Die And Let Live

I guess I'll get them out of here. We can collect them and leave. I'll get them out of here. I'll get them out of here. I'll get them out of here.

But 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. Sad, 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. I've never met any inquiries about who it was, but of course they've given me life. He's got a obvious head injury to intubate him, he's got intusions on his chest.

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. It is rarely welcome, but life can flow from death. On a Saturday morning in July, a team of physicians and support personnel at Baylor Medical Center in Dallas, 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 the needed blood throughout her body. Doctors cut through her sternum to get to the vital organs. Soon afterward, 47-year-old Jean Gillier is wheeled into operating room number five. His will be the first lung transplant ever performed in Dallas. A 34-year-old woman who suffered two heart attacks only the week before is brought into operating room number two. Transplant physicians coordinate the upcoming procedures with members of the Southwest organ bank team.

The organ bank works with hospitals and retrieving and transplanting organs in addition to assisting donor families. Two lungs should stay in the cooler. Are you going to take both lungs? Yeah, the same. Okay. We put it inside the cooler and bury the specimen inside the cooler. Meanwhile, the transplant team makes progress on the donor surgery. It's a beautiful liver actually. It's on smooth and soft and pink. The man to receive that liver has been brought to the floor of operating rooms. 61-year-old Shim Park waits to begin his surgery in OR number four. I'm not even scared because I trust 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, I mean, I hate to say that the stroke will not be there.

The situation will not be there. 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 the bike kind of a disease, it is a really fatal. I will do it right now. A little more than an hour after the procedure begins, the donor heart and lungs come into full view. The work begins to stop the heart from beating and cool it down. Bucket after bucket of icy slush is poured into the chest cavity. Doctors work patiently until the heart has dipped to a temperature of 10 degrees. The intensity in the operating room builds as the moment nears for both the heart and lungs to be removed together. With no fanfare, the organs are lifted into a nearby stainless steel bowl.

Dr. Peter Alvazato's heads to the operating room down the hall where the heart and lungs will be set to leave. Only one lung is salvageable. Unfortunately, the one gene gilliered needs the most was damaged in the car accident. Doctors decide to use the good lung anyway. The transplant team's task is tedious and they must work quickly. Using careful precise snips, the heart transplant team works to separate the heart and lungs.

It takes the surgeon's 15 minutes to accomplish their goal, while another group of surgeons ready's gilliered for his new lung. The gilliered, over the gilliered, thank you. Again, Dr. Alvazato's is on the move. His last run down the hall is to the operating room where the heart attack victim waits for the healthy heart of an 18-year-old. The donor heart is now ready to be transplanted into the waiting recipient. 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 transplant get underway, the donor 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. This July day, three lives have been prolonged thanks to a single donor. Later in the weekend, when the donor's kidneys are transplanted, the life count will rise to five. I was there when the doctor told the family the patient's condition and broached the subject of organ donation. Baylor Chaplin, Dow Loftus This was not a situation where the donor had talked about this at all, but the family felt like it was a good thing to do. They felt like they could help a lot of people by doing this and so they agreed to donate organs. But the number of families who choose not to donate far out numbers those who do. Across the country, over 20,000 people wait for organs. Most won't get them. Families often choose not to donate because of the misunderstanding and confusion associated with brain death.

Many people do not realize that in order to donate organs, a person must be the victim of a severe enough head injury to be declared brain dead. Brain death is a difficult concept for even medical professionals sometimes to deal with. Because, you know, down through the ages, cardiac death is what we've all become accustomed to. The body becomes cold, there's no signs of life as we know it and the heart stops beating. Well, brain death is death as well, but there's the typical signs that we're all used to are not there. Their relative looks alive to them. I mean, he's lying in the bed warm there with the heart monitor showing in 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 understand all too well the concept of brain death. They learned it the hard way.

In February of 1987, 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. Sad, 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.

And there be colony any day now. 36 year old Mary Green needs a kidney transplant. For 10 years, the Fort Worth woman has undergone dialysis. She resumed the procedure nine months ago after the kidney she received in a transplant back in 1984 stopped working. It's no fun. It's none I can do about it. It keeps me alive and that's all that's important to me. 40% of the patients at Fort Worth's dialysis center are black. Four hours a day, three times a week they are hooked to the life-saving dialysis machines that do for them what their failing kidneys can no longer do. For some, a kidney transplant could end the dreaded cycle. Studies show African Americans and Hispanics have a greater need for kidney transplants than any other segment of the population. But in spite of the need, minorities are reluctant to donate organs.

Locally 80% of all organ donors are white. 12% are Hispanic, 8% are black. Dr. Charles Andrews heads the kidney transplant program at Harris Methodist Hospital in Fort Worth. He's frustrated by the extremely low number of blacks who donate. For instance, here in Fort Worth in five years we have one black donor. I was doing the first year and we've had a lot of potential donors say no. It's just split these kidneys into two. Andrews explains that the success rate of transplanting among blacks is lower than the success rate for whites. He says immunological differences play a significant role in the pattern. The genetic frequency of certain immunological agents which help fight against rejection are not the same in blacks and whites. When we're looking at transplanting, we're looking at transplanting 90% white kidneys. So a lot of blacks are getting kidneys from whites. So the likelihood that the kidneys are going to be less well-matched is greater for blacks than the kidneys going into white patients who are more likely to share the rejection antigens.

Dr. Goren Clint Mom heads the transplant unit at Baylor Medical Center. He says some blacks refuse to donate family members organs because of a mistrust of the medical community. He says some families have voiced fears that only white patients will get the organs. In reality, the majority of organ recipients are white, 62% compared to 38% who are black. Blacks are more likely to receive kidneys than any other organ, but not solely because of a higher rate of kidney disease. Blacks also suffer from heart disease in higher numbers than whites, but blacks receive fewer heart transplants because they can't afford them. Kidney transplants can be paid for by Medicaid. In kidney transplantation, 30% of all the recipient of kidney transplants here in Dallas and in Texas are actually blacks. So it's not that we are kind of exploiting the undeprivileged to give those organs to the overprivileged. It's not that way.

And that's a misconception and understanding and an understandable misconception, but it is a misconception. We have to overcome the lack of knowledge and general education as well as the fears of exploitation and racial distrust. For those who do wait, the race of the donor is usually not a consideration. It was frustrating waiting. Now, I really wasn't so much concerned about whether it was a minority donation or whoever donated the kidney. It was just important to me that I get a kidney. Mary and Myers has had two kidney transplants. Her latest kidney was donated by her brother. My first kidney transplant, the family, parents of this young girl had to give, make that decision right away. And even though they made that decision, they really benefit two lives.

Because with my kidney that I received from her, I was able to have a child. And before then I didn't have children. Mary Green knows she has a better chance for a successful transplant if the donor is black. But she has a message for any prospective donor family. I would tell them, will you please think about it, signing a license with your donors on it, not just on your kidneys, the other all parts of the body. I don't know, maybe if they were in my shoes, they would understand because if it wasn't done around with me, I'd be willing to get mine. I'm going to carry my leg issues, give us some time. The reasons people say no to organ donation vary. Few people have actually thought about their own deaths and don't plan for it. Family members often haven't discussed their wishes about organ donation ahead of time. At a time of crisis, the decision can be too traumatic.

The difficulty is if a family has an assumption that this means organ donation means they're going to be cut up. Then we have to work at finding ways to help them understand. This is treated just as if it would be a surgery and you were going to be leaving the hospital the next day. It's done with a great deal of care and a great deal of respect. 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 a 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. 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. A key link in the organ donation process takes place long before any surgical procedure.

Critical care medical personnel and chaplains must be sensitive as they approach families about the possibility of organ donation. We're here to save and to help heal and so when somebody is dying the staff really struggle with how best to approach and how best to support the family. And the staff that do the best are the ones who are trained and work more with death. Some in the medical community believe organ donation should become mandatory but that's an ethical dilemma with many faces. 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. Now I'm realistic to believe that I know that it will never happen in this country because of the lawyers that are waiting in the wings to sue everybody. Lawyers, however, wouldn't present the only possible voices of dissent.

I have a strong belief that the gift makes a difference both to the giver and the receiver and that it helps us keep ourselves in perspective. I would hate to see the day and I hope that it doesn't happen that we get into a mentality of this is a requirement or this is just a given because then I think we are playing God. So good. So what we're going to plan on is letting you go home in the morning. Tomorrow? Tomorrow. How about that? No, it's not too early. You're doing great. It's been nearly 40 years since the first kidney transplant in the United States. Transplants are much more commonplace now, but not everyone who needs a transplant can get one. Because of the critical shortage of organs, transplant professionals are often put in the position of deciding who lives and who dies. She has no history of substance abuse or smoking. Transplant centers at hospitals all across the country hold weekly evaluation meetings to determine which patients qualify medically for transplants.

During this meeting at Baylor Hospital, physicians and social workers discuss the case of a 54 year old woman. She would prefer another method of treatment if at all possible. She right now is feeling a little better, but she's also very anxious about the whole thing. In her own mind, what are she psychologically ready for such a major commitment? As head of Baylor's transplant unit, Dr. Goran Clint-Mom emphasizes that the committee's decision is based solely on medical reasons. Social status and financial status do not come into play. Everyone agrees she's a good candidate for transplant? Well, financial status isn't considered by the medical 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. The computerized network is part of a federally regulated process of determining who gets a transplant.

It is run by the United Network for Organ Sharing or UNOs, a nonprofit federally contracted agency. In June alone, several candidates accepted by Baylor's transplant evaluation committee were turned down by the hospital's financial department because they had no insurance and no other ability to pay. Though they were medically eligible, they could not be listed on the computer. Do you think everybody who needs an organ has an equal fair shot at getting one? No, there is not a fair shot. You have to have the ability to pay. And many times they have insurance that pays, but if you need an art 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. When you look at an institution that perhaps does 200 transplants a year, it's not a therapy that the hospital can absorb the cost of and stay afloat. The cost of a transplant varies depending on the organ. A kidney transplant ranges from $25,000 to $30,000, a pancreas from $30,000 to $40,000.

A heart transplant can cost anywhere 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. For Jimmy Regan, the cost of a liver transplant is painfully expensive. It will cost him $150,000 up front to get on the waiting list for the operation that is his only chance of survival. His medical insurance won't cover the transplant because his liver disease is a pre-existing condition. This day is Regan's last day of work. He's too sick to continue his job as a hairstylist. His wife plans to take over his clients until he can hopefully return. For the 36-year-old man, the reality of his situation is crystal clear. Three years ago, his brother died of the same disease after he was unable to raise the money required for a transplant.

We took it upon ourselves, the best we could, and his health went downhill faster than we could raise the money. Regan has had more success than his brother. His church has helped involve the community in fundraising. And less than three months, they've raised $110,000 of the $150,000 he needs. I've checked out, all over the United States, called so many hospitals, talked to so many agencies, talked to lots of individuals, lots of transplant recipients. And when you turn around and get right back to that $150,000 up front, it sets you back. I've never imagined that type of money. It takes me a lot of time to work and make that much money.

But you don't have a lot of time, right? No, I have very little time. Regan needs to have the transplant by November 1st. He hopes he will be able to raise the money in time. The memory of his brother's death helps keep him motivated. When my brother was diagnosed, he was approximately in the physical condition I am in. And six months later, he was not marriage condition unbelievable. And yet a transplant could have made all the difference. If he didn't receive the transplant by some people that could possibly just said, let's do this for this kid. He'd be alive today. I know his wife and his children would be a lot happier for it. Coffee is very good.

It is good when you like the cup. Less than three weeks after receiving the liver from the 18-year-old donor at Baylor, Shim Park is enjoying his daily strolls on the 14th floor with his wife Teresa. It's just like a miracle to us. And just watching him doing ordinary things, like walking around, watching TV, reading books, just like ordinary times, with someone else's liver in his body. It just seems like a miracle. The Baylor University Physics professor suffered from liver cancer. Dr. Park had been told a transplant was his only option. More immensely grateful. The young lady was very immensely grateful. I even talked to some of my students who came up to see me. Now, with the 18-year-old liver, I can outrage you. It's really grateful.

I have a second chance of my life. In some ways, I actually feel better than I felt in 20 years. Toby Tate also had a liver transplant. A month afterward, he was still emotional. Without the transplant, the Washington DC composer would probably have been dead by the time we interviewed him. In spite of his critical need for a transplant, he had some fears. When we first came down for the evaluation process, we met with the people in the support that some people who had had transplants very recently, some a longer time. And it was very encouraging to see live people. What would you say to a family in the position to have to consider whether to donate organs or not? Well, in the midst of their grief, I think there's nothing more wonderful that they could do. Then to give somebody else the gift of life is they've given to me and to others.

And I'm immensely grateful. I believe in protecting their privacy. I've never met any inquiries about who it was. But, of course, they've given me life. For your video cassette copy of tonight's broadcast of Die and Let Live, please send a check for $25 to KERA, Die and Let Live, $3,000 Harry Heinz Boulevard, Dallas, Texas, 75201. You

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