By
The Associated Press
WASHINGTON - Organ donations from the living jumped by 16 percent last year, the largest increase on record, as the waiting list for transplants grew much faster than donations from people who had died.
More than 5,500 people gave a kidney or, less commonly, a piece of the liver, accounting for nearly half the nation's donors in 2000, the Department of Health and Human Services said yesterday.
The number of living donors has been growing more quickly than the number of cadaveric donors for a decade, but the gap was particularly striking in 2000. While the number of living donors jumped 16.5 percent, donations from the dead edged up by just 2.7 percent.
At this rate, living donors will outnumber cadaveric donors within a year or two.
Today, HHS Secretary Tommy Thompson is to unveil a major donation initiative, including a new campaign with businesses and unions to promote donations among their workers. His department also plans to introduce a national donor card that backers hope will give transplant officials a stronger case for proceeding with donation even if the family is wary.
Debate has raged for several years over how to distribute scarce organs for transplant, but relatively little focus has been placed on how to increase the number of donors.
Until now, most of the effort has been channeled into media campaigns that encourage people to talk to their families about donation. HHS also has moved to require hospitals to report deaths to local organ banks so transplant professionals can identify potential donors and approach their survivors.
These efforts, all aimed at donation after death, have produced only tiny increases over the last several years. In the 1990s, the number of patients on waiting lists grew five times as fast as the number of transplant operations.
The long wait - close to 76,000 people are now in line - has helped produce the spike in living donations, experts said.
"When you have to tell patients the wait is going to be three or four years, you say, 'I'd look around and see who might donate a kidney - your family, your friends or someone,'" said Dr. Patricia Adams, president of the United Network for Organ Sharing, who works with kidney patients at Wake Forest University in Winston-Salem, N.C.
In 2000, a total 22,827 organ transplants were performed, an increase of 5.4 percent over 1999, according to data compiled by the transplant network.
The increases were much more dramatic among living donors, who now comprise nearly half of all organ donors. Still, cadaveric - or dead - donors account for the bulk of transplants because each cadaver can donate several organs.
Last year, there were 5,532 living donors and 5,984 dead donors.
A huge majority of donations from the living are kidneys, since most people have two healthy kidneys but must have only one. Last year there were also 344 living liver donations, where surgeons remove a part of a liver for transplant and each piece grows into a whole organ.
Medically, doctors have only been dividing livers for the last few years, explaining the quick rise in the number of these living livers donations.
And for kidneys, research over the last few years has proven that living donations, even from people who are not close relatives, are just as successful - if not more so - than kidneys from people who have died.
That's because the donor is typically quite healthy, and the transplant can be planned more carefully. The donated kidney is usually outside the body for a half hour or less, allowing it to begin functioning in its new body more quickly, said Arthur Matas, a kidney transplant surgeon at the University of Minnesota.
And laparoscopic surgery, where the kidney is removed through a small incision, has reduced the pain and recovery time for the donor.
Still, Matas emphasizes, risks to donors accompany any major surgery.
"When I talk to them, I try to just lay it on the line and say, 'This is an operation that has risks without any physical benefits (to the donor),'" he said, but few are dissuaded. "When I see patients, their families are there, having already decided who's going to be a donor."
