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Gifts Under the Skin, Not the Tree

Donors needed for organ transplants.

For the gift that keeps on giving, nothing can beat life itself. That is what organ transplants offer.

At this season of giving, there are 83,550 people waiting for various organs nationwide, according to Toni Webb, director, Community Affairs, Washington Regional Transplant Consortium. Of that total, 2,301 live within this region.

"One of the reasons that the Washington area has such a large percentage of those on the waiting list is that we are a very sickly area," Webb explained. "We have a high incidence of infectious diseases, plus stress and other illness that cause organ damage."

There are 43 hospitals within WRTC's sphere which includes the District, Northern Virginia, and suburban counties in Maryland. "When there is a death in any one of the hospitals we immediately assess whether there are appropriate organs or tissue. Once that is established we then contact the family to see if they will agree to an organ donation," Webb said.

WRTC, located in the Merrifield area of Falls Church, is within 45 minutes of every hospital they service, according to Webb. They are also connected to the United Network for Organ Sharing (UNOS) which maintains the national list of organs needed by gender, weight, age, blood type, and other characteristics.

CONTRARY TO common belief, even many healthy people who have agreed to be organ donors will not qualify at time of death. It is based on the cause of death.

"In the vast majority of cases the donor has to die of a brain injury such as in an accident," she said. "Heart attack victims and those who die from lingering illnesses are usually not eligible donors."

The reason is that when the heart stops the blood flow to the organs stops and they begin to deteriorate. "When paramedics reach an accident scene they immediately attach a respirator if the person is still alive. That is essential to keeping the victim alive. But, if they do die after reaching the hospital the blood has been circulating to the organs," Webb said.

However, continuing blood flow is not as essential when dealing with tissue transplants, Webb clarified. It is viable much longer.

"Tissue and bone are not subject to the same degree of deterioration in a short time span as the vital organs," she said. "We are constantly trying to find more ways to preserve and, thereby, be able to get more organs."

Most organ transplants are "very successful", Webb claimed. "A recipient must take suppressant medication for the rest of their life to thwart rejection but they all tell us how much better life is with the new organ," Webb said.

TWO WHO CAN testify to that are Thomas Hitselberger and Nathan Stokes, both of Alexandria. Both had liver transplants at Inova Fairfax Hospital, the only medical facility in Northern Virginia performing the procedure. Hitselberger's operation was in January 2003, and Stokes' was on December 22, 2000, just in time for Christmas.

"Everything is great. I waited for a couple of years. But I also had other medical complications that had to be taken care of before I could get the transplant," Stokes explained.

"When I first got the new liver I had to take nearly 60 pills a day to prevent rejection. Now I'm down to only two a day," he said.

Hitzelberger was diagnosed with cirrhosis of the liver in 1997. "But it wasn't critical at that time," he said. "Then it got really bad. I was in the hospital a total of 26 days. I had to go in a week before the surgery because I was so sick." His wait was only six months after he reached a critical stage, he noted.

"Matching livers is easier than matching kidneys," he maintained. "It apparently has to do with the blood type as well. That makes a big difference. I'm lucky because I'm a type A which is fairly common."

Hitzelberger lived in Alexandria as a child then his family moved to New Jersey. He moved back to this area in 1979 and back to Alexandria in 1992 when he acquired a condominium in the West End.

"I have experience with both sides of the transplant/organ donation issue," he noted. "In 1988, my sister was killed in an automobile accident and was an organ donor."

THE ONLY NEGATIVE described by Hitzelberger was "the suppressant medication makes you more susceptible to disease and illness — even the common cold. It weakens the immune system somewhat. But, so far I've been very lucky — not so much as a sniffle."

He was a little apprehensive about the current flu situation. "They don't want you to get any inoculations for about a year," he said. "By the time my year is up on January 19, most of the flu critical period will be over."

One good side effect to the suppressant medication, according to Hitzelberger, is that it apparently cures psoriasis. "I had a very severe case of psoriasis and it cured it," he said.

ON THE OTHER END of the scale is Sidney N. Maududy, a resident of Alexandria since 1992, who, at age 59, has been waiting for a kidney transplant for seven years. "I go in for dialysis every Monday, Wednesday, and Friday. Once a year I go to Fairfax Hospital for evaluation," he said.

"This past Spring they called me about a living donor. I went in for the blood tests and all. They had also called other possible recipients. Even though it was a good match for me there was someone on the list ahead of me who also matched and he got the kidney," Maududy explained.

"I'm very happy for him. I understand he is doing very well. I'll just keep waiting. But I've been told that the older you get it becomes harder and harder for the body to accept the kidney. I hope I don't have to wait much longer," he said.

Buttressing the argument as to the difficulty of finding suitable kidneys for transplant recipients is Larry Rushin of Cameron Station. He's been waiting for two years.

"I was called about two months ago at 6:30 a.m. and told to stand by. They said there was a potential kidney available outside the region. Then they called back about four hours later and told me it wasn't suitable," he said.

"I've been doing dialysis for about a year now three times a week. But that takes about 15 hours out of my work week," Rushin explained. "I've exhausted all the possibilities within the family either because of a none matching blood type or because the kidneys are not healthy enough."

Rushin felt that more needed to be done to encourage living donors for kidney transplants. "People really only need one kidney. And, with our population there could be an over abundance of kidneys which would virtually eliminate the wait list for that organ," he speculated.

"We are now approaching 60 to 70 percent of kidney donors being living donors. But, we need more people to step forward," Rushin said.

LAST YEAR WRTC had 87 organ donors as compared to 78 in 2001, according to Webb. Since the organization came into existence in 1986, the highest number of donors in a single year was 92, she said.

Those donors enabled Inova Fairfax Hospital to perform more than 160 organ transplants last year, according to Susan Peters, director, Inova Transplant Center. "Fairfax hospital is the only medical facility in the region that does transplant for all organs," Peters stressed.

When she refers to "all" organ transplants, that encompasses kidneys, liver, lung, pancreas and heart. Others hospitals do some organ transplants but not all. The organ transplant number does not include tissue and bone, these are done in addition.

"More than one half of our kidney donors are now living donors," Peters stated. All Inova Health System hospitals are participants in the donor network.

Virginia is one of only seven or eight states that have initiated a registry for donors, according to Peters. "This enables us to quickly verify the desire of a donor to participate," she explained.

Those wishing to learn more about organ donation and other facts about organ transplants are urged to log onto save7lives.org for the Virginia registry and www.wrtc.org for the Washington Regional Transplant Consortium.

"Also, we urge people to talk to their families so everyone is aware of their desires," Peters said.