ORGAN DONATION is a true gift of life. With a new multi-organ transplant facility at Vancouver Gen- eral Hospital and an expanding intensive care unit at Lions Gate Hospital, staffed by doctors and nurses committed to supporting the provincial organ donor Program, there is a timely need for people to talk organ donation. This is the second of a two-part series looking at some of the issues raised by the organ donation process. Organ donations open a new door to life AT LIONS Gate Hospital, intensive care unit medical B staff routinely salvage the lives of critically-injured pa- tients. But sometimes patients die. And if the circumstances permit it, vital organ donation becomes possible. In death, a new dcor is opened to life. Doctor Warren Mayo, head of intensive care at LGH, is a strong supporter of the Pacific Organ Retrieval for Transplantation (PORT) Program. The program works because of people like Mayo. When a pa- tient is declared brain dead, it is up to Mayo and his staff to ap- proach the patient’s family and attempt to secure consent for organ donation. On average, one or two deaths in a hundred allow for vital organ donation. Organs such as heart, lungs, kidneys, liver and pancreas can only be recovered from donors whose circulation and respiration are maintained by hospital support systems. The task of achieving suc- cessful organ transplantation begins in an intensive care unit. The process is both physically and emotionally taxing. Said Mayo: ‘‘First you look after a patient and then your pa- tient essentially dies. So there’s the failure. And then you have to teH the family on short notice. Usually it’s a trauma case. So half an hour before, they had a vital family member. And then half an hour later they have a stranger telling them that seme- one they loved is dead. Then you have to attempt to ask them if they would consider organ dona- tion. That’s emotionally very dif- ficult.” The challenge of maintaining a donor’s organs, uniil they can be removed, often has Mayo putting in 36 consecutive hours of work. ‘‘Once they become brain dead, it is extremely time consuming and technically difficult to keep the rest of the body alive. “There is much that flows from the brain, both hormonally and neurologically, that regulates everything else in the bady. When that regulatory system is destroyed, then we have to regu- late externally,’’ he zaid. LGH has taken a lead in the province as a major referral cen- tre for organ donations, in part, because of its designation as a regional trauma centre. Said Mayo: ‘‘We get a certain type of patient, they’re the ones who tend to become organ donors — motorcycle injury, head injury. The rest of the body is pristine, it has not been in- jured, but that means that their heart, their lungs, their kidneys, Business .... By MIC LL BECKER News Reporter their liver, their corneas are available for somebody else. You're looking at eight potential benefaciors.”’ Thanks to community and hospital expenditures, the inten- sive care unit has received an in- fusion of approximately $750,000 worth of life support and monitoring equipment over the past few years. The number of intensive care doctors, whose skills are neces- sary for the care of organ donors, has also been increased. LGH organ referrals may be matched with recipients undergo- ing transplantation operations at Vancouver General Hospital, St. -Paul’s Hospital, or out of pro- ince. “PORT's policy is to try to keep the organs within the pro- vince, but it’s a very democratic system. There’s no jealousy throughout North America. If yau have a heart, they'll try des- perately hard to get a match anywhere. It’s such a rare com- modity that only lasts for so long,’’ he said, adding, *‘We've sent hearts to Seattle, London, Ontario, down to the states. PORT