By Staci E. Hensley
For David Cary and his wife, Valerie, the nightmare began in 1995, only a few months after their son, Trenton, was born, when they learned that the baby needed a heart transplant right away.
Meanwhile, for Mary Blankenship Pointer and her 30-year-old son, Nicholas, an uncertain future is unfolding as she prepares to give him life a second time via one of her kidneys.
These two families – and thousands of others across the country – are coping each day with the physical and psychological ramifications of organ transplantation.
The good news is that today’s transplant patients have more life-saving options than ever. Organs and tissues that can be donated include: hearts, kidneys, lungs, livers, the pancreas, intestines, corneas, skin, tendons, heart valves, bone marrow/stem cells and umbilical cord blood. Donations can come not just from someone who is deceased, but increasingly through live donations such as the Pointers are planning. Live donations between non-related individuals are also on the rise.
In Oklahoma, the vast majority of transplant patients are treated at the Nazih Zuhdi Transplant Center, part of the Integris Healthcare Network. The center acts as both a state and regional resource, providing not just medical procedures, but also psychological support, educational programs and other assistance.

Dr. Vivek Kholi
“We have been doing transplants since the late 1980s,” said Dr. Vivek Kholi, associate director of the Zuhdi Center’s Abdominal Organ Transplant Division. “We do complex procedures and the most high-risk cases. Our outcomes are really excellent. We are in the top 10 percent nationally, and we are the only transplant facility in Oklahoma certified by the Center for Medicare Services. We have treated patients from as far away as California and Israel. Our youngest patient was 3 months old, and the oldest was well into their 70s.”
How It Works
The process to match a donated organ or tissues with a recipient begins within minutes after a donor has passed away. Who receives them is determined primarily by who is at the top of the organ registry waiting list, how far away they are, if the recipient is available to have the procedure in a timely fashion, and if he or she is strong enough to withstand the surgery.
It’s a much lengthier process when the donation is going from a live person to a patient. Before anyone can be considered as a live donor, they must undergo blood and tissue typing, a complete physical, an antibody screen, psychosocial evaluation and multiple other medical tests.
Mary Pointer is currently working her way through these tests, and is counting the days until the procedure can take place. Meanwhile, Nicholas continues nine hours of grueling kidney dialysis each night, while continuing his job as a bond trader.
“He’s a trouper; he’s just going on with life,” Mary said. “The wait has been the hardest part for me. As a mom, I’ve always been able to put a band-aid on something, and I can’t do that now. It’s very hard to wait and feel helpless.”
The surgery itself is only the first step in the process.
“All these patients get an organ that is not part of their body,” Kholi said. “They need immunosuppressant medication, and they need to be on that medication for the rest of their lives.” These medications must be carefully balanced in order not to destroy the individual’s immune system and leave them vulnerable to infections.
“The transplant physicians are the ones who manage these medications before and after surgery,” Kholi added. “I call immunosuppressant medications a ‘necessary evil’ of transplantation. If you go without them, you end up with organ rejection and death.”
After surgery, donor recipients have regular checkups, including blood work. For patients living far away, the Zuhdi Center allows them to have blood tests done locally and sent in, where they are processed that same day.
“We are very interactive,” Kholi said. “If we can make it easy for the patient, the compliance rate goes way up, and that compliance is essential because when symptoms do show up, you usually end up with organ failure.”
Immunosuppressant medications have improved considerably over the years, and Kholi said there are promising new developments on the horizon. In particular, research in which bone marrow stem cells from the donor are placed in the recipient, where they can fool the body into thinking the new organ belongs to it.
“Basically it’s a ‘chimeric’ effect, where the body gets a sort of dual immune system,” Kholi said.
“To me, it’s an amazing wonderment being able to take an organ from someone who is already brain dead and put it into another person and save their life,” he added. “It’s a very dynamic, ever-changing inter-disciplinary field, and it’s very time-intensive. But it’s all worth is when we see someone returning to normal after they have been sick for months or years.”
Live Donations
More and more, living donors are providing organs to family, friends or even strangers. These donations can be kidneys, a single lung lobe, or portions of the liver, pancreas and intestines. Like the Pointers, donations can be made between blood relatives. Unrelated donors can include people who have a connection to the patient, such as spouses, friends and coworkers. Other donors can be unrelated or even strangers.
A relatively new phenomenon is paired donations, in which organs are exchanged between two sets of people (see graphic). For example, with two husband-wife teams, Wife A needs a kidney which is being donated by Husband B; at the same time, Wife B is donating a kidney to Husband A. These types of paired donations have been performed at the Zuhdi Center.
Myths vs. Reality
One of the most frustrating aspects for medical personnel, donor recipients and their champions are the ongoing myths that keep some people from becoming donors. One of the most prevalent is that doctors won’t work as hard to save someone if they know they’re an organ donor. In reality, when someone is sick or injured and admitted to the hospital, the number one priority is to save their life. Organ donation can only be considered after brain death has been declared by a physician.
The truth of the matter is:
* People of all ages and medical histories are potential donors. A person’s medical condition at the time of death – not their age – will determine what organs and tissues can be donated.
* All major religions approve of organ and tissue donation, considering it to be one of the ultimate gifts to one’s fellow man.
* There is no charge to the donor or his/her family. All costs are paid by the recipients’ families.
* An open-casket funeral is still possible for organ and tissue donors. These are removed surgically, with no disfigurement to the body.
* Celebrities and wealthy individuals do NOT go straight to the head of the line. The only factors considered for someone on the waiting list are the severity of the illness, the time spent waiting, blood type and other important medical information.
* A patient will NOT wake from surgery to find they’ve had a kidney removed for a black market transplant. A widely-circulated urban legend, there is no known case of such activity occurring in the United States.
For Mary Pointer, the decision to donate to her son was a no-brainer, and she is trying to be patient as she and Nicholas go through the full spectrum of tests and preparation required.
“I signed up to be an organ donor when I got my driver’s license, but never really thought about it,” she said. “I never dreamed I would be facing this situation with my own son.”
Emotional Fallout
It’s common for recipients to feel guilt if their life-saving transplant was the result of someone else’s death. But that’s often alleviated by meetings between the families of donors and recipients. One of the things that can be most comforting for those who’ve lost someone is knowing that their loved one saved multiple lives.
About a year after the surgery, Cary and his family met their donor family – whose son was about the same age as Trenton when he passed away.
“For us, it was a huge relief to be able to show our gratitude,” he said. “But even more importantly, it was a gift to the donor family. After we met, the father told us later that day that it was the first time in a year that he had seen his wife smile.”
“I tell people that becoming an organ donor is the easiest, cheapest way to have a major, direct impact on the well-being of someone else,” Cary said. “No money. Nothing to do while you are alive. I recall prior to our experience not being against organ donation, but rather apathetic to even thinking about it. ‘Yeah, I’ll probably become an organ donor sometime.’ But just think about what would have happened to Trenton if his donor family had not been prepared to make that decision.”
Now a healthy 18-year-old, Trenton Cary continues to enjoy life as a self-professed “computer nerd” and a nationally ranked second-degree black belt in tae kwon do. He too has a message for would-be donors.
“If your friend was dying and you knew you could save his or her life, would you?” he asked. “The only thing that’s different in organ donation is that you don’t always know the person. Why have everyone’s last memory of you be of how you died, instead of how you saved another’s life?”
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How to Become a Donor
Currently, more than 105,000 people are awaiting life-saving organ transplants in the United States; tens of thousands more need tissue transplants.
In Oklahoma, approximately 760 people are on a waiting list, and approximately 50 Oklahomans die each year waiting for a matching organ, according to LifeShare Organ Transplantation Services of Oklahoma.
In most states, including Oklahoma, hospitals can legally proceed with organ, eye or tissue donation without consent from next of kin if that person has a driver’s license with an organ donor designation or has signed up with an organ donor registry, such as www.lifeshareregistry.org. However, it’s important to talk to family members about that decision at the time it’s made, so that they are aware of that person’s wishes and will feel comfortable honoring them. Under most circumstances, organs donated in Oklahoma must be given to someone in the state, under legislation passed during the 1997-1998 session.
Information on organ donation in Oklahoma is also available through http://www.dmv.org/ok-oklahoma/organ-donor.php.
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Helpful Resources
More information about organ and tissue donation is available through the following websites:
National Marrow Donor Program, www.marrow.org
American Red Cross (blood and tissue donation), www.redcross.org
The Organ Procurement and Transplantation Network, http://optn.transplant.hrsa.gov
U.S. Department of Health and Human Services, www.organdonor.gov
Donate Life America, www.donatelife.net