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Organ donation program again honored by Dick Peterson Special to the Catalyst MUSC received national recognition recently with a Congressional Medal of Honor for organ donation, having achieved greater than 75 percent consent rate for patient’s medically eligible for organ donation during 2007.   The medal is MUSC’s third in as many years.   The award is given to hospitals who have achieved a consent rate greater than 75 percent, which is a national standard set three years ago. The goal, with guidelines from a study of how the most successful hospitals succeed at achieving high consent rates, is set to alleviate a dire shortage of viable organs for transplant at a time when the organ transplant waiting list is approaching 100,000 nationally.   “The number of donors has not gone up to the degree that the number of those who need organs has increased,” said Transplant Service Line administrator Kim Phillips.   Several years ago, the U.S. Department of Health and Human Services (HHS) recognized the problem and made it a regulation for hospitals to report all patient deaths to the local organ recovery agency, which for South Carolina is Life Point. Other regulations followed and advertising campaigns urged people to sign on and become organ donors, but still the demand for organs continued to outstrip the supply.   “Few of these initiatives had a significant impact on the total number of organs available for transplant,” Phillips said.   With people dying on an ever-growing waiting list, HHS and the Health Resources and Service Administration (HRSA) three years ago decided to identify the top volume hospitals most successful at having people say “yes” to donation. A study of the top 10 or 12 hospitals with the highest conversion rate revealed methods in how to best approach potential donors and the families of potential donors.   Usually, the most likely organ donors are people who suffer from irreversible brain injury. Often the situation is sudden and desperate, leaving family members unprepared to make difficult decisions on behalf of a loved one. The study showed that hospitals with the best conversion rates, some approaching as much as 90 percent, were those that helped patients and patient families when death was imminent and counseled family members after a loved one had died.   “What they did was look at the top 200 largest hospitals—MUSC included—and develop a program to push them to a 75 percent conversion rate,” Phillips said. The average conversion rate for those hospitals was about 50 percent at the time. The National Organ Donation Collaborative was organized and invited the top 200 hospitals to participate in a study of the most successful programs, learn what they did best and bring what they learned back to their individual programs.   “They went into the centers with the most success, talked to everybody, collected information and came up with key strategies that could be implemented,” Phillips said. “HHS decided to honor hospitals that achieved a 75 percent or greater conversion rate for a rolling 12-month period with a Congressional Medal of Honor.”   MUSC’s conversion rate before the program was instituted was in the low 30 percent to 40 percent range, but has since achieved 75 percent for the past three years. Phillips said that four years ago MUSC took the initiative to work with Life Point to identify ways to increase donation through staff education and support provided to families dealing with the death of a loved one. This contributed to a higher donation consent rate.   “We owe it to the donor family to be very honest about the process of donation and the possibility of a positive future outcome to provide comfort during their time of grief. Donation should never be offered to someone who isn’t irreversibly dead,” he said. “But once brain death has been declared, there should be a very well thought-out process so that when a family is approached and organ donation is discussed, the family will positively consider it, and say ‘yes’.”   “When you talk to a donor family a few months after the donation, the one thing they will all say is that they really didn’t understand the healing that comes from knowing that there is a positive aspect to their horrible loss,” Phillips said.   A state program to create an organ donation registry promises to increase organ donations and alleviate family indecision when a loved one is dying. Phillips said that the registry will be a reflection of what a person wants with regard to organ donation and a “yes” will add legal support to a person’s intent, something the current driver’s license entry does not do.   Public notification of the registry will be coming out in April, he said.     Friday, Dec. 21, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.