Saving Lives: Addressing Misconceptions in Organ Donation

By David DeStefano
President & Chief Executive Officer
We Are Sharing Hope SC

Every myth that undermines trust in organ donation equals a life not saved. Every time someone hesitates to register as an organ donor due to false beliefs means another person on the transplant waiting list may never get their call. It is imperative that we discuss donation honestly and see it for the complex miracle that it is.

Last year in South Carolina, 700 lives were saved and over 34,000 were enhanced thanks to organ and tissue donors in South Carolina. This profound impact stems from the selfless decision of our donors and their families.

Donation represents real people who were given a second chance, thanks to the courageous decisions made in moments of profound grief and loss. As President of We Are Sharing Hope SC (SHSC), the federally designated Organ Procurement Organization (OPO) for South Carolina, I am inspired by the incredible generosity that makes organ donation possible. However, recent discussions have compelled me to push back against misconceptions and the crucial role OPOs play that must be addressed.

In the United States, Organ Procurement Organizations (OPOs) are independent, non-profit, mission-based organizations who are entrusted with coordinating the donation process at the end of life. Our role is to educate our community on organ donation, to advocate for donation with our donor families and hospital partners and to communicate clinical information to transplant centers, who make the decision to transplant waiting recipients.

OPOs do not control the donation process. Instead we are part of the team – Hospitals, OPOs and Transplant Centers – that supports a legacy for dying patients and helps save the lives of those waiting for a second chance. Donation requires engaged and complex collaboration to make this miracle happen.

To begin, OPOs do not provide medical care for living patients. We also do not determine death and are expressly prohibited from any role in the declaration of death process. That is the exclusive domain of the hospital. OPOs are also not responsible for transplant decisions. That is the domain of the Transplant Centers. They make those decisions for their recipients. Our role is to provide care and comfort for the family and to coordinate the donation process at the end of life.

As an OPO, our involvement begins when a hospital notifies us of a patient’s death or a plan to withdraw life support. Once the hospital has declared death or after a family decides to withdraw life support, our team steps in to support the family, advocate for donation, and coordinate the donation process. This includes working with our transplant partners to offer organs to their patients.

Recently, the media has highlighted one donation pathway called Donation after Circulatory Death (DCD). This option is for patients who have suffered a recent brain injury where there is no meaningful chance of survival, are dependent on a ventilator to live and where the family has made the difficult decision to stop ventilator support. In DCDs, the hospital is solely responsible for classifying the patient’s condition as non-survivable and talking to the family about stopping the ventilator. Additionally, OPOs are prohibited from talking to families about donation until after there is a decision to withdraw ventilator support. This is so the family makes a decision to withdraw support independent of any donation option.

In DCD, the OPO will advocate for donation only after a decision to withdraw support has been made, the OPO will collect and communicate clinical information to the transplant centers and will recover organs after the heart naturally stops.

It is crucial to understand that in DCD Donation, the OPO has no control or involvement in the patient’s care and absolutely no involvement in the declaration of death. This is the exclusive purview of the hospital physician. OPOs remain in the background and engage only if the patient’s heart stops naturally. This strict separation upholds the highest ethical standards, prioritizing the donor’s well-being and their family’s needs.

The misconceptions surrounding OPOs and this process of organ donation aren’t just harmless misunderstandings. They contribute to the tragic reality that thousands of people in our country die each year waiting for a transplant that never comes. Organ donation is a profound act of humanity. Let’s work together to ensure fear and falsehoods don’t stand in the way of hope, healing and life.

David DeStefano currently serves as President and CEO at We Are Sharing Hope SC (SHSC) in Charleston, South Carolina. SHSC is South Carolina’s nonprofit, federally designated organ and tissue recovery service. SHSC is dedicated to inspiring hope and transforming lives through donation. To learn more or become a registered donor visit: SharingHopesc.org.