- By Dr. Joan Pellegrini

There is extensive information available about how to become an organ and tissue donor. Most of us by now know that there are 100,000 people in the US waiting for a life-saving organ transplant. We even make it easy in the State of Maine by allowing you to designate yourself as a donor when you get or renew your driver's license. However, there is almost no information out there about what this might mean for your loved ones if the time comes for them to be notified that you are a potential organ donor.

The vast majority of organ donors sign a declaration card without knowing exactly what this will mean for their family and loved ones if in fact something tragic really does happen to them. I very much want everyone to be an organ donor but I also want donors and their families to be well-informed about the processes that will take place. Once you sign an organ donor card, please tell your family about your wishes. Then, tell them what might happen if you are a potential donor. Our local resource is the New England Organ Bank (www.neob.org or 800-446-6362). Their website does not have this type of information but you may call them with questions. Alternatively, you may print this page to help you discuss this with your family.

Many of us think that if we are an organ donor, then our organs will be taken as soon as we die. Unfortunately, if your heart is not beating, then the doctors will not be able to use your organs. You may still be a bone and tissue donor though. In order for you to donate organs, your heart and lungs must still be alive in order to keep your organs alive.

Most organ donors have had a sudden illness such as a stroke or heart attack or have been critically injured. If this were to happen to you, before approaching your family about donating your organs, the doctors usually first determine that your brain is dead and there is no chance for recovery. In order for your organs to be donated, the doctors and nurses must keep your heart and lungs alive on a breathing machine in the intensive care unit. Your illness or injury may not be visible and so you may look very much alive to your loved ones. Because you may look "OK", the news will be even more difficult for your family to understand. Your family will be devastated by the bad news and this would be a terrible time for them to learn that you wish to be an organ donor in the event of your death.

Organ donation does not happen immediately after it is determined that you are a potential donor. In fact, it may take 12-24 hours or even more. The reason for this is that the organ procurement organization (OPO) must review your medical history and do lab tests to look for reasons why they may not be able to use your organs. Some of these tests take hours for the results to come back. Also, some of these tests are actual procedures that take some time to be done (cardiac catheterization, bronchoscopy, tissue biopsies to name a few). Once your organs are found to be transplantable, the OPO must then match them to people on the waiting list who have your same blood type and tissue characteristics. Coordinating this effort takes time.

Steps that you should take:

Decide to be an organ and tissue donor.

Let your family and loved ones know about your wishes.

Tell your family that if something terrible were to happen to you, the doctors and nurses will help them to understand what is happening.

If the medical team determines that your illness is likely nonsurviveable, they will discuss organ donation with your family.

If you become an organ donor, the team will need several hours to coordinate this effort. The medical team will spend quite a bit of time with your family to help them understand the process.

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