Tucked away behind unassuming double doors on the fifth floor of Rush University Medical Center sits a new, very different type of medical unit.
It’s a unit for patients who will save lives, even though they themselves have no hope of survival.
The Gift of Hope Organ Donor Care Center at Rush is the first of its kind in Illinois. The center accepts patients from area hospitals who’ve been declared brain dead and who’ve been authorized to be organ donors. At the center, doctors and nurses work to keep donors’ organs functioning and ultimately procure their organs, so they can be transported to some of the more than 104,000 people now on waiting lists for organs in the U.S. The center received its first donor Sunday.
Those behind the center say it’s a more efficient way of recovering organs that will save more lives.
“It will lead to more organs transplanted,” said Lisa Hinsdale, director of organ operations for Gift of Hope Organ & Tissue Donor Network, the not-for-profit organization that’s responsible for recovering organs from deceased donors in the northern two-thirds of Illinois and Lake County, Indiana.
“If one more organ can be transplanted to each recipient, that’s one more person off the wait list,” Hinsdale said. Seventeen people die each day waiting for an organ transplant, according to the federal Health Resources & Services Administration.
Now, when a person is deemed brain dead in the Chicago area, Gift of Hope evaluates whether the person is medically eligible to donate organs. Organs that can be donated include the heart, lungs, liver, pancreas, kidneys and intestine.
Fewer than 1% of people die in such a way that it would even be possible to donate their organs, according to the Health Resources & Services Administration. They’re most frequently people who suffer strokes, heart attacks or severe head injuries, according to the United Network for Organ Sharing, which manages the nation’s organ transplant system.
If the patient is eligible to donate, Gift of Hope specialists then talk with the patient’s family members to explain the donation process and confirm the patient’s status as a legally registered donor or to confirm the family’s permission to donate the person’s organs if they were not a registered donor. If the patient can donate, the patient typically remains at the hospital where they died, and it’s up to that hospital to keep the patient in its intensive care unit throughout the process.
Gift of Hope enters information about the donor into a national computer system to match the donor’s organs with people on the national waiting list. Surgeons—sometimes from other areas of the country—then often travel to the hospital to remove the organs and transport them elsewhere.
It’s a complex process that can take about 60 hours from start to finish—and it can put pressure on community hospitals, say Gift of Hope leaders.
If an organ donor dies at a community hospital, the hospital must often keep the donor in a bed in its intensive care unit until the organs are retrieved, meaning less space for other patients. The hospital must find time in its operating room schedule for surgery to remove the organs—a task that might be delayed as hospitals prioritize emergency surgeries. And it must accommodate multiple surgeons and teams who travel to the hospital to retrieve organs for their patients.
The new center is meant to streamline that process.
“Our hope is by moving the donor to the organ care center, we can take some of that burden off the referring hospital,” said Mike Harmon, vice president of organ operations at Gift of Hope.
The center is a collaboration between Gift of Hope and Rush, with Rush providing the space and services such as a pharmacy, labs and respiratory care. Both groups provide staffing. Rush decided to partner with Gift of Hope on the center because it felt the center would be a good match for its mission and value system, said Dr. Edie Chan, division chief for transplant surgery at Rush.
Gift of Hope and Rush will now transfer organ donors from community hospitals to the center, where they will be cared for by Gift of Hope and Rush nurses and advanced practitioners until it’s time for surgery. Hospitals that do their own transplants, such as Northwestern Memorial, Loyola University Medical Center and University of Chicago Medical Center will not transfer patients to the unit.
The new 10,000-square-foot space at Rush includes six medical bays that are specifically set up for the needs of donors, with equipment such as ventilators, heart monitors and space for waste, such as from dialysis.
The center also has two operating rooms, including one that’s about twice the size of a typical operating room—space that’s needed to accommodate the 40 or 50 medical workers who might be there simultaneously if a donor is donating multiple organs. In the massive operating room, swinging lights hang over an operating table, machines to make sterile ice are at the ready, and metal tables offer a place where organs can be packaged before they’re taken out of the room to waiting patients across the country.
The center will also be better for families, say Gift of Hope and Rush leaders. Families can choose to say goodbye to their loved ones before they’re transported to the donor care center or follow them there, if they wish. The medical bays at the center each include a couch that can be used by visitors, if a family member wants to stay with the donor.
A small, light-filled waiting room across the hall is designated for family members of donors—a place where they can sit quietly, surrounded by huge windows overlooking the United Center.
“These families have gone through it,” said Dr. Harry Wilkins, president and CEO of Gift of Hope. “Some families may want to come, and if they do, we want to honor their needs and their loved ones.”
Donor care units are a growing part of the organ transplantation system in the U.S.
In 2022, a report from the National Academies of Sciences, Engineering, and Medicine on achieving equity in organ transplantation recommended that the federal government require each organ procurement organization in the country to establish a donor care unit.
The report’s authors wrote, “Donor care units are an innovation in organ procurement and provide an opportunity to bring consistency and high-quality care to donor organ procurement and the donor family care experience.”
That same report noted that a donor care unit in St. Louis recovered 6% to 18% more organs between 2009 and 2014 than the national average for organs recovered at hospitals.
The U.S. organ transplantation system has faced controversy in recent years. In 2023, Congress passed a bill that was signed into law, aiming to reform the system, after allegations of inefficiency and negligence. This month, a House subcommittee held a hearing on the progress made on that legislation, and heard startling anecdotes about problems in the system.
In July, the Tribune published an article detailing how an Organ Procurement and Transplantation Network algorithm was supposed to help distribute lungs more fairly, but a flaw in the process meant some people didn’t receive the care they should have.
Wilkins said the donor care center at Rush is a move in the right direction.
“The system is not perfect, otherwise there would not be 100,000 people waiting for organs,” Wilkins said. “We’re still evolving, and this is yet another step in that evolution.”
2024 Chicago Tribune. Distributed by Tribune Content Agency, LLC.
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New center for organ donors is first of its kind in Illinois (2024, September 27)
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