ISSUE 142, Special Section: Cancer Care

Know A Good Doctor? We Do.

Organ Donation: Anyone Can Be a Lifesaver

LOUISVILLE As president and CEO of Kentucky Organ Donor Affiliates, Julie Bergin, BSN, FACHE wants you to remember two things:

Everyone has the potential to be an organ donor.
Registering to be an organ donor saves lives.

“Nothing automatically excludes you from being a candidate for organ donation,” Bergin says.

Julie Bergin, BSN, FACHE, president and CEO of Kentucky Organ Donor Affiliates

Bergin’s passion for healthcare began at age 16 while working during school breaks at a hospital where her mother was a nurse. She joined KODA in 2003 as an organ recovery coordinator. After a brief return to ICU nursing and clinical education, she came back to KODA in 2011 as director of quality services. She was promoted to COO in 2014 and CEO in 2017.

Bergin’s heart connected solidly with KODA’s mission after a family member was a donor and a close friend became a recipient. Many of KODA’s 100+ employees share similar connections.

KODA serves most of Kentucky and small areas of Indiana, Ohio, and West Virginia. Its mission is to unite organs and tissues with those in need. They partner with Kentucky Circuit Clerks’ Trust For Life, who registers Kentucky residents as organ donors, and Kentucky Lions Eye Bank, which handles cornea donations and transplants.

KODA operates 365 days a year. Its 24/7 call center takes over 25,000 calls a year from hospitals, which are required to report all onsite deaths. Teams respond quickly to assess every situation and discuss potential donations with families.

Six organs — hearts, lungs, livers, kidneys, pancreas, and intestines — qualify for donation. They may come from recently deceased individuals or patients with no brain function, typically due to injury or cardiac death. Donations that involve discontinuing ventilation often reflect a patient’s desires expressed through a living will or advance directive.

Tissue donations include skin, bones, tendons, and saphenous veins. These typically come from hospital patients who experience cardiac standstill. A carefully controlled process allows tissue donations up to 24 hours after heart standstill occurs.

“Quick action is critical,” Bergin says. “We sometimes have only a 2-to 4-hour window for recovery.”

Numbers Speak Loudly

In 2021 KODA facilitiated 189 donations that changed the lives of 496 organ recipients. This marked a fifth consecutive annual increase in donations. Since 2017 organ donations have increased 75%, and tissue donations have increased 45%.

“We’re proud of achieving the most donations ever seen in Kentucky and hope to continue this trend,” Bergin says.

“Nothing automatically excludes you from being a candidate for organ donation.”

Historically, Kentucky’s small rural hospitals have transferred critical patients to trauma centers and other higher acuity facilities. With transfers limited by the pandemic, KODA has worked with smaller hospitals statewide to perform their first-ever in-house organ donations.

During the pandemic’s first 15 months KODA recovered no organs from COVID-positive patients. Currently, COVID patients can donate organs. Bergin said abdominal organs — specifically kidneys and livers — can be transplanted without transmitting COVID.

Approximately 60% of organ donors are male and 40% are female. Transplant recipients are all ages and come from all walks of life.

About 1,000 people are on Kentucky’s organ wait list. Nationwide more than 100,000 people are in need of a transplant.

While thousands of donor referrals are made annually, Bergin notes that only 1% of the population dies in a way that makes organ donation possible. This underscores the urgency of evaluating all potential donations.

Nationwide, kidneys are the most frequently donated organs, followed by livers and hearts. KODA facilitated 130 liver transplants and 60 heart transplants last year.

Lungs account for a relatively small percentage of transplants. KODA has seen a two-year decline in lungs recovered for transplant although the need may grow due to COVID complications.

Pancreas transplants are also rare, since effective control measures are widely available for Type I diabetics. Pediatric patients are usually the only candidates for an intestines transplant.

In Kentucky 63% of the adult population are registered donors with one of country’s fastest growing registries.

KODA encourages everyone to document their wishes by signing up for the donor registry. This “act of love” spares loved ones the pain of making hard decisions in situations that may occur with little advance warning.

In such situations families want to be sure their loved ones have received the best care possible. KODA wants everyone to know donation is not an option until care teams have done everything possible to save a patient. Even if patients are registered donors, donation is not considered until no care options are left, and all donors are treated with great respect.

Organ recovery takes place in an OR where an anesthesiologist, scrub nurses, and the recovery team work together. KODA recently hired its own recovery surgeon, Cosme Manzarbeitia, MD, FACS. This strategic move helps lighten the hospital care teams’ heavy workloads.

Raising Awareness, Quashing Misperceptions

KODA strives to raise awareness about the importance of organ donation. For example, a February art exhibit at Louisville’s KULA Gallery compared organ wait time among minorities (up to 10 years) vs. that for Caucasians (7 years). The Faces of Donation exhibit was coordinated by Donate Life KY to kick off National Minorities Month.

On April 8 the Live to Save Lives Concert took place at Ashland, Kentucky’s Paramount Arts Center. It featured local and regional stars and was co-hosted by the Kentucky Circuit Court Clerks’ Trust For Life.

On national Blue & Green Day, April 12, people were encouraged to wear the colors of the day and register as organ donors. Louisville’s Big Four Bridge, Churchill Downs’ Twin Spires, and other venues statewide lit up to honor those who save lives through the gift of donation.

Advocacy is a key part of KODA’s work and has contributed to two recent pieces of encouraging legislation.

SB30, a bill sponsored by Kentucky State Senator Brandon Storm (R), was signed into law in March and adds a donor registry question to online car tag renewals.
HB777 looks at addressing Kentucky’s ambulance shortage. It includes provisions to facilitate organ transportation after recovery. Ambulance availability is crucial for transporting donated hearts and lungs, which have tight viability windows.

People may assume only young, healthy people can donate organs. Not so, says Bergin. In 2021 a 95-year-old man from West Virginia became the oldest organ donor in U.S. history. His liver saved a woman’s life and his tissue and corneas helped 77 people.

“You’re never too sick or too old to register to be a donor,” says Bergin.

Many people mistakenly believe illnesses such as hepatitis C or HIV rule out organ donation. Now that hepatitis C can be cured, it is not a barrier to organ donation. The HOPE Act of 2013 made it possible for those with a history of HIV to be organ donors.

All major religious and faith systems support organ donation. They widely view it as an ultimate act of charity and love. Ultimately, this is something we should all be able to agree about and act upon.