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At a glance
Some facts about organ donation:
•Organ transplant recipients are chosen according to six criteria: Severity of illness, time spent on the waiting list, blood type, tissue type, size of organ and location of donor and recipient.
•When organs are recovered in Indiana, officials try to place them with recipients in Indiana.
•Families who donate organs and tissue do not pay any costs for the procedures.
•The success rates for vital organ transplants average 80 percent to 90 percent. The rate for various tissue transplant types is over 90 percent.
Source: Indiana Organ Procurement Organization Inc.

Parkview lags in organ donation

Fitzgerald
Dorko
Tector
The Journal Gazette

A dramatic plunge this year in the number of organ donations handled through Parkview Hospital has prompted an outcry from Indiana University’s transplant surgeons, who worry that lives are being lost as a result.

From Jan. 1 through July 31, only 1 of 11 families who were approached with information gave consent for kidneys and other organs to be removed after patients were declared clinically brain dead. That’s 9 percent, compared with the state average of 71 percent during the same period.

As a result, Parkview has revised how it approaches families of patients who are deemed appropriate candidates for organ donation.

The new process, which invites an Indiana Organ Procurement Organization staff member to join the conversation, is “effective immediately,” spokeswoman Danette Fitzgerald said Thursday afternoon. But she declined to say whether the decision was made Thursday.

Fitzgerald, who learned about the doctor’s concerns from The Journal Gazette on Wednesday, called the sample too small to give an accurate picture.

But data from the last four years show the Fort Wayne health care provider consistently trailed the state average and the performance of cross-town rival Lutheran Health Network. Lutheran’s consent rate for the first seven months of this year was 50 percent – or four of eight.

Dr. A. Joseph Tector III, chief medical officer of the IU Health Transplant Institute, considered the situation an “emergency” to be addressed immediately. Currently, 1,399 patients in Indiana are on the list waiting for transplants, according to the Indiana Organ Procurement Organization.

Fitzgerald said Parkview officials regularly work with IOPO and have been reviewing processes in a bid for continuous improvement.

“We’re identifying action steps that we might take,” she said on Wednesday.

IOPO is a non-profit organization dedicated to advancing organ and tissue donation efforts throughout the state. Among its education programs are materials targeting elementary and high school students, faith organizations, minorities and drivers.

Kellie Hanner, IOPO’s chief operating officer, confirmed conversations have been ongoing with Parkview.

“Their consent rate is definitely below the average for the state,” she said Thursday.

Previously, Parkview hasn’t allowed IOPO staff to talk to family members about organ donation.

Hanner declined to say whether she believes a significant cause of Parkview’s low consent rate has been the health care system’s decision not to use IOPO staff members, who spend two to six months in training, to approach families.

Bill Broydrick, spokesman for Indiana University’s transplant surgeons, has no doubt about the connection. Before Thursday, Parkview had failed to adopt a process that works well at other hospitals, he said.

“They are the only hospital in Indiana that behaves this way. And their results show their abject failure,” he said.

Dr. Tector, who is also a surgery professor at the IU School of Medicine in Indianapolis, agreed.

He thinks Parkview should invite IOPO-trained staff in to talk to families of patients who are considered organ donation candidates.

“At a time where more than 110,000 Americans are clinging to life waiting for an organ transplant, it is disappointing to think that any hospital in this state is allowed to use a different protocol for obtaining consent for organ donation, despite consistently failing to help families come to the decision to donate without asking for help,” Tector said in a written statement made before Parkview confirmed its policy change.

“Each donor could provide the gift of life to anywhere from one to five people,” he said.

Overall, hospitals across the state have supported donation efforts, Tector said.

“Indiana has been a shining example of how organ transplant can work when an entire state gets behind organ donation,” he said.

Fort Wayne-based Lutheran Health Network is among the health care providers with a strong track record.

Joe Dorko, president and CEO, said Lutheran Hospital relies on IOPO staff to talk to patients’ families. He called them the “experts” on broaching the sensitive conversations and helping families work through the decision of whether to donate.

“We sort of hand off that to the people who do that for a living,” he said. “And that is the IOPO staff.”

Dorko doesn’t want his staff to have conflicts of interest because nurses and doctors there often care for critically ill patients who are waiting to receive an organ. And they develop relationships with those who have successfully received a donated organ.

Surgeons have performed 278 heart transplants and 144 kidney transplant operations at Lutheran Hospital, spokesman Geoff Thomas said.

Not including the kidneys that came from living donors – more than 50 percent – it has been “rare that an organ procured at Lutheran ends up being transplanted into a patient at Lutheran,” Thomas said. But it has happened.

Dorko encourages people who want to donate organs to discuss that decision with loved ones. Families who are dealing with shock and grief following an accident should be able to say with confidence that they know what the patient wanted, the CEO said.

Lutheran Hospital has a history of supporting organ donation. The hospital’s donor council hosts an awareness drive to register donors each April.

In 2008, the U.S. Department of Health and Human Services presented its Medal of Honor to Lutheran Hospital to recognize the hospital’s success in increasing organ donation rates.

Parkview recently received recognition for its participation in a cornea transplant program.

Indiana Lions Eye & Tissue Transplant Bank in July presented its Vision Award to Parkview for “demonstrating leadership and a commitment to the Lions’ donor program.”

Parkview Hospital last year ranked first among Indiana hospitals in the number of corneas donated. The local health care provider removed corneas that were implanted in 204 patients, Fitzgerald wrote in an email. Parkview helped provide sight to 722 patients over the past five years through cornea donations.

sslater@jg.net

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