Faced with tragic loss, families face difficult choice of organ donation

When Kelli Jo Lovich was asked to donate the organs of her 4-year-old son, Colbee, who died after suffering severe brain injuries last year in an ATV accident, her response was immediate: "No."

But Shannon Pribik, a procurement coordinator with the Center for Organ Recovery and Education (CORE), persisted. Pribik promised there would be minimal trauma to Colbee during organ recovery and agreed to stay by his side until the funeral director arrived for his body.

Lovich relented. "He was only 4," she said of Colbee, "but he loved to help."

Procurement coordinators are on the front lines of the nation's overwhelmed transplant system.

They approach families like the Loviches in the midst of a tragic loss and ask them — when their grief is raw and their spouse, child or sibling is tethered to machines in the intensive care unit — to donate their loved one's organs so that others can live.

"When you do it for the first time, you feel like you're invading their space," said Linda Miller, who operates a University of Toledo graduate training program for coordinators.

The stakes are high.

With more than 122,000 people waiting for transplants, and an average of 22 of them dying each day, coordinators face great pressure to recover organs from the roughly 2 percent of Americans who end their lives in a way — usually of brain injuries while on a hospital ventilator — that makes donation possible. People who die outside of a hospital cannot be donors because their organs deteriorate too quickly.

Sometimes, a family will say, "It's just not for us. Let the next person be the donor," said Jonathan Coleman, a coordinator at CORE.

Because donation can occur only in limited situations, he said, coordinators stress a family's "unique opportunity" to turn its tragedy into somebody else's second chance at life. Often, advocates say, the decision to donate a loved one's organs — to let that person live on through others — sustains a family for years.

While demand for organs is growing, donation rates have been stagnant, with deceased donors numbering about 8,000 annually for the past decade.

Overall, procurement organizations recover organs from eligible donors 73.6 percent of the time. If a person had registered as a donor — the option is given at a driver's license center, among other places — procurement organizations have the authority to recover organs even if relatives object. If the person was not registered, coordinators try to persuade the family to donate the organs.

A former anesthesia tech, Lovich once walked in on organ recovery surgery by mistake and blanched at the sight. Her reservations about organ donation were clear.

But Lovich said Pribik's promise that the cuts to Colbee's body would be minimal — no greater than that required for regular surgery — softened her resistance. Pribik's promise to stay with Colbee until the funeral director arrived for his body also helped; Lovich didn't want him "to just sit in a basement somewhere."

Finally, the thought of Colbee helping others moved her aching heart.

Coordinators are trained to address concerns and answer questions while guiding the family toward donation. Families often make special requests, and Pribik, who has held donor children in her arms, played their favorite songs in the operating room and kept treasured belongings near them, obliges when she can.

Miller said she speaks with her students about the "top 20 objections/concerns that families might have" and urges them to ask "probing questions" to get to the root of unspoken fears.

Faced with the loss of a loved one, some families are dazed. Others are angry. "We are prepared for that," Miller said.

Coordinators often suggest that donation would be a heroic act in keeping with the patient's good character.

"We don't ask the family. We offer them the opportunity. I really feel I'm giving them something good," CORE coordinator Amy Weisgerber said.

As soon as possible after the transplant, procurement organizations give donor families news about the donated organs' fate. Lovich learned that Colbee's kidneys had gone to a man and a woman, both in their late 50s, and his heart valve to an 11-month-old baby.

She has continued to stay in touch with Pribik and has registered as a donor so that she has a chance to follow Colbee's example.

"If my son can do it," she said, "I can do it."