March 1, 2024 ybftsd

Flowers, chocolates, organ donation — are you in?

photo illustration of a heart shape in dark red with the words organ donors save lives on it in white

Chocolates and flowers are great gifts for Valentine’s Day. But what if the gifts we give then or throughout the year could be truly life-changing? A gift that could save a life or free someone from dialysis?

You can do this. For people in need of an organ, tissue, or blood donation, a donor can give them a gift that exceeds the value of anything that you can buy. Fittingly, Valentine’s Day is also known as National Donor Day, a time for blood drives and sign-ups for organ and tissue donation. Have you ever wondered what can be donated? Had reservations about donating after death or concerns about risks for live donors? Read on.

The enormous impact of organ, tissue, or cell donation

Imagine you have kidney failure requiring dialysis 12 or more hours each week just to stay alive. Even with this, you know you’re still likely to die a premature death. Or, if your liver is failing, you may experience severe nausea, itching, and confusion; death may only be a matter of weeks or months away. For those with cancer in need of a bone marrow transplant, or someone who’s lost their vision due to corneal disease, finding a donor may be their only good option.

Organ or tissue donation can turn these problems around, giving recipients a chance at a long life, a better quality of life, or both. And yet, the number of people who need organ donation far exceeds compatible donors. While national surveys have found about 90% of Americans support organ donation, only 40% have signed up. More than 103,000 women, men, and children are awaiting an organ transplant in the US. About 6,200 die each year, still waiting.

What can you donate?

The list of ways to help has grown dramatically. Some organs, tissues, or cells can be donated while you’re alive; other donations are only possible after death. A single donor can help more than 80 people!

After death, people can donate:

  • bone, cartilage, and tendons
  • corneas
  • face and hands (though uncommon, they are among the newest additions to this list)
  • kidneys
  • liver
  • lungs
  • heart and heart valves
  • stomach and intestine
  • nerves
  • pancreas
  • skin
  • arteries and veins.

Live donations may include:

  • birth tissue, such as the placenta, umbilical cord, and amniotic fluid, which can be used to help heal skin wounds or ulcers and prevent infection
  • blood cells, serum, or bone marrow
  • a kidney
  • part of a lung
  • part of the intestine, liver, or pancreas.

To learn more about different types of organ donations, visit Donate Life America.

Becoming a donor after death: Questions and misconceptions

Common misconceptions about becoming an organ donor limit the number of people who are willing to sign up. For example, many people mistakenly believe that

  • doctors won’t work as hard to save your life if you’re known to be an organ donor — or worse, doctors will harvest organs before death
  • their religion forbids organ donation
  • you cannot have an open-casket funeral if you donate your organs.

None of these is true, and none should discourage you from becoming an organ donor. Legitimate medical professionals always keep the patient’s interests front and center. Care would never be jeopardized due to a person’s choices around organ donation. Most major religions allow and support organ donation. If organ donation occurs after death, the clothed body will show no outward signs of organ donation, so an open-casket funeral is an option for organ donors.

Live donors: Blood, bone marrow, and organs

Have you ever donated blood? Congratulations, you’re a live donor! The risk for live donors varies depending on the intended donation, such as:

  • Blood, platelets, or plasma: If you’re donating blood or blood products, there is little or no risk involved.
  • Bone marrow: Donating bone marrow requires a minor surgical procedure. If general anesthesia is used, there is a chance of a reaction to the anesthesia. Bone marrow is removed through needles inserted into the back of the pelvis bones on each side. Back or hip pain is common, but can be controlled with pain relievers. The body quickly replaces the bone marrow removed, so no long-term problems are expected.
  • Stem cells: Stem cells are found in bone marrow or umbilical cord blood. They also appear in small numbers in our blood and can be donated through a process similar to blood donation. This takes about seven or eight hours. Filgrastim, a medication that increases stem cell production, is given for a number of days beforehand. It can cause side effects such as flulike symptoms, bone pain, and fatigue, but these tend to resolve soon after the procedure.
  • Kidney, lung, or liver: Surgery to donate a kidney or a portion of a lung or liver comes with a risk of complications, reactions to anesthesia, and significant recovery time. It’s no small matter to give a kidney, or part of a lung or liver.

The vast number of live organ donations occur without complications, and donors typically feel quite positive about the experience.

Who can donate?

Almost anyone can donate blood cells –– including stem cells –– or be a bone marrow, tissue, or organ donor. Exceptions include anyone with active cancer, widespread infection, or organs that aren’t healthy.

What about age? By itself, your age does not disqualify you from organ donation. In 2023, two out of five people donating organs were over 50. People in their 90s have donated organs upon their deaths and saved the lives of others.

However, bone marrow transplants may fail more often when the donor is older, so bone marrow donations by people over age 55 or 60 are usually avoided.

Finding a good match: Immune compatibility

For many transplants, the best results occur when there is immune compatibility between the donor and recipient. Compatibility is based largely on HLA typing, which analyzes genetically-determined proteins on the surface of most cells. These proteins help the immune system identify which cells qualify as foreign or self. Foreign cells trigger an immune attack; cells identified as self should not.

HLA typing can be done by a blood test or cheek swab. Close relatives tend to have the best HLA matches, but complete strangers may be a good match as well.

Fewer donors among people with certain HLA types make finding a match more challenging. Already existing health disparities, such as higher rates of kidney disease among Black Americans and communities of color, are worsened by lower numbers of donors from these communities, an inequity partly driven by a lack of trust in the medical system.

The bottom line

You can make an enormous impact by becoming a donor during your life or after death. In the US, you must opt in to be a donor after death. (Research suggests the opt-out approach many other countries use could significantly increase rates of organ donation in this country.)

I’m hopeful that organ donation in the US and throughout the world will increase over time. While you can still go with chocolates for Valentine’s Day, maybe this year you can also go bigger and become a donor.

About the Author

photo of Robert H. Shmerling, MD

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

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March 1, 2024 ybftsd

Beyond the usual suspects for healthy resolutions

photo of a new pair of white and orange sneakers in a box, viewed from above on a white and orange background with an angled division between the colors

Early in the new year, promises to reboot your health typically focus on diet, exercise, and weight loss. And by now you may have begun making changes — or at least plans — to reach those goals. But consider going beyond the big three.

Below are 10 often-overlooked, simple ideas to step up personal health and safety. And most won’t make you break a sweat.

Review your health portals

Your medical information is kept in electronic records. You have access to them through the patient portal associated with your doctor’s office. Set aside time to update portal passwords and peruse recent records of appointments, test results, and notes your doctor took during your visits.

“Many studies have shown that when patients review the notes, they remember far better what went on during interactions with their clinicians, take their medicines more effectively, and pick up on errors — whether it’s an appointment they forgot to make or something their doctor, nurse, or therapist got wrong in documenting an encounter,” says Dr. Tom Delbanco, the John F. Keane & Family Professor of Medicine at Harvard Medical School and cofounder of the OpenNotes initiative, which led shared clinician notes to become the new standard of care.

Doing this can help you become more engaged in your care. “We know from numerous studies that engaged patients who share decisions with those caring for them have better outcomes,” he adds.

Ask about health insurance freebies

Your insurance plan may offer perks that can lead to better health, such as:

  • weight loss cessation programs
  • quit-smoking programs
  • free or reduced gym memberships.

Some insurers even offer breastfeeding counseling and equipment. Call your insurance company or take a close look at their website to find out if there’s anything that would help you.

Get rid of expired medications

Scour your cabinets for expired or unneeded drugs, which pose dangers for you and others. Look for prescription and over-the-counter medications (pills, potions, creams, lotions, droppers, or aerosol cans) as well as supplements (vitamins, minerals, herbs).

Bring your finds to a drug take-back site, such as a drugstore or law enforcement office, or a medical waste collection site such as the local landfill.

As a last resort, toss medications into the trash, but only after mixing them with unappealing substances (such as cat litter or used coffee grounds) and placing the mixture in a sealable plastic bag or container.

Invest in new sneakers

The wrong equipment can sabotage any exercise routine, and for many people the culprit is a worn pair of sneakers. Inspect yours for holes, flattened arch support, and worn treads. New sneakers could motivate you to jazz up your walking or running routine.

For example, if it’s in the budget, buy a new pair of walking shoes with a wide toe box, cushy insoles, good arch support, a sturdy heel counter (the part that goes around your heel), stretchy uppers, and the right length — at least half an inch longer than your longest toe.

Cue up a new health app

There are more than 350,000 health apps geared toward consumer health. They can help you with everything from managing your medications or chronic disease to providing instruction and prompts for improving diet, sleep, or exercise routines, enhancing mental health, easing stress, practicing mindfulness, and more.

Hunt for apps that are free or offer a free trial period for a test drive. Look for good reviews, strong privacy guardrails, apps that don’t collect too much information from you, and those that are popular — with hundreds of thousands or millions of downloads.

Make a schedule for health screenings and visits

Is it time for a colonoscopy, mammogram, hearing test, prostate check, or comprehensive eye exam? Has it been a while since you had a dermatologist examine the skin on your whole body? Should you have a cholesterol test or other blood work — and when is a bone density test helpful?

If you’re not sure, call your primary care provider or any specialists on your health team to get answers.

Four more simple healthy steps

The list of steps you can take this year to benefit your health can be as long as you’d like it to be. Jot down goals any time you think of them.

Here are four solid steps to start you off:

  • Take some deep breaths each day. A few minutes of daily slow, deep breathing can help lower your blood pressure and ease stress.
  • Get a new pair of sunglasses if your old ones have worn lenses. Make sure the new pair has UV protection (a special coating) to block the sun’s ultraviolet (UV) light, which can cause eye damage and lead to permanent vision loss.
  • Make a few lunch dates or phone dates with friends you haven’t seen in a while. Being socially connected wards off loneliness and isolation, which can help lower certain health risks.
  • Do a deep cleaning on one room in your home per week. Dust and mold can trigger allergies, asthma, and even illness.

You don’t have to do all of these activities at once. Just put them on your to-do list, along with the larger resolutions you’re working on. Now you’ll have a curated list of goals of varying sizes. The more goals you reach, the better you’ll feel. And that will make for a very healthy year, indeed.

About the Author

photo of Heidi Godman

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

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