The number of transplants performed in Alabama this year -- 349 -- is the lowest since 1992, according to the U.S. Department of Health & Human Services.
Organs have been transplanted from 134 deceased donors in Alabama so far this year, which is more than the number of deceased donors in 2009 and 2008, but below 2007's record-setting number of 155, the Alabama Organ Center reported.
However, the number of transplants from living donors in Alabama this year -- 63 -- is the smallest number since 1991.
Deceased donors are less common than in years past, in part, because traumatic injuries today are less likely to be fatal, said Dem Lalisan, director of the Alabama Organ Center, the organ procurement organization for the state.
"Safety has played an important part," Lalisan said.
Cyclists are more likely to wear helmets, drivers and passengers are more likely to wear seatbelts and the number of fatal wrecks is dropping.
The economy also has contributed to a decline in travel and other leisure activities that in the past contributed to accidental deaths, Lalisan said. That means fewer young people are dying accidentally.
"They are 60, 70 and 80-year-olds," Lalisan said of deceased donors. "They (older people) may have transplantable organs, but not as many."
Compounding illness
One reason for the decline of living donations is that the same medical problems that force people to seek kidney transplants -- the most common transplant surgery -- also often afflict the family members that would make the best donors, said Dr. Devin Eckhoff, chief of the UAB Division of Transplantation and the AOC's medical director.
"We don't want the donors on dialysis 10 years later," Eckhoff said.
UAB Hospital has performed more than 8,400 transplants since 1968, Eckhoff said, making it the nation's second largest transplant center in the nation, just behind The University of California, San Francisco.
"We have a whole team of people trying to save lives," Eckhoff said. "We can't do it without organ donors."
In December 2009, 2,415 Alabamians were awaiting a transplant. This year, that number has grown to 3,522, according to the United Network for Organ Sharing. Nationwide, there are 109,870 patients in need of one or more organs, up from 104,043 this time last year.
"We'll never keep up," Lalisan said.
Call to register
To serve the needs of those on the waiting list, the AOC has launched an aggressive public education campaign to persuade more Alabamians to register as donors. UAB is working to convince more people -- particularly minorities -- to become living donors.
There are roughly 1.7 million registered donors in Alabama. Recently released U.S. Census data puts the state's population at an estimated 4.8 million. That rate of registered donors -- about 35 percent -- puts Alabama on par with other states.
However, Lalisan said, the state is often not able to transplant as many organs from donors, something he attributed to poor eating habits and the diabetes, hypertension and other health problems those habits cause.
"The number of organs we're able to transplant is not up to par with other states, but it's improving," he said.
Lalisan said he hopes new, frequently aired television ads featuring stories of families who agreed to let deceased loved ones' organs be donated and the tales of those who benefited from transplants will convince more Alabamians to register.
Lalisan said much of the AOC's time is spent dispelling these common misconceptions about organ donation:
Organ donors won't receive the best of medical care. "Doctors take an oath to provide that care," Lalisan said. The AOC is never involved until doctors determine someone is brain dead or death is imminent, he said.
Families will have to pay for the donation of the organs. Lalisan said families are never asked to pay.
Open casket funerals aren't possible for organ donors. "If it isn't possible, it wasn't because of the donation, it was because of the mechanism of death," Lalisan said.
One key area of public education efforts is a state law revised in 2008 that allows people greater choice when deciding to be a donor. Before the revision, family consent was needed to remove organs from registered donors.
The law now allows donors to decide which organs they wish to donate, those they do not, and whether they want to donate the organs for transplant or scientific research.
A website maintained by the AOC -- www.alabamaorgancenter.org -- allows potential donors to register and those who were already donors to decide which organs they wish to donate and the purpose of the donation.
"We're not asking (relatives) ... to make the decision in a hospital waiting room at 3 in the morning," Lalisan said. "We're letting them know it has been made and telling them about the process."
Lalisan said part of the public education campaign involves urging registered donors to discuss their decision with loved ones. The registration site allows donors to e-mail up to five people an announcement.
Of all deaths that take place in a hospital, about half of those people have organs that are suitable for transplanting. Of those with suitable organs, only about 60 percent typically have given prior consent for their organs to be used.
In cases when the AOC is contacted about the death or imminent death of someone who is not a registered donor, staffers are successful in persuading relatives to allow the transplants about 55 to 60 percent of the time, he said.
Because of those factors, "These opportunities can quickly start to dwindle," Lalisan said.
That's another reason more needs to be done to educate people about living donations, particularly minorities, Eckhoff said.
Blacks comprise 26 percent of Alabama's total population, but make up nearly two-thirds of Alabamians needing a kidney transplant, according to the Scientific Registry of Transplant Recipients.
And while about 45 percent of white Alabamians are registered donors, only about 23 percent of blacks in the state are registered donors, the registry showed.
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