9238 or send 2495 to the address on your screen. This is PBS.