WEBVTT - SYSK Selects: How Organ Donation Works 0:00:00.080 --> 0:00:03.680 M Hey everybody, it's me Josh and for this week's 0:00:03.800 --> 0:00:07.440 s Y s K Selects, I've chosen January two thousand 0:00:07.520 --> 0:00:11.720 ten episode called How Organ Donation Works. We get into 0:00:11.760 --> 0:00:15.120 the ins and outs of organ donation, that what you 0:00:15.200 --> 0:00:17.560 can do and what you can't, and we also talk 0:00:17.640 --> 0:00:22.680 about the black market for organs um, which is something 0:00:22.720 --> 0:00:24.560 that's been in the news recently. There has been a 0:00:24.680 --> 0:00:30.680 huge Reuters expose on the secondary organ donation market for 0:00:30.880 --> 0:00:34.800 profit market, which is worth reading too, especially if this 0:00:34.840 --> 0:00:38.680 episode floats your boat. So I hope you enjoy How 0:00:38.800 --> 0:00:50.320 Organ Donation Works. Welcome to Stuff you Should Know from 0:00:50.320 --> 0:00:59.200 House Stuff Works dot com. Hey, and welcome to the podcast. 0:00:59.280 --> 0:01:02.640 I'm Josh Lark with me as always as Charles W. 0:01:02.880 --> 0:01:08.520 Chuck Bryant, who I assume has two functional kidneys. I do, 0:01:08.920 --> 0:01:11.600 but I would give one up for you, brother. Wow, 0:01:12.120 --> 0:01:15.080 would you really? Maybe? I think I think that three 0:01:15.160 --> 0:01:17.959 Chuck as a living donor maybe not? But if I died, 0:01:18.000 --> 0:01:20.200 then sure you get thanks. Man. What about your liver, 0:01:20.280 --> 0:01:23.960 because I'm pretty certain I'm gonna need somebody's livers. I 0:01:24.040 --> 0:01:26.039 don't know that you would want mine either, to be honest. 0:01:26.040 --> 0:01:28.560 Oh yeah, that'd be like getting Mickey Mantle's liver. I 0:01:28.560 --> 0:01:31.600 need like a we need a virginal liver, don't. Yeah, 0:01:31.600 --> 0:01:35.000 so I can just start over again, wash it in vodka. 0:01:35.480 --> 0:01:37.680 So what are we talking about, Josh? We're talking about 0:01:37.760 --> 0:01:44.600 organ donation, Chuck perfect, which I find absolutely fascinating. UM. 0:01:44.760 --> 0:01:47.400 Back in nineteen fifty four, let me take you back 0:01:47.400 --> 0:01:52.440 a little bit here, the first successful living human to 0:01:52.680 --> 0:01:56.120 human organ donation took place. It was a kidney. Yeah, 0:01:56.120 --> 0:01:58.960 it was a great story. Kidneys actually remained the most 0:01:59.040 --> 0:02:09.000 commonly donated and UM received organs. But this was actually 0:02:09.320 --> 0:02:12.240 a couple of twin brothers, one of whom was dying 0:02:12.520 --> 0:02:17.000 of chronic nephritis. Yeah, Richard and Ronald Herrick. And Richard 0:02:17.360 --> 0:02:20.200 was the one dying, and Ronald was in good shape, right, 0:02:20.280 --> 0:02:22.800 and Ronald said, well, you know what, you're my twin brother, 0:02:22.840 --> 0:02:24.600 and I don't really want you to die young, so 0:02:24.639 --> 0:02:27.639 I'm going to give you one of my kidneys. And UM. 0:02:27.680 --> 0:02:31.560 There have been uh some other transplants before that. They 0:02:31.560 --> 0:02:33.640 didn't work out though, well some of them did, but 0:02:33.680 --> 0:02:37.240 it wasn't live human to human UM like for example, 0:02:37.360 --> 0:02:41.119 the first I think the first organ, the first donation 0:02:41.240 --> 0:02:43.920 or transplant that ever took place was way back in 0:02:44.000 --> 0:02:48.040 sixteen sixty where they fused part of a dog's skull 0:02:48.360 --> 0:02:52.640 under human's head and that graft worked. H We have 0:02:53.080 --> 0:02:56.680 taken testicles from monkeys and successfully in playing them into humans. 0:02:57.639 --> 0:03:03.440 A pig kidney was successfully transplanted into a human vein transplants, uh, 0:03:03.480 --> 0:03:06.799 And a lamb kidney was put into a recipient in 0:03:06.880 --> 0:03:09.480 nineteen twenty three and that person lived for nine days. 0:03:09.760 --> 0:03:13.560 But nineteen fifty four finds the first time a living 0:03:13.600 --> 0:03:16.960 person donated an oregan to another living person, and it 0:03:17.000 --> 0:03:21.120 was successful. And the reason why, they think was because 0:03:21.120 --> 0:03:25.320 they're twins, there was a very low chance of rejection, right. Yeah. 0:03:25.360 --> 0:03:27.400 And the story is great because Richard, you know that 0:03:27.520 --> 0:03:30.680 the dying brother had a moment, a clear moment where 0:03:30.720 --> 0:03:33.359 he literally, like the day before, said don't do this. Man, 0:03:33.400 --> 0:03:35.840 get out of here right now. And the brother said, no, 0:03:36.520 --> 0:03:39.040 I'm gonna give you my kidney like it or not, chump, 0:03:39.120 --> 0:03:41.400 and he did. And it was a great story. Yeah, 0:03:41.440 --> 0:03:44.720 And they actually both lived to ripe old ages reproduced, 0:03:44.760 --> 0:03:48.240 so they fulfilled their destinies humans. And since then, Josh, 0:03:48.280 --> 0:03:49.720 there have been more than a half a million of 0:03:49.720 --> 0:03:53.480 these organ transplants performed. Right, We've gotten a lot better 0:03:53.560 --> 0:03:57.080 at it. Um. As I was rambling off that list 0:03:57.120 --> 0:03:59.600 of stuff that took place before nineteen fifty four, we 0:03:59.680 --> 0:04:03.240 have and exponentially better. Uh. In two thousand three, we 0:04:03.320 --> 0:04:06.400 successfully transplanted a tongue. Yeah, I saw that, which I 0:04:06.440 --> 0:04:09.000 could use a tongue transplant. A slightly thinner tongue would 0:04:09.040 --> 0:04:10.920 would do me a lot better. I think you had 0:04:10.960 --> 0:04:14.440 a fat tongue. Yeah. And do you remember the um, 0:04:16.120 --> 0:04:19.760 what do we do the face transplant? Huh um. That 0:04:19.800 --> 0:04:23.800 woman actually remember she got her face from a suicide victim. 0:04:24.120 --> 0:04:27.120 That was in two thousand five and in two thousand six, 0:04:27.279 --> 0:04:30.560 so I know it's coming. A cadaver's penis was transplanted 0:04:30.560 --> 0:04:35.040 onto a living humane and that man gave it back. Yes, 0:04:35.160 --> 0:04:37.800 and I love The reason they gave was because of uh. 0:04:38.200 --> 0:04:41.599 It caused psychological problems between the man and his wife, 0:04:41.839 --> 0:04:45.320 which I can imagine. Let your imagination running with that one. Yeah, yeah, 0:04:45.400 --> 0:04:47.920 that's just uh. I would say the same thing would 0:04:47.920 --> 0:04:50.800 happen to my household. So thanks to m A better 0:04:50.920 --> 0:04:54.080 understanding of how the human body works of blood type, 0:04:54.240 --> 0:04:58.320 of the development of anti rejection drugs like Chuck said, 0:04:58.839 --> 0:05:02.920 we've hit about half a million transplant surgery so far. Right, 0:05:03.040 --> 0:05:06.839 So Chuck actually is hot and heavy, uh to to 0:05:06.920 --> 0:05:09.120 give out a stat and this is a very special 0:05:09.200 --> 0:05:12.960 stat because it's actually most likely going to change by 0:05:12.960 --> 0:05:15.560 the end of the podcast. Yes, these are taking away. 0:05:15.600 --> 0:05:18.479 These are current stats. If you go to the website 0:05:18.680 --> 0:05:22.080 u n O s dot org, the United Network for 0:05:22.160 --> 0:05:25.360 organ Sharing, they actually have up to the minute statistics 0:05:25.400 --> 0:05:28.400 on who needs what and who's giving what and what 0:05:28.520 --> 0:05:31.360 operations are being performed. And I didn't realize this, but 0:05:31.960 --> 0:05:33.640 it's up to the minute because earlier in the day 0:05:33.680 --> 0:05:36.760 I checked on kidneys and the number actually dropped by 0:05:36.800 --> 0:05:39.000 three about an hour later on the waiting list, So 0:05:39.120 --> 0:05:41.599 three people got kidneys in that like half hour span. 0:05:42.480 --> 0:05:44.000 So I'm just gonna read a couple now and then 0:05:44.000 --> 0:05:47.120 we'll check back in for fun in twenty minutes and 0:05:47.120 --> 0:05:49.320 see if that's changed at all. Okay, I'm gonna write 0:05:49.360 --> 0:05:51.400 this down to Chuck because we'll never remember it. This 0:05:51.440 --> 0:05:53.400 is the first time we've ever used a laptop in 0:05:53.440 --> 0:05:59.480 the studio and a pen usually just us in our mouths. Uh. Total, Josh, 0:05:59.520 --> 0:06:03.680 we got one five hundred and five thousand, two people 0:06:03.680 --> 0:06:07.080 are waiting for organs, and we'll do kidney because that's 0:06:07.080 --> 0:06:10.440 the most popular. Eight three thousand and twelve people are 0:06:10.480 --> 0:06:14.040 waiting for a kidney as of two oh three pm. 0:06:14.160 --> 0:06:17.480 All right, and we'll check that in twenty minutes and 0:06:17.680 --> 0:06:20.760 hopefully those numbers have gone down. Yeah, because that will 0:06:20.800 --> 0:06:23.520 mean that either the people on the waiting list have 0:06:23.680 --> 0:06:26.600 died or they received a transplant. I guess we could 0:06:26.680 --> 0:06:29.320 put those two, we could compare against one another, and 0:06:29.440 --> 0:06:35.800 maker we could surmise for So, Chuck, what are organs? Yeah? 0:06:35.839 --> 0:06:38.600 I had a feeling you're going to ask me that, Josh, 0:06:38.800 --> 0:06:42.520 go ahead, No, okay. Organs are systems of cells, Josh 0:06:42.600 --> 0:06:45.440 and tissues, and they all are in our body for 0:06:45.480 --> 0:06:48.120 a very specific reason, each one. And what I like 0:06:48.160 --> 0:06:50.839 about the organs is that they are all over equipped, 0:06:51.279 --> 0:06:54.080 which is what you're looking for in an organ. You 0:06:54.120 --> 0:06:56.320 don't want like the heart to be like boy, if 0:06:56.360 --> 0:06:59.560 it beats one beat less, you're really screwed. So um 0:06:59.600 --> 0:07:03.000 our art. Actually, a twenty year old's heart beats pumps 0:07:03.040 --> 0:07:05.640 about ten times more than the amount of blood we need. 0:07:06.320 --> 0:07:08.960 And uh, we we have this reserve capacity in all 0:07:08.960 --> 0:07:12.520 of our organs. As young lads and lasses. Right. But 0:07:12.840 --> 0:07:17.160 as Tom Chief, who you know as my bff who 0:07:17.160 --> 0:07:20.760 wrote this article, he points out that the corneas, when 0:07:20.800 --> 0:07:25.280 you talk about eye transplants, they're talking about corneal transplants. Um, 0:07:25.320 --> 0:07:29.400 they actually don't necessarily deteriorate like all the other organs. Yeah, 0:07:29.400 --> 0:07:32.560 that's pretty cool. Um, So the corneas of seventy five 0:07:32.600 --> 0:07:36.200 year old donor are just as good, considering you know, 0:07:36.280 --> 0:07:40.320 there's not more wear and tear than say a twenty 0:07:40.400 --> 0:07:42.120 year old. Yeah, you could put a seventy year old 0:07:42.640 --> 0:07:45.120 person's cornea inside of a young person and there would 0:07:45.120 --> 0:07:48.600 be no difference. Right. But for organs, they deteriorate with age. 0:07:48.680 --> 0:07:52.080 Well that's the bad news, right, Um, so eventually you 0:07:52.120 --> 0:07:54.840 may need one, right, Well, yeah, because what happens is, 0:07:54.920 --> 0:07:57.720 let's say one organ can deteriorate while the rest of 0:07:57.760 --> 0:08:00.680 your body remains pretty healthy. That's actually best case scenario, 0:08:01.080 --> 0:08:03.920 as weird as that sounds, because that means you can 0:08:03.920 --> 0:08:07.360 just swap that sucker out and you'll be fine again. Right. Well, 0:08:07.480 --> 0:08:11.080 that that's in a very ideal utopian world. That's exactly 0:08:11.080 --> 0:08:13.520 what happens. The problem is, there is a lot more 0:08:13.600 --> 0:08:16.120 people in need of organs than there are organs available 0:08:16.280 --> 0:08:19.480 right right, there's um a waiting list. Some aren't so bad. 0:08:19.520 --> 0:08:22.240 I think kidneys go pretty quick, as you're you're talking 0:08:22.240 --> 0:08:25.800 about earlier. The longest wait I found, um was the 0:08:25.840 --> 0:08:30.000 old heart lung combo. That median wait time was six 0:08:30.040 --> 0:08:32.520 point seven years. It's a long time to wait for 0:08:32.559 --> 0:08:34.120 a heart and a long if you need it. Yeah, 0:08:34.160 --> 0:08:36.600 a long time because nobody goes I'm probably gonna need 0:08:36.600 --> 0:08:38.600 a heart and a long combo. Eventually, I'll just put 0:08:38.600 --> 0:08:41.320 myself on the waiting list. Now you need it, like 0:08:41.360 --> 0:08:44.120 the moment you go onto that waiting list and you 0:08:44.160 --> 0:08:47.080 have to wait six point seven years until you get it, right, Yeah, 0:08:47.160 --> 0:08:50.720 and that's why. Um, the mortality rate while waiting for 0:08:50.760 --> 0:08:54.280 a heart, which is that's not as bad as I 0:08:54.280 --> 0:08:59.640 would I would be, like the lungs are, and um, 0:08:59.720 --> 0:09:05.600 the ever actually is the worst good Yeah, sorry, um. 0:09:05.720 --> 0:09:08.360 There's two ways you can get organs from a live 0:09:08.480 --> 0:09:12.520 person or a dead person. Yes, Traditionally we don't take 0:09:12.760 --> 0:09:15.640 organs like the heart from a live donor because they 0:09:15.640 --> 0:09:18.760 would be a dead donor. After that, you can take 0:09:18.880 --> 0:09:23.920 things like uh, the liver pancreas uncommonly, but it can 0:09:23.960 --> 0:09:29.360 be done a portion of the intestine, um, blood, blood, 0:09:29.400 --> 0:09:33.960 stem cells, bone, marrow, bones, all and bones. Yeah, which 0:09:34.400 --> 0:09:37.600 giving up a bone that's really something like, I mean 0:09:37.640 --> 0:09:40.000 after that, you just kind of have this floppy arm, 0:09:40.679 --> 0:09:42.559 but somebody else has a bone, you know, I mean, 0:09:42.600 --> 0:09:44.600 that's pretty nice. You Know. What I thought was interesting 0:09:44.600 --> 0:09:46.520 about the kidney deal, like why you can give up 0:09:46.520 --> 0:09:49.760 one kidney and still be okay, is that most of 0:09:49.800 --> 0:09:52.959 the times when your kidneys are affected, they are both 0:09:53.000 --> 0:09:56.600 affected at the same time, so it's one's never gonna 0:09:56.640 --> 0:09:58.560 go down and you'd be like, oh, I wish I 0:09:58.600 --> 0:10:01.080 still have my healthy kidney because they both would have 0:10:01.080 --> 0:10:04.320 been unhealthy. And uh, all right, I think we've arrived 0:10:04.320 --> 0:10:08.000 at the liver Chuck. This is fascinating to me. It 0:10:08.160 --> 0:10:10.760 is where where should we start? Well, let's just start 0:10:10.760 --> 0:10:15.000 by saying that the liver can grow. It's like the 0:10:15.040 --> 0:10:17.800 starfish of oregans. Yeah, it can regenerate itself, which is 0:10:17.880 --> 0:10:22.800 just freaking amazing. Sure. Um, So, for instance, let's say 0:10:23.080 --> 0:10:26.480 you wanted to split your liver in half and transplant 0:10:26.520 --> 0:10:29.400 that into two different people. You could do that. You 0:10:29.440 --> 0:10:32.760 could and actually, if you're an adult donor, they can 0:10:32.800 --> 0:10:37.360 cut off a portion, a child sized portion, UH, which 0:10:37.559 --> 0:10:40.120 is I think the same as like a child sized 0:10:40.200 --> 0:10:43.040 meal where you get like three chicken nuggets from UH 0:10:43.080 --> 0:10:46.080 and give it to a kid and chuck, this is 0:10:46.080 --> 0:10:50.360 so great. It grows along with the kid right to 0:10:50.559 --> 0:10:53.560 a full size liver once again, but in step with 0:10:53.600 --> 0:10:57.080 the kid's maturation. Right, that's just mind boggling. Let's say 0:10:57.080 --> 0:10:59.720 you needed a piece of your liver. Let's say you 0:10:59.720 --> 0:11:01.960 needed liver replace and I cut half of my liver 0:11:02.040 --> 0:11:04.480 off and gave it to you. My liver would eventually 0:11:04.679 --> 0:11:07.200 grow to full size once again. Yeah, if I live 0:11:07.280 --> 0:11:09.280 that long, so mine would grow and yours would grow. 0:11:09.320 --> 0:11:12.000 And the cool thing is with the liver, you don't 0:11:12.000 --> 0:11:13.760 even have to take out the old liver. You can 0:11:13.800 --> 0:11:16.240 just put in the new one. It's like the best 0:11:16.360 --> 0:11:19.080 organ on the planet. It really is, and our favorite 0:11:19.160 --> 0:11:22.080 organ because of the function that it serves. So Chuck, 0:11:22.160 --> 0:11:24.200 Like I said, you can neither be a dead donor 0:11:24.360 --> 0:11:27.440 or a living donor. A dead donor can donate anything, right, 0:11:27.960 --> 0:11:33.120 including your yeah, and your eyes, um, heart, lung, all 0:11:33.120 --> 0:11:38.120 that stuff that you can't really take from a living donor. Um. 0:11:38.160 --> 0:11:42.360 But there are some exceptions. If you have HIV or 0:11:42.480 --> 0:11:46.400 disease causing bacteria in your blood stream or tissue. They're 0:11:46.440 --> 0:11:49.719 not going to be taking your organs. Um, And if 0:11:49.800 --> 0:11:53.160 you are a practitioner of the Shinto religion, there's not 0:11:53.200 --> 0:11:55.920 gonna be a lot of organ donation going on there either, right. Yeah, 0:11:55.960 --> 0:11:59.280 not only that, but if you are Amish, they might 0:11:59.320 --> 0:12:02.760 support your donation if there is a certainty relative certainty 0:12:02.760 --> 0:12:07.080 of success, but they're more reluctant if it's uh less 0:12:07.120 --> 0:12:10.200 probable of success. Right. And Tom actually mentioned why the 0:12:10.240 --> 0:12:14.040 Gypsies don't agree with the organ donation. They believe that, um, 0:12:14.240 --> 0:12:16.719 you need your body for the first year to get 0:12:16.760 --> 0:12:19.480 around the afterlife. Apparently after that you got it down 0:12:19.520 --> 0:12:21.839 pat and you don't really need it any longer. Um. 0:12:21.880 --> 0:12:25.200 But he didn't mention Shinto, but I looked it up. Uh. 0:12:25.240 --> 0:12:28.280 They believe that the corps is impure. The body becomes 0:12:28.280 --> 0:12:30.760 impure after death. So would be like, here, take this 0:12:31.080 --> 0:12:33.480 rotting piece of flesh that will save your life, but 0:12:33.559 --> 0:12:36.199 you're going to be impure while you live. Interesting, So, 0:12:36.320 --> 0:12:41.160 as a result in Japan, uh doing donation rates are 0:12:41.280 --> 0:12:45.480 like really really low like the USA. Yeah, and Jehovah's 0:12:45.480 --> 0:12:47.679 witnessed we should cover them because we're we always like 0:12:47.760 --> 0:12:50.000 to talk about them. Uh, they're not opposed to it, 0:12:50.040 --> 0:12:52.160 but they have one rule which I thought was interesting. 0:12:52.440 --> 0:12:54.360 You can donate your organ as long as they drain 0:12:54.440 --> 0:12:56.839 all of the blood out of the organ first before 0:12:56.840 --> 0:12:59.000 giving to someone else. So I guess we're not big 0:12:59.040 --> 0:13:24.720 on translusions. I don't think so, that'd be my guess. Yeah, okay, Um, 0:13:24.760 --> 0:13:27.720 how do you register Chuck? Well, it's pretty easy. Actually 0:13:27.760 --> 0:13:29.600 in most states, you can do it at the d 0:13:29.720 --> 0:13:32.120 m V, which I always found interesting. Yeah, you can 0:13:32.160 --> 0:13:33.520 do it right with there when you're getting your new 0:13:33.559 --> 0:13:37.240 driver's license. And uh here in Georgia, actually we used 0:13:37.240 --> 0:13:40.840 to have the one of the highest donor rates, or 0:13:40.920 --> 0:13:44.000 I should say one of the most expansive donor registries 0:13:44.000 --> 0:13:46.640 in the country. And the reason was when you went 0:13:46.720 --> 0:13:49.800 to go get your driver's licenses. I'm sure you remember, Um, 0:13:49.840 --> 0:13:53.079 they'd knock seven bucks off of your driver's license. I 0:13:53.120 --> 0:13:54.920 love that. So you were an idiot if you didn't 0:13:54.960 --> 0:13:59.520 sign up. The problem is that there's not supposed to 0:13:59.559 --> 0:14:04.160 be any kind of compensation whatsoever for being even though 0:14:04.200 --> 0:14:08.600 this was legal under state law. Um. The Georgia Organ 0:14:08.679 --> 0:14:12.600 Procurement organization, which we'll talk about a minute. Um, they 0:14:12.679 --> 0:14:15.880 were very hesitant to draw from the Georgia donor list 0:14:16.320 --> 0:14:18.400 because they weren't sure if the person was just looking 0:14:18.400 --> 0:14:20.760 for the seven bucks off or else if they really 0:14:20.800 --> 0:14:25.240 wanted to be an organ donor. So actually, the contribution 0:14:25.360 --> 0:14:29.480 rates were very low in comparison of the size of 0:14:29.520 --> 0:14:32.560 the registry in Georgia until two thousand five when they stopped. 0:14:32.640 --> 0:14:34.040 They stopped it, I think to actually give you a 0:14:34.080 --> 0:14:36.160 T shirt too that says I sold my lungs for 0:14:36.200 --> 0:14:38.240 seven dollars. That's illegal, and all I got was this 0:14:38.320 --> 0:14:42.920 lousy T shirt. Yeah. No, under UM law, you can't 0:14:42.920 --> 0:14:46.440 have any valuable compensation for organ procurement, right what we'll 0:14:46.440 --> 0:14:49.400 get to that too, the whole black market deal. Okay, 0:14:50.160 --> 0:14:52.240 So Chuck, if you're a dead donor, how do you donate? 0:14:52.280 --> 0:14:57.000 There's two ways, right? Uh? Two ways, sure, two ways 0:14:57.000 --> 0:15:00.480 of death. Brain death and cardiac death. Is that what 0:15:00.520 --> 0:15:06.200 you mean? Obviously? Cardiac death is um a little trickier 0:15:06.240 --> 0:15:08.320 because you only have a certain amount of time to 0:15:08.320 --> 0:15:10.960 get the organs from the body. Brain deaths a lot 0:15:11.000 --> 0:15:14.800 easier in one sense, because um, there could be is 0:15:15.080 --> 0:15:17.760 you know, weeks to find a match and to prepare 0:15:17.800 --> 0:15:20.800 the organ for donation and get it carried out. But 0:15:20.920 --> 0:15:23.880 there's a wrinkle there. So there's a lot of wrinkles there. 0:15:24.400 --> 0:15:27.120 Let me let me say something about cardiac death first, right, 0:15:27.680 --> 0:15:33.120 Um this there are there are no laws really governing 0:15:33.240 --> 0:15:36.520 organ procurement. It's not a case by case basis, And 0:15:36.600 --> 0:15:41.200 basically everybody involved in the organ procurement process does their 0:15:41.240 --> 0:15:46.000 best to walk a very cautious line while harvesting organs 0:15:46.040 --> 0:15:48.880 to try to save other lives, right, yeah, because there's 0:15:48.920 --> 0:15:53.960 families involved grieving obviously. Um. With cardiac death, there was 0:15:54.000 --> 0:15:56.600 a board I think out of Harvard in the late 0:15:56.680 --> 0:16:00.240 nineties that established a five minute wait time from the 0:16:00.280 --> 0:16:04.240 cessation of a heartbeat. Right, so, you you take somebody 0:16:04.240 --> 0:16:06.960 off a life support, wait for the heart to stop beating. 0:16:07.200 --> 0:16:10.640 Five minutes after and while this this the heart's winding down, 0:16:10.680 --> 0:16:14.320 you're prepping the patient for surgery. Five minutes after, Uh, 0:16:14.360 --> 0:16:17.080 somebody pronounces the person dead and they cut them open 0:16:17.120 --> 0:16:20.160 and take the organs. But in five minutes the heart 0:16:20.480 --> 0:16:23.040 is useless pretty much at that point. Some of the 0:16:23.080 --> 0:16:26.960 other organs, like the liver, the kidneys, maybe the lungs 0:16:27.000 --> 0:16:29.160 can survive that five minutes, but the heart's gone. So 0:16:29.200 --> 0:16:32.400 if you have a cardiac death, you have a useless heart, 0:16:32.440 --> 0:16:34.480 even though the heart might have been perfectly healthy. Five 0:16:34.480 --> 0:16:37.640 minutes again right, So there was this doctor in Colorado 0:16:37.680 --> 0:16:41.040 that said, you know what, there's no law whatsoever that 0:16:41.080 --> 0:16:44.000 says I have to wait five minutes. This guy did 0:16:44.120 --> 0:16:46.800 a lot of research and found in the medical literature 0:16:47.160 --> 0:16:51.040 the longest duration between the cessation of a heartbeat and 0:16:51.040 --> 0:16:54.880 the spontaneous regeneration of a heartbeat ever recorded was sixty 0:16:54.880 --> 0:16:58.200 five seconds. So he started a sixty five second rule, 0:16:58.880 --> 0:17:01.880 got the pants suit off of them. It was an 0:17:01.960 --> 0:17:05.040 unsuccessful lawsuit, and now all of a sudden, the president 0:17:05.080 --> 0:17:07.360 has been set and now there's a sixty second rule 0:17:07.400 --> 0:17:10.080 out there that some people adhere to. That is how 0:17:10.640 --> 0:17:14.080 organ procurement has been established in the US. Somebody pushes 0:17:14.080 --> 0:17:17.640 the envelope, they get sued. They if the cases uh 0:17:17.960 --> 0:17:21.399 isn't one by the by the plaintiff, then you have 0:17:21.440 --> 0:17:24.760 a new rule. Isn't that weird? There's like zero guidance 0:17:24.840 --> 0:17:27.480 for organ procurement except that the person has to be dead. 0:17:27.800 --> 0:17:32.200 We don't have any real definition for death. Well, that's 0:17:32.200 --> 0:17:35.920 where brain death gets really really true. Exactly. Take it, Chuck, Well, 0:17:36.000 --> 0:17:38.240 I don't. I mean, you're the you're the expert here. 0:17:38.400 --> 0:17:41.000 I don't. I can't weigh in morally because I don't 0:17:41.040 --> 0:17:44.000 know what I think. Really Nah. I mean, I know 0:17:44.040 --> 0:17:46.320 what I might believe for myself, but I don't know 0:17:46.320 --> 0:17:49.880 about establishing guidelines for others. But we need them, though, 0:17:49.880 --> 0:17:52.000 don't we? Yeah? But I don't want to make up 0:17:52.040 --> 0:17:55.080 those rules, do you know? And apparently the federal government 0:17:55.080 --> 0:17:57.960 doesn't either. Um. Every once in a while, I think 0:17:58.000 --> 0:18:00.920 Carter assigned a panel to create a white paper on this, 0:18:01.520 --> 0:18:04.520 and I guess George Bush did right before he left office, 0:18:04.560 --> 0:18:06.439 because there was one that came out in two thousand 0:18:06.440 --> 0:18:08.879 and eight. Either Bush did right before he left office 0:18:09.200 --> 0:18:10.960 or it was like the first thing Obama did when 0:18:10.960 --> 0:18:14.080 he came into office. But there was a very recent 0:18:14.280 --> 0:18:17.600 white paper that came out that said, Okay, here's how 0:18:17.680 --> 0:18:21.320 we feel about brain death. Right, here's the problem. Back 0:18:21.359 --> 0:18:23.280 in the fifties, I think we came up with this 0:18:23.280 --> 0:18:26.479 thing called the ventilator. And with the ventilator, you can 0:18:26.560 --> 0:18:29.879 keep somebody who for all intents and purposes dead, you 0:18:29.880 --> 0:18:34.199 can keep their organs functioning. So you're masking death. We 0:18:34.280 --> 0:18:37.600 have no idea what would happen if that ventilator wasn't there, 0:18:37.600 --> 0:18:39.880 would the person die? And if the person does die, 0:18:39.920 --> 0:18:41.880 how long do we have to wait until we say 0:18:41.920 --> 0:18:46.240 that that person is dead? Right? So the the ventilator 0:18:46.280 --> 0:18:48.639 made it so we could procure organs more easily in 0:18:48.680 --> 0:18:50.960 brain death because we can keep them alive. At the 0:18:51.000 --> 0:18:54.240 same time, it blurred the line between life and death. Well, 0:18:54.280 --> 0:18:56.960 now they came out with this recommendation that said brain 0:18:57.040 --> 0:19:02.520 death is disengagement of no the um end of meaningful 0:19:02.560 --> 0:19:06.840 engagement with the rest of the world, which really widened 0:19:06.920 --> 0:19:10.200 the scope of who exactly is dead. And so when 0:19:10.240 --> 0:19:13.600 you have a brain dead patient and you procure their organs, 0:19:14.040 --> 0:19:15.920 what what you actually do is you have to run 0:19:15.960 --> 0:19:18.719 them through this battery of tests where you are um 0:19:18.920 --> 0:19:22.359 shining lights in their pupils. Uh, there's an ice water 0:19:22.440 --> 0:19:25.560 injection into the ear canal to see if you move 0:19:25.880 --> 0:19:28.919 toward or away from the stimulus um And there's this 0:19:28.920 --> 0:19:32.679 battery of tests to establish brain death. And then here's 0:19:32.720 --> 0:19:36.240 the clincher. They do an apneus test where they take 0:19:36.320 --> 0:19:39.040 you off the ventilator for two minutes and see what happens, 0:19:39.680 --> 0:19:44.480 and see what happens. Inevitably, the um, the heartbeat is 0:19:44.480 --> 0:19:47.080 going to slow down. And then after two minutes they 0:19:47.119 --> 0:19:49.800 put the ventilator back on. But that two minutes where 0:19:49.800 --> 0:19:52.680 your brain was starved of oxygen was enough to to 0:19:53.400 --> 0:19:57.960 create real brain death if you weren't before. Wow, think 0:19:58.000 --> 0:20:02.199 about that. This is why they call you supplementary research man. Right, 0:20:02.400 --> 0:20:05.000 that's why that's your superhero. Can you hear like people 0:20:05.040 --> 0:20:09.879 fast forwarding through to get through this, partners, It's like Josh, Josh, Josh, Josh. Okay, 0:20:09.920 --> 0:20:12.639 So we have this, we have this new definition of 0:20:12.680 --> 0:20:17.959 brain death. And when the second apnea test happens and 0:20:17.960 --> 0:20:23.000 you're declared brain dead, what they anesthetize you, they inject 0:20:23.000 --> 0:20:27.040 you with anti paralytics. Will you into that hospital room 0:20:27.080 --> 0:20:29.120 and they harvest your organs, so you actually die from 0:20:29.160 --> 0:20:34.440 a lack of organs present in your body. So that's 0:20:34.480 --> 0:20:37.520 that it's a ghoulish matter. And this these people who 0:20:37.600 --> 0:20:41.119 are in charge of making sure that people donate and 0:20:41.240 --> 0:20:44.239 keeping the image of organ donation is a gift of 0:20:44.280 --> 0:20:48.520 life alive, have to battle with this, the fact that 0:20:48.560 --> 0:20:52.359 it's a very ghoulish process. So who's who's in charge 0:20:52.400 --> 0:20:56.520 of this stuff, by the way, for what for that 0:20:56.600 --> 0:21:01.560 whole soap op spiel anytime, buddy, Yes, Josh. That would 0:21:01.560 --> 0:21:03.840 be called an O p O, which is an organ 0:21:04.040 --> 0:21:08.879 procurement organization and they are federally designated nonprofits and they 0:21:08.880 --> 0:21:13.080 are local all over the country. There's usually UM one 0:21:13.160 --> 0:21:15.119 in the central location of a state and then different 0:21:15.119 --> 0:21:18.920 satellite office is obviously because you need to be close by. 0:21:19.000 --> 0:21:21.080 You know, you can't be hopping all over the country 0:21:21.080 --> 0:21:23.760 to get these organs, although that happens as well. And 0:21:23.840 --> 0:21:29.600 they basically responsible for awareness, recruitment, evaluation, UM organ removal, 0:21:29.800 --> 0:21:32.760 and transportation. So they're the people that's standing there with 0:21:32.800 --> 0:21:36.000 a cooler waiting to drop your organ in there and 0:21:36.080 --> 0:21:38.600 rush it to the recipient. They're also the people that 0:21:38.680 --> 0:21:42.520 talk to the family generally. Well. Sure, so anytime somebody dies, 0:21:42.640 --> 0:21:47.520 you the hospital is legally obligated to notify the organ 0:21:47.560 --> 0:21:49.840 procurement organization, right and you know this this is a 0:21:49.840 --> 0:21:51.439 good point to bring this up. If you want to 0:21:51.440 --> 0:21:53.760 be an organ downer or if you are, you really 0:21:53.760 --> 0:21:56.280 need to tell your family the stuff, and you should 0:21:56.280 --> 0:21:58.320 have it all in your living will because things can 0:21:58.320 --> 0:22:02.120 get a little ugly. UM for instance, let's say you 0:22:02.200 --> 0:22:06.960 are from a very strict religious background. Maybe your family 0:22:07.000 --> 0:22:08.760 doesn't want you cut up. They think that would be 0:22:08.800 --> 0:22:11.560 a bad thing, but you want it. You gotta have that, 0:22:12.200 --> 0:22:14.800 you know, in paper on paper, in writing, right, you 0:22:14.840 --> 0:22:17.800 need and if you have a documented um in a 0:22:17.840 --> 0:22:20.680 lot of cases, even if you if your family is like, no, 0:22:20.800 --> 0:22:22.719 we don't want to donate the organs, the organ per 0:22:22.800 --> 0:22:26.520 human organization will say, you know what, ts sorry, he 0:22:26.600 --> 0:22:28.440 want he or she wanted to be an organ owner. 0:22:28.800 --> 0:22:30.560 And the last thing you want after you die is 0:22:30.600 --> 0:22:32.320 for your spouse, let's say, to have to mountain this 0:22:32.359 --> 0:22:35.480 campaign against your family like a tug of war like that. 0:22:35.520 --> 0:22:39.760 You gotta have it all spelled out nice. Um. So 0:22:39.800 --> 0:22:42.520 where are we? The United Network of organ Sharing that's 0:22:42.520 --> 0:22:44.520 another group. This is where that's where you got the 0:22:44.600 --> 0:22:47.680