It's hard for a family member to block a relative's decision to donate an organ should he or she die unexpectedly. Individuals can now register the desire to be an organ donor and specify organs through a Web site, www.yesutah.org. That decision is protected by law.
That means Intermountain Donor Services no longer has to ask those families for permission to harvest organs for transplant — or simply to honor the donor card in the individual's wallet, according to Dr. John Sorensen, medical director of the transplant program at LDS Hospital.
It's also generally a relief, added Kristie Baker, transplant coordinator for the program. They don't have to make an important decision at a time when they're wrestling with the shock and grief of losing someone they love.
Sorensen and Baker said people don't seem to balk when confronted with a decision that already has been made, even if it's a binding decision. They genuinely want to honor the wishes of the person who died.
Sorensen and Baker were featured on Saturday's Deseret Morning News/Intermountain Health Care Hotline, where they discussed becoming an organ donor and the transplant process.
The organs they help transplant include the liver, the kidneys and the pancreas. Donors also can provide hearts, lungs, skin, tissue, cornea and more, sometimes helping many individuals at one time.
The greatest need is kidneys, Sorensen said.
But livers are becoming increasingly necessary, in part because of the huge number of people who have hepatitis C, many of them without knowing it. As many as 4 million Americans are believed to be infected with the liver-destroying virus. And that could well be an under-count, Sorensen said.
At present, about 40 percent of the liver transplants he performs are due to the virus. About 7 percent are alcohol related, though by the time the transplant is needed, the individual must have a history of sobriety to get the organ. The rest of the liver transplants are the result of various liver disorders, the largest group classified as cholystatic liver diseases.
Cirrhosis is a leading cause of disease leading to liver transplants and can result from causes like alcohol and hepatitis C. It is for many years a silent process, but detected in a pre-cirrhosis stage, when it is simply fibrous (classified by four increasingly severe levels), the liver can recover, though it does not reverse the scarring that has occurred.
Cirrhosis is not reversible. The liver, which has unequaled ability to heal itself, even growing to a normal size when a section is transplanted, cannot recover then.
A kidney must be transplanted within 24 hours of removal and preferably much less. A liver should be transplanted in less than 12 hours. The longer it takes to transplant them, the slower the organ recovers.
Sorensen also pointed out that an individual can donate every vital organ and the family can still have an open-casket viewing.
Age is not necessarily a barrier to donation of certain organs and tissues. Sorensen said he once transplanted a liver from a 79-year-old, though that's uncommon.