Tissue donation efforts to grow beyond hospital walls
Allegheny County officials and the local organ-donation organization want to expand efforts to collect skin, corneas and bones from donors they say are often ignored when they die.
The effort would address about a tenth of the 8,000 people who die in the county annually. The Medical Examiner's Office helps to certify the deaths of about 800 people -- who usually die in their homes -- without doing an autopsy.
Right now, those people and their families have no middleman connection to the medical teams that collect organs from willing volunteers, as is standard after hospital deaths and county autopsies, Medical Examiner Dr. Karl Williams said.
"If people want to be a donor, and they don't die in a hospital, that shouldn't preclude them from being a donor," said Susan Stuart, executive director for the Center for Organ Recovery and Education, the nonprofit federally designated to recover local organs.
Federal law mandates that hospitals notify the center, known as CORE, when eligible donors dies there. The Medical Examiner's Office is working to fill in gaps in the law, which doesn't require the same notification for people who die elsewhere.
If it works, coroners could adopt it throughout CORE's region, which stretches from western New York through most of West Virginia, Stuart said.
The county adopted a policy to notify CORE of bodies -- about 1,000 annually -- that arrive at the morgue for autopsies and other exams. CORE officials first suggested this summer the county expand that policy to include other people -- about 800 cases each year in which the medical examiner was called, is involved in the case, but does not do an autopsy. These are people with easily identified chronic health conditions who have unsuspicious deaths, Williams said.
The medical examiner will ask the next of kin if they'd be willing to consider donation. If their answer is yes, the county passes their contact information to CORE, which is responsible for explaining the donation process to the families, getting permission and the body, and surgically removing the body parts.
"We didn't figure it would be much of a burden to pass on a notification. That's all it really amounts to on our part," Williams said. "If they say no, we move on. In four years I've never got a complaint, that I know of, to the office that says, 'Oh, no, you asked about organ donation.'"
CORE officials aren't sure how many people will be eligible. Chronic illnesses will disqualify some, Stuart said. None will be giving internal organs like hearts and lungs, which can only come from people who die in hospitals. But corneas could be taken for the blind, skin could go for burn victims, and tendons and bones could be use to help fix sports injuries, she said.
Removal of skin and bones can make it more difficult to prepare for funerals, several funeral directors from the region said. People from strong ethnic and religious communities can get anxious about the day or two that adds to the embalming process, adding a sensitive component to any policy decision Williams might make, said former County Coroner Dr. Cyril H. Wecht.
The Allegheny County Funeral Directors Association is supporting the idea because it could lead to more life-saving donations, association President Mark Donato said. At most it could lead to a 10 percent increase in the number of bodies that become donors, which local funeral homes can absorb, he added.
CORE started working harder to meet the needs of funeral directors, even delivering bodies to the funeral homes, said B. David McDermott, funeral director at Schepner-McDermott Funeral Home in Crafton. CORE pays funeral homes about $800 to $1,200 per body when their work causes extra work for the funeral homes, McDermott said.
"We've always been pro-CORE because of extending life for other people," he said. "As long as the family knows what's going on. If they're happy, I'm happy."