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Law Will Require Hospitals to Seek Organ Donations From Next of Kin

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Associated Press

People lay in pain with failing organs while doctors across town often skip asking families for donation of body parts from dead patients.

That is the situation legislators say prompted a new state law they hope will help save the lives of thousands needing organ transplants.

The law is designed to increase the number of scarce organs available for transplants by requiring hospitals to routinely ask relatives of dead patients to allow organ removal, if the deceased are suitable donors.

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California on Jan. 1 will become the third state, after New York and Oregon, to require the solicitations.

Assemblyman Bill Leonard (R-Redlands), who sponsored the legislation, said doctors and hospital staffs are too often reluctant to intrude on a family’s grief with pleas for organs.

Hospital transplant coordinator Cassie Pike said she has “great difficulty getting doctors to approach families about donations. I’ve had people contact me afterwards and say, ‘Why wasn’t I asked?’ ”

“That’s an example of the reason we’re seeing this law. . . . More and more families end up asking the doctors,” said Pike, who works at the University of California, Davis, Medical Center in Sacramento.

Dr. Stuart W. Jamieson, director of Stanford University Medical Center’s heart-lung transplant program, acknowledged that hospitals “only retrieve a small percentage of the available organs for transplantation purposes.”

Jamieson and other researchers say the transplant effort has attained success rates as high as 94% for some organs, despite what he calls inadequate procedures for finding donors.

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Leonard said his measure allows hospitals to develop their own procedures that make the organ requests part of standard operations. Currently, hospitals have the option of skipping the requests.

For example, he said, questions regarding possible donations will either have to be asked of families when they are informed of a relatives’ death or when a family inquires about funeral arrangements.

Robbin Lewis, consultant to the Assembly Health Committee, said the law will also require hospitals that have organs available to notify one of the private organ and tissue organizations, which take body parts to people needing them. Many organs must be transplanted swiftly in order to remain healthy.

She said California Medical Assn. representatives successfully argued that the law allows doctors to take into account “discretion and sensitivity to a family’s situation.”

Some religions and races object to various aspects of the donor program, Lewis said.

The law, in addition, reaffirms relatives’ rights over organ donations by loved ones, she said.

Californians can authorize organ donations on one of the cards mailed out with drivers’ licenses, but after death their donations will not take place unless next of kin approve.

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At University Medical Center, Pike said she had “had families that, even with a signed card, just couldn’t give permission.”

The law also was fashioned so that it will not conflict with existing regulations on the role of county coroners in organ transplants, Assembly Health Committee consultants say.

Coroners are supposed to--but are not required to--help identify potential donors and ask permission of families. Coroners also are authorized to offer organs from indigents, if thorough attempts to reach relatives have failed.

Original guidelines for the transplant program, including rules on who can donate and who receives the organs, were established in the Uniform Anatomical Gift Act of 1970.

At Stanford University Medical Center, which has the largest heart transplant center in the world, spokesman Spyros Andreopoulos said estimates show that a fourth of the people in need of transplants nationwide die waiting for the organs.

“That’s the biggest anxiety, the thought of coming here and dying,” said Stanford’s Mary Burge, a clinical social worker on the transplant screening team.

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The Regional Procurement Agency of Southern California estimates that about 10,000 people nationwide are waiting for kidney transplants, 175 for livers, 150 for hearts and 30 for pancreases.

Assembly consultants estimate that last year in California doctors transplanted 700 kidneys, 75 hearts, 50 livers and 2,000 corneas.

Assemblyman Leonard said the new law should improve the figures.

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