Tissue and bones donated in Utah benefit Utah patients with medical and dental, not cosmetic, needs. And bodies are only used for research with the family's permission.
That's the promise from Utah organizations that process organ, tissue, bone and other body parts after the question was raised nationally. What happens to donor bodies became an issue this week when the Orange County Register in California published a lengthy series on an investigation that found bodies donated in many parts of the country were apt to be sold to companies making products for cosmetic surgeries, generating huge profits for those companies, often without the knowledge of the families donating a loved one's remains.
The Register series said that a "single dead body yields raw materials worth tens of thousands of dollars to businesses whose stock is traded on Wall Street and to nonprofit agencies that obtain the parts for them."
The tissue trade, it said, "now generates about $500 million annually." And the paper's investigation showed that the hardest-hit by the commercialization of tissue donation were burn units, which often could not get skin needed to graft on patients who had been burned, although cosmetic surgeons at the same time in the same communities had no problem getting the skin they needed for procedures.
"We're not having the same problem at all," said Pat Larkin, nurse manager for the Intermountain Burn Unit at the University of Utah Health Sciences Center. "We had our own skin and tissue center until last fall when it was sold, but we have no problems getting skin from them."
It was, in fact, part of the contract during the sale that the burn unit would get the tissue it needs.
Cadaver skin is often used to cover burn wounds until the patient's own skin begins to grow in. With small burns, skin can be taken from elsewhere on the patient's body. With large burns, though, a donor graft is needed.
Without the graft, infections are hard to control. Use of such "homografts" has significantly improved survival rates for people who have been burned.
"It's such a vital way to treat burn patients, and if it's not available it would seriously impact care of burn patients," Larkin said. "They have to have burns excised, and it needs temporary covering. We can't wait for three or four weeks to excise old tissue. Vital areas are covered first with (a patient's) own skin. But a homograft (from donated tissue) doesn't have to match tissue at all."
The reason Utah doesn't have such problems is philosophical. Both the Intermountain Tissue Center, which spun off as a nonprofit from the U., and the Intermountain Organ Recovery System, which recovers organs and tissues for transplants and grafts in a four-state area, have policies that put medical needs first.
"It all comes back to the local community for medical needs," said Lynette Phillips, spokeswoman for the Intermountain Organ Recovery System, the designated organ procurement agency for Utah, Idaho and parts of Wyoming and Nevada.
Skin donations are handled by the Intermountain Tissue Center. According to center manager and certified tissue bank specialist Dan Smith, skin is kept for up to 10 days, and if the burn unit doesn't use it in that time, it's reprocessed and stored in a deep freeze at -84 degrees Celsius. That way, it can be kept for up to five years, and "99.9 percent of the time, we ship it to other burn units." The U.'s burn unit tries to use only fresh skin. Others prefer to have it frozen.
Smith said the center was pleased that donations of tissue have increased over the last year. "From Jan. 1 to today we're where we were last year in August. That's good, because there's a real need for tissue. We went through such a shortage about last July, and we couldn't keep up at all. Freezers were empty, and donor tissue was used immediately."
The center also handles muscular skeletal tissue, but that's not its primary focus. It can use tissue from donors up to age 75. Besides recovering vital organs for transplant, the Intermountain Organ Recovery System recovers bones, veins, arteries, heart valves and tendons, which are processed through Cryolife or the Muscular Skeletal Transplant Foundation.
"All the bone comes back to the local community and is used in neurosurgeries and dental surgeries and to replace bones that were damaged by accidents or cancer tumors, for instance," Phillips said. "Veins and heart valves and arteries all come back for cardiovascular surgery here. Tendons and ligaments come back for orthopedic surgeries."
Asked if anyone is getting rich off the process, she hoots with laughter.
"Absolutely not. We have screened agencies that process (body parts) to make sure they are only used for transplants. And it only goes to research if the family specifically says it may. We go through a list, organ by organ and tissue by tissue. (Families) tell us what and where and specify how it can be used — transplant or research. And we only use tissues recovered for research if for some reason they can't be transplanted. They're too old or whatever."
Saying that bones come back to Utah for use isn't strictly accurate, Phillips said. It's like donating blood for someone. They may not actually get your blood, but they get some blood, on a one-for-one exchange. "We may need tissues faster than they can be processed. So if we send a certain amount in, we get that amount back in exchange."
Eyes are donated to the Lion's Club Eye Bank, operated out of the University of Utah, for distribution. They make cornea transplants possible.
One of the biggest needs for cadaver donors is bone to be made into "dental dust." Local dentists and oral surgeons use it as a sort of glue compound to build up missing bone on the jaw. Longer bones may be cut into fibular and tibular rings, to be used for spinal fusions.
You can reach Lois M. Collins by e-mail at lois@desnews.com