WEBVTT - How Organ Donation Works 0:00:01.080 --> 0:00:04.520 Welcome to Stuff you should know from house stuff Works 0:00:04.559 --> 0:00:13.320 dot com. Hey, and welcome to the podcast. I'm Josh 0:00:13.400 --> 0:00:17.080 Clark with me as always as Charles W. Chuck Bryant, 0:00:17.880 --> 0:00:22.439 who I assume has two functional kidneys. I do, but 0:00:22.480 --> 0:00:25.840 I would give one up for your brother. Wow, would 0:00:25.880 --> 0:00:28.520 you really? Well? Maybe I think I think that through 0:00:28.600 --> 0:00:31.400 Chuck as a living donor. Maybe not. But if I died, 0:00:31.440 --> 0:00:33.640 then sure you get thanks. Man. What about your liver, 0:00:33.720 --> 0:00:37.400 because I'm pretty certain I'm gonna need somebody's livers. I 0:00:37.479 --> 0:00:39.479 don't know that you would want mine either, to be honest. 0:00:39.520 --> 0:00:41.879 Oh yeah, yeah, that'd be like getting Mickey Mantle's liver. 0:00:41.920 --> 0:00:45.040 I need like a we need a virginal liver, don't I? Yeah, 0:00:45.040 --> 0:00:48.440 so I can just start over again, wash it in vodka. 0:00:48.920 --> 0:00:51.120 So what are we talking about, Josh? We're talking about 0:00:51.200 --> 0:00:58.160 organ donation, Chuck perfect, which I find absolutely fascinating. UM. 0:00:58.200 --> 0:01:01.200 Back in nineteen let me take you back a little 0:01:01.200 --> 0:01:07.000 bit here, the first successful living human to human organ 0:01:07.080 --> 0:01:09.720 donation took place. It was a kidney. Yeah, it was 0:01:09.720 --> 0:01:15.160 a great story. Kidneys actually remained the most commonly donated 0:01:15.280 --> 0:01:23.160 and UM received organs. But this was actually a couple 0:01:23.200 --> 0:01:28.320 of twin brothers, one of whom was dying of chronic nephritis. Yeah, 0:01:28.440 --> 0:01:31.960 Richard and Ronald Herrick. And Richard was the one dying, 0:01:32.040 --> 0:01:34.800 and Ronald was in good shape right, and Ronald said, well, 0:01:34.880 --> 0:01:36.720 you know what, you're my twin brother, and I don't 0:01:36.720 --> 0:01:38.440 really want you to die young, so I'm going to 0:01:38.520 --> 0:01:41.480 give you one of my kidneys. And um. There have 0:01:41.640 --> 0:01:45.399 been uh some other transplants before that. They didn't work 0:01:45.400 --> 0:01:47.520 out though, well some of them did, but it wasn't 0:01:47.560 --> 0:01:51.440 live human to human um like. For example, the first 0:01:51.480 --> 0:01:55.360 I think, the first organ, the first donation or transplant 0:01:55.400 --> 0:01:59.560 that ever took place, was way back in sixteen where 0:01:59.560 --> 0:02:02.120 they few was part of a dog's skull under a 0:02:02.200 --> 0:02:06.120 human's head, crazy and that graft worked. H. We have 0:02:06.520 --> 0:02:10.120 taken testicles from monkeys and successfully in playing them into humans. 0:02:11.080 --> 0:02:16.880 A pig kidney was successfully transplanted into a human vein transplants, uh, 0:02:16.919 --> 0:02:20.239 and a lamb kidney was put into a recipient in 0:02:20.320 --> 0:02:23.280 ninety three and that person lived for nine days. But 0:02:23.919 --> 0:02:27.359 nineteen fifty four finds the first time a living person 0:02:27.400 --> 0:02:31.120 donated an oregon to another living person and it was successful. 0:02:31.680 --> 0:02:35.320 And the reason why they think was because they're twins, 0:02:35.720 --> 0:02:38.760 there was a very low chance of rejection, right. Yeah. 0:02:38.800 --> 0:02:40.880 And the story is great because Richard, you know that 0:02:40.960 --> 0:02:44.120 the dying brother had a moment, a clear moment where 0:02:44.160 --> 0:02:46.799 he literally, like the day before, said don't do this. Man, 0:02:46.880 --> 0:02:49.280 get out of here right now. And the brother said, no, 0:02:49.960 --> 0:02:52.480 I'm gonna give you my kidney like it or not, chump, 0:02:52.560 --> 0:02:54.839 and he did and it was a great story. Yeah. 0:02:54.880 --> 0:02:58.160 And they actually both lived to ripe old ages reproduced, 0:02:58.200 --> 0:03:01.680 so they fulfilled their deskin these humans. And since then, Josh, 0:03:01.720 --> 0:03:03.160 there have been more than a half a million of 0:03:03.200 --> 0:03:06.920 these organ transplants performed. Right, We've gotten a lot better 0:03:07.000 --> 0:03:10.280 at it. Yeah. Um, as I was rambling off that 0:03:10.320 --> 0:03:12.760 list of stuff that took place before nineteen fifty four, 0:03:12.960 --> 0:03:16.560 we have gotten exponentially better. Uh. In two thousand three, 0:03:16.639 --> 0:03:19.799 we successfully transplanted a tongue. YEA, I saw that which 0:03:19.800 --> 0:03:22.480 I could use A tongue transplanted slightly thinner tongue would 0:03:22.480 --> 0:03:24.360 would do me a lot better. I think you had 0:03:24.400 --> 0:03:27.880 a fat tongue. Yeah. And do you remember the um, 0:03:29.600 --> 0:03:33.560 what do we do the face transplant? Um? That woman 0:03:33.600 --> 0:03:37.240 actually remember she got her face from a suicide victim 0:03:37.560 --> 0:03:40.560 that was in two thousand five and in two thousand six, 0:03:40.720 --> 0:03:44.000 so I know it's coming. A cadaver's penis was transplanted 0:03:44.000 --> 0:03:48.480 onto a living human. Yeah, and that man gave it back, Yes, 0:03:48.600 --> 0:03:50.960 and I love The reason they gave was because of 0:03:51.640 --> 0:03:55.040 it caused psychological problems between the man and his wife, 0:03:55.280 --> 0:03:58.760 which I can let your imagination run with that one. Yeah, Yeah, 0:03:58.840 --> 0:04:01.560 that's just UH would say the same thing would happen 0:04:01.600 --> 0:04:04.960 in my household. So thanks to a better understanding of 0:04:04.960 --> 0:04:08.600 how the human body works, of blood type, of the 0:04:08.880 --> 0:04:12.720 development of anti rejection drugs, like Chuck said, we've hit 0:04:12.720 --> 0:04:16.640 about half a million transplant surgery so far. Right, so 0:04:16.760 --> 0:04:20.520 Chuck actually is hot and heavy. Uh to to give 0:04:20.560 --> 0:04:22.960 out a stat and this is a very special stat 0:04:23.080 --> 0:04:26.479 because it's actually most likely going to change by the 0:04:26.560 --> 0:04:29.200 end of the podcast. Yes, these are taking away. These 0:04:29.200 --> 0:04:32.240 are current stats. If you go to the website U 0:04:32.400 --> 0:04:36.200 n O s dot org, the United Network for Organ Sharing, 0:04:36.240 --> 0:04:39.640 they actually have up to the minute statistics on who 0:04:39.680 --> 0:04:42.640 needs what and who's giving what and what operations are 0:04:42.680 --> 0:04:45.760 being performed. And I didn't realize this, but it's up 0:04:45.800 --> 0:04:47.559 to the minute because earlier in the day I checked 0:04:47.640 --> 0:04:50.800 on kidneys, and the number actually dropped by three about 0:04:50.839 --> 0:04:53.080 an hour later on the waiting list, So three people 0:04:53.120 --> 0:04:56.120 got kidneys in that like half hour span. So I'm 0:04:56.160 --> 0:04:57.839 just gonna read a couple now and then we'll check 0:04:57.839 --> 0:05:00.920 back in for fun in twenty minutes and see if 0:05:00.920 --> 0:05:03.160 that's changed at all. Okay, I'm gonna write this down 0:05:03.160 --> 0:05:05.000 to check because we'll never remember it. This is the 0:05:05.000 --> 0:05:07.359 first time we've ever used a laptop in the studio 0:05:07.360 --> 0:05:12.960 and a pen usually just us in our mouths. Uh. Total, Josh, 0:05:12.960 --> 0:05:16.160 we got one oh five hundred and five thousand, two 0:05:16.360 --> 0:05:19.680 d eight people are waiting for organs, and we'll do 0:05:19.760 --> 0:05:22.320 kidney because that's the most popular. Eight three thousand and 0:05:22.360 --> 0:05:26.280 twelve people are waiting for a kidney as of two 0:05:26.279 --> 0:05:29.240 oh three pm. All right, and we'll check that in 0:05:29.320 --> 0:05:33.359 twenty minutes and hopefully those numbers have gone down. Yeah, 0:05:33.400 --> 0:05:36.320 because that will mean that either the people on the 0:05:36.320 --> 0:05:39.360 waiting list have died or they received a transplant. I 0:05:39.400 --> 0:05:42.080 guess we could put those two, we could compare against 0:05:42.120 --> 0:05:46.080 one another, and maker we could surmise for So, Chuck, 0:05:47.360 --> 0:05:50.200 what are organs? Yeah? I had a feeling you're going 0:05:50.240 --> 0:05:54.480 to ask me that, Josh, gohad no, okay. Organs are 0:05:54.760 --> 0:05:58.120 systems of cells, josh and tissues, and they all are 0:05:58.240 --> 0:06:00.440 in our body for a very specific reason, each one. 0:06:00.960 --> 0:06:02.800 And what I like about the organs is that they 0:06:02.800 --> 0:06:06.440 are all over equipped, which is what you're looking for 0:06:06.520 --> 0:06:08.760 in an organ. You don't want, like the heart to 0:06:08.839 --> 0:06:10.920 be like boy, if it beats one beat less, you're 0:06:10.960 --> 0:06:14.480 really screwed. So um, our heart. Actually, a twenty year 0:06:14.520 --> 0:06:18.000 old's heart beats pumps about ten times more than the 0:06:18.040 --> 0:06:21.039 amount of blood we need, and uh, we we have 0:06:21.120 --> 0:06:24.080 this reserve capacity in all of our organs as young 0:06:24.400 --> 0:06:28.520 lads and lasses. Right. But as Tom Schif, who you 0:06:28.560 --> 0:06:32.080 know as my bff, who wrote this article, he points 0:06:32.080 --> 0:06:35.839 out that the corneas, when you talk about eye transplants 0:06:35.839 --> 0:06:40.080 there they're talking about corneal transplants. Um, they actually don't 0:06:40.120 --> 0:06:43.640 necessarily deteriorate like all the other organs. Yeah, that's pretty cool. Um, 0:06:43.760 --> 0:06:47.240 So the corneas of seventy five year old donor are 0:06:47.400 --> 0:06:51.040 just as good, considering you know, there's not more wear 0:06:51.080 --> 0:06:54.480 and tear than say a twenty year old. Yeah, you 0:06:54.480 --> 0:06:57.320 could put a seven year old person's cornea inside of 0:06:57.360 --> 0:06:59.480 a young person and there would be no difference. Right, 0:06:59.480 --> 0:07:02.640 But for organs, they deteriorate with age. Well that's the 0:07:02.640 --> 0:07:06.240 bad news, right, Um, so eventually you may need one, 0:07:06.320 --> 0:07:09.120 right Well, yeah, because what happens is, let's say one 0:07:09.279 --> 0:07:11.840 organ can deteriorate while the rest of your body remains 0:07:11.880 --> 0:07:15.480 pretty healthy. That's actually best case scenario, as weird as 0:07:15.520 --> 0:07:18.040 that sounds, because that means you can just swap that 0:07:18.080 --> 0:07:21.000 sucker out and you'll be fine again. Right. Well, that 0:07:21.160 --> 0:07:24.960 that's in a very ideal, utopian world. That's exactly what happens. 0:07:25.000 --> 0:07:27.400 The problem is, there is a lot more people in 0:07:27.480 --> 0:07:30.200 need of organs than there are organs available, right right, 0:07:30.560 --> 0:07:33.040 there's um a waiting list. Some aren't so bad. I 0:07:33.040 --> 0:07:36.400 think kidneys go pretty quick, as you're you're talking about earlier. 0:07:36.920 --> 0:07:39.880 The longest wait I found, um was the old heart 0:07:39.960 --> 0:07:44.480 lung combo. That median wait time was six point seven years. 0:07:44.960 --> 0:07:46.360 It's a long time to wait for a heart and 0:07:46.360 --> 0:07:47.960 a long if you need it. Yeah, a long time 0:07:48.000 --> 0:07:50.400 because nobody goes I'm probably gonna need a heart and 0:07:50.440 --> 0:07:52.600 a long combo. Eventually, I'll just put myself on the 0:07:52.600 --> 0:07:55.440 waiting list. Now you need it, like the moment you 0:07:55.480 --> 0:07:58.000 go onto that waiting list and you have to wait 0:07:58.040 --> 0:08:00.680 six point seven years until you get it. Yeah, and 0:08:00.760 --> 0:08:04.280 that's why. Um, the mortality rate while waiting for a 0:08:04.320 --> 0:08:07.680 heart is, which is that's not as bad as I 0:08:07.720 --> 0:08:14.040 would I would like, and um, the liver actually is 0:08:14.080 --> 0:08:20.080 the worst. Oh good, yeah, sorry, Um. There's two ways 0:08:20.160 --> 0:08:22.640 you can get organs from a live person or a 0:08:22.720 --> 0:08:27.160 dead person. Yes, Traditionally we don't take organs like the 0:08:27.280 --> 0:08:29.600 heart from a live donor because they would be a 0:08:29.640 --> 0:08:33.439 dead donor. After that, you can take things like, uh, 0:08:33.960 --> 0:08:38.000 the liver pancreas uncommonly, but it can be done. A 0:08:38.040 --> 0:08:45.320 portion of the intestine, um, blood, blood, stem cells, bone, marrow, bones, 0:08:45.520 --> 0:08:49.280 all and bones. Yeah, which giving up a bone that's 0:08:49.280 --> 0:08:51.880 really something like, I mean, after that you just kind 0:08:51.880 --> 0:08:55.439 of have this floppy arm, but somebody else has a bone, 0:08:55.480 --> 0:08:57.320 you know, I mean, that's pretty nice. You Know. What 0:08:57.360 --> 0:08:59.319 I thought was interesting about the kidney deal, like why 0:08:59.360 --> 0:09:01.479 you can give up one kidney and still be okay, 0:09:02.120 --> 0:09:05.719 is that most of the times when your kidneys are affected, 0:09:05.760 --> 0:09:09.520 they are both affected at the same time, so one's 0:09:09.600 --> 0:09:11.600 never gonna go down. And you'd be like, oh, I 0:09:11.640 --> 0:09:14.199 wish I still have my healthy kidneys because they both 0:09:14.240 --> 0:09:17.120 would have been unhealthy. And uh, all right, I think 0:09:17.160 --> 0:09:20.760 we've arrived at the liver. Chuck. This is fascinating to me. 0:09:21.360 --> 0:09:23.880 It is where where should we start? Well, let's just 0:09:23.920 --> 0:09:28.160 start by saying that the liver can grow. It's like 0:09:28.320 --> 0:09:31.120 the starfish of oregan. Yeah, it can regenerate itself, which 0:09:31.160 --> 0:09:36.280 is just freaking amazing. Um. So, for instance, let's say 0:09:36.559 --> 0:09:39.920 you wanted to split your liver in half and transplant 0:09:39.960 --> 0:09:43.160 that into two different people. You could do that. You could. 0:09:43.640 --> 0:09:46.440 And actually, if you're an adult donor, they can cut 0:09:46.440 --> 0:09:51.080 off a portion, a child sized portion, uh, which is 0:09:51.160 --> 0:09:53.880 I think the same as like a child sized meal 0:09:53.960 --> 0:09:56.640 where you get like three chicken nuggets from uh and 0:09:56.679 --> 0:09:59.920 give it to a kid, and chuck, this is so great. 0:10:00.160 --> 0:10:04.320 It grows along with the kid right to a full 0:10:04.360 --> 0:10:08.600 size liver once again, but in step with the kid's maturation. Right, 0:10:08.679 --> 0:10:12.000 that's just mind boggling. Let's say you needed a piece 0:10:12.040 --> 0:10:14.120 of your liver. Let's say you needed your liver replace 0:10:14.200 --> 0:10:15.959 and I cut half of my liver off and gave 0:10:15.960 --> 0:10:18.920 it to you. My liver would eventually grow to full 0:10:18.960 --> 0:10:21.160 size once again. Yeah, if I live that long, so 0:10:21.280 --> 0:10:23.200 mine would grow and yours would grow. And the cool 0:10:23.280 --> 0:10:25.880 thing is with the liver, you don't even have to 0:10:25.920 --> 0:10:27.640 take out the old liver. You can just put in 0:10:27.640 --> 0:10:30.680 the new one. It's like the best organ on the planet. 0:10:30.720 --> 0:10:33.760 It really is, and our favorite organ because of the 0:10:33.760 --> 0:10:36.280 function that it serves. So Chuck, like I said, you 0:10:36.320 --> 0:10:38.600 can neither be a dead donor or a living donor. 0:10:38.640 --> 0:10:43.160 A dead donor can donate anything, right, including your yeah, 0:10:43.240 --> 0:10:47.280 and your eyes, um, heart, lung, all that stuff that 0:10:47.360 --> 0:10:51.680 you can't really take from a living donor. Um. But 0:10:51.760 --> 0:10:56.280 there are some exceptions. If you have HIV or disease 0:10:56.320 --> 0:10:59.920 causing bacteria in your blood streamer tissue there and I 0:11:00.040 --> 0:11:03.559 gonna be taking your organs um. And if you are 0:11:03.679 --> 0:11:06.880 a practitioner of the Shinto religion, there's not gonna be 0:11:06.920 --> 0:11:09.360 a lot of organ donation going on there either, right. Yeah, 0:11:09.400 --> 0:11:12.720 not only that, but if you are Amish, they might 0:11:12.800 --> 0:11:16.199 support your donation if there is a certainty relative certainty 0:11:16.200 --> 0:11:20.560 of success, but they're more reluctant if it's uh less 0:11:20.559 --> 0:11:23.640 probable of success. Right. And Tom actually mentioned why the 0:11:23.679 --> 0:11:27.520 Gypsies don't agree with organ donation. They believe that, um, 0:11:27.679 --> 0:11:30.160 you need your body for the first year to get 0:11:30.200 --> 0:11:32.920 around the afterlife. Apparently after that you got it down 0:11:32.960 --> 0:11:35.280 pat and you don't really need it any longer. Um. 0:11:35.320 --> 0:11:38.640 But he didn't mention Shinto, but I looked it up. Uh. 0:11:38.679 --> 0:11:41.720 They believe that the corps is impure. The body becomes 0:11:41.720 --> 0:11:44.200 impure after death. So would be like, here, take this 0:11:44.559 --> 0:11:46.920 rotting piece of flesh that will save your life, but 0:11:47.000 --> 0:11:49.640 you're going to be impure while you live. Interesting, So, 0:11:49.760 --> 0:11:54.600 as a result in Japan, uh doing, donation rates are 0:11:54.720 --> 0:11:58.200 like really really low copared to like the USA. Yeah, 0:11:58.320 --> 0:12:00.680 and Jehovah's witnessed. We should cover them because we're we 0:12:00.720 --> 0:12:03.199 always like to talk about them. Uh, they're not opposed 0:12:03.200 --> 0:12:05.000 to it, but they have one rule which I thought 0:12:05.040 --> 0:12:07.320 was interesting. You can donate your organ as long as 0:12:07.320 --> 0:12:09.640 they drain all of the blood out of the organ 0:12:09.760 --> 0:12:12.120 first before giving to someone else. So I guess they're 0:12:12.120 --> 0:12:15.640 not big on transfusions. I don't think so that would 0:12:15.640 --> 0:12:40.200 be my guess. Yeah, okay, Um, how do you register Chuck? Well, 0:12:40.200 --> 0:12:42.360 it's pretty easy. Actually in most states. You can do 0:12:42.440 --> 0:12:44.880 it at the d m V, which I always found interesting. 0:12:45.360 --> 0:12:46.760 You can do it right with there when you're getting 0:12:46.760 --> 0:12:50.040 your new driver's license, and uh, here in Georgia. Actually, 0:12:50.240 --> 0:12:54.040 we used to have the one of the highest donor rates, 0:12:54.200 --> 0:12:56.800 or I should say, one of the most expansive donor 0:12:56.880 --> 0:12:59.840 registries in the country. And the reason was when you 0:13:00.000 --> 0:13:03.240 went to go get your driver's licenses. I'm sure you remember, Um, 0:13:03.280 --> 0:13:06.920 they'd knock seven bucks off of your driver's license. Love that. 0:13:07.040 --> 0:13:08.839 So you were an idiot if you didn't sign up. 0:13:09.280 --> 0:13:13.640 The problem is that there's not supposed to be any 0:13:13.720 --> 0:13:17.960 kind of compensation whatsoever for being Even though this was 0:13:18.080 --> 0:13:23.439 legal under state law. UM. The Georgia organ Procurement Organization, 0:13:23.760 --> 0:13:26.600 which we'll talk about a minute, UM, they were very 0:13:26.640 --> 0:13:30.160 hesitant to draw from the Georgia donor list because they 0:13:30.200 --> 0:13:32.040 weren't sure if the person was just looking for the 0:13:32.040 --> 0:13:34.720 seven bucks off or else if they really wanted to 0:13:34.760 --> 0:13:39.600 be an organ donor. So actually, the contribution rates were 0:13:40.280 --> 0:13:43.640 very low in comparison of the size of the registry 0:13:43.640 --> 0:13:46.040 in Georgia until two thousand five when they stopped and 0:13:46.080 --> 0:13:47.480 they stopped it, I think to actually give you a 0:13:47.520 --> 0:13:49.600 T shirt too that says I've sold my lungs for 0:13:49.640 --> 0:13:51.679 seven dollars that's illegal, and all I got was this 0:13:51.760 --> 0:13:56.040 lousy T shirt. Yeah. No, under a um law. You 0:13:56.120 --> 0:13:59.640 can't have any valuable compensation for organ procurement. Right. Well, 0:13:59.679 --> 0:14:02.960 we'll get to that too, the whole black market deal. Okay, 0:14:03.600 --> 0:14:05.679 So Chuck, if you're a dead donor, how do you donate? 0:14:05.720 --> 0:14:10.440 There's two ways, right, Uh? Two ways sure, two ways 0:14:10.440 --> 0:14:13.800 of death, brain death and cardiac death. Yeah, is that 0:14:13.800 --> 0:14:19.120 what you mean? Obviously, cardiac death is um a little 0:14:19.120 --> 0:14:21.640 trickier because you only have a certain amount of time 0:14:21.680 --> 0:14:24.160 to get the organs from the body. Brain death a 0:14:24.240 --> 0:14:28.040 lot easier in one sense, because um, there could be 0:14:28.120 --> 0:14:30.680 as you know, weeks to find a match and to 0:14:30.800 --> 0:14:34.000 prepare the organ for donation and get it carried out. 0:14:34.160 --> 0:14:36.680 But there's a wrinkle there. Oh, there's a lot of 0:14:36.680 --> 0:14:39.760 wrinkles there. Let me let me say something about cardiac 0:14:39.800 --> 0:14:43.200 death first, right, Um this there are there are no 0:14:44.040 --> 0:14:48.640 laws really governing organ procurement. It's not a case by 0:14:48.680 --> 0:14:52.720 case basis, and basically everybody involved in the organ procurement 0:14:52.760 --> 0:14:57.320 process does their best to walk a very cautious line 0:14:57.920 --> 0:15:01.880 while harvesting organs to try to of other lives, right, yeah, 0:15:01.880 --> 0:15:06.840 because there's families involved greeting obviously, um, with cardiac death, 0:15:07.080 --> 0:15:09.680 there was a board I think out of Harvard in 0:15:09.720 --> 0:15:13.320 the late nineties that established a five minute wait time 0:15:13.400 --> 0:15:17.000 from the cessation of a heartbeat. Right, So, you you 0:15:17.080 --> 0:15:19.600 take somebody off the life support, wait for the heart 0:15:19.680 --> 0:15:22.960 to stop beating. Five minutes after and while this this 0:15:23.240 --> 0:15:25.880 the heart's winding down, you're prepping the patient for surgery. 0:15:26.280 --> 0:15:29.760 Five minutes after, Uh, somebody pronounces the person dead and 0:15:29.760 --> 0:15:32.280 they cut them open and take the organs. But in 0:15:32.360 --> 0:15:35.880 five minutes, the heart is useless pretty much at that point. 0:15:36.160 --> 0:15:39.119 Some of the other organs, like the liver, the kidneys, 0:15:39.520 --> 0:15:41.840 maybe the lungs can survive that five minutes, but the 0:15:41.840 --> 0:15:44.520 heart's gone. So if you have a cardiac death, you 0:15:44.600 --> 0:15:46.800 have a useless heart, even though the heart might have 0:15:46.800 --> 0:15:49.960 been perfectly healthy five minutes ago. Right. So, there was 0:15:50.000 --> 0:15:52.280 this doctor in Colorado that said, you know what, there's 0:15:52.360 --> 0:15:56.120 no law whatsoever that says I have to wait five minutes. 0:15:56.640 --> 0:15:59.200 This guy did a lot of research and found in 0:15:59.200 --> 0:16:03.320 the medical latter sure the longest duration between the cessation 0:16:03.360 --> 0:16:06.600 of a heartbeat and the spontaneous regeneration of a heartbeat 0:16:06.640 --> 0:16:10.320 ever recorded with sixty five seconds. So he started a 0:16:10.400 --> 0:16:13.960 sixty five second rule. Got the pants suit off of him. 0:16:14.920 --> 0:16:17.760 It was an unsuccessful lawsuit, and now all of a sudden, 0:16:17.880 --> 0:16:20.080 the president has been set and now there's a sixty 0:16:20.080 --> 0:16:22.200 five second rule out there that some people adhere to. 0:16:22.840 --> 0:16:26.520 That is how organ procurement has been established in the US. 0:16:26.720 --> 0:16:30.040 Somebody pushes the envelope, they get sued if they if 0:16:30.080 --> 0:16:33.560 the cases uh isn't one by the by the plaintiff, 0:16:34.040 --> 0:16:37.080 then you have a new rule. And then weird, there's 0:16:37.080 --> 0:16:40.240 like zero guidance for organ procurement except that the person 0:16:40.280 --> 0:16:43.680 has to be dead. We don't have any real definition 0:16:43.960 --> 0:16:47.800 for death. Well that's where brain death gets really really true. Exactly. 0:16:48.240 --> 0:16:50.600 Take it, Chuck, Well, I don't. I mean, you're the 0:16:50.680 --> 0:16:52.880 you're the expert here. I don't. I can't weigh in 0:16:52.960 --> 0:16:56.520 morally because I don't know what I think. Really Nah, 0:16:56.720 --> 0:16:58.880 I mean I know what I might believe for myself, 0:16:58.920 --> 0:17:02.400 but I don't know about establishing guidelines for others. But 0:17:02.600 --> 0:17:04.920 we need them, though, don't we? Yeah? But I don't 0:17:04.920 --> 0:17:07.080 want to make up those rules to you know, and 0:17:07.160 --> 0:17:10.520 apparently the federal government doesn't either. Um. Every once in 0:17:10.560 --> 0:17:13.240 a while, I think Carter assigned a panel to create 0:17:13.280 --> 0:17:16.639 a white paper on this, and I guess George Bush 0:17:16.640 --> 0:17:18.800 did right before he left office, because there was one 0:17:18.840 --> 0:17:21.000 that came out in two thousand and eight. Either Bush 0:17:21.040 --> 0:17:23.040 did right before he left office or it was like 0:17:23.080 --> 0:17:25.600 the first thing Obama did when he came into office. 0:17:26.320 --> 0:17:28.600 But there was a very recent white paper that came 0:17:28.640 --> 0:17:33.000 out that said, Okay, here's how we feel about brain death. Right, 0:17:33.480 --> 0:17:36.000 here's the problem. Back in the fifties, I think we 0:17:36.040 --> 0:17:38.879 came up with this thing called the ventilator. And with 0:17:38.920 --> 0:17:41.439 the ventilator, you can keep somebody who for all intents 0:17:41.440 --> 0:17:45.760 and purposes dead, You could keep their organs functioning, so 0:17:45.960 --> 0:17:49.560 you're masking death. We have no idea what would happen 0:17:49.680 --> 0:17:52.320 if that ventilator wasn't there. Would the person die? And 0:17:52.359 --> 0:17:54.080 if the person does die, how long do we have 0:17:54.160 --> 0:17:56.680 to wait until we say that that person is dead? Right, 0:17:57.520 --> 0:18:01.359 So the ventilator made it so we could procure organs 0:18:01.400 --> 0:18:03.760 more easily in brain death because we can keep them alive. 0:18:04.200 --> 0:18:06.640 At the same time, it blurred the line between life 0:18:06.680 --> 0:18:09.520 and death. Well, now they came out with this recommendation 0:18:09.560 --> 0:18:14.639 that said brain death is disengagement of no the um 0:18:14.960 --> 0:18:17.320 end of meaningful engagement with the rest of the world, 0:18:18.000 --> 0:18:22.160 which really widened the scope of who exactly is dead. 0:18:23.000 --> 0:18:25.760 And so when you have a brain dead patient and 0:18:25.800 --> 0:18:28.760 you procure their organs, what what you actually do is 0:18:28.800 --> 0:18:30.800 you have to run them through this battery of tests 0:18:30.880 --> 0:18:34.520 where you are um shining lights in their pupils. Uh, 0:18:34.520 --> 0:18:38.000 there's an ice water injection into the ear canal to 0:18:38.040 --> 0:18:41.880 see if you move toward or away from the stimulus um. 0:18:41.920 --> 0:18:44.760 And there's this battery of tests to establish brain death. 0:18:44.840 --> 0:18:48.639 And then here's the clincher. They do an apneas test 0:18:49.040 --> 0:18:51.479 where they take you off the ventilator for two minutes 0:18:51.680 --> 0:18:56.960 and see what happens. And see what happens. Inevitably the um, 0:18:57.000 --> 0:18:59.760 the heartbeat is going to slow down, and then after 0:18:59.800 --> 0:19:02.320 two minutes they put the ventilator back on. But that 0:19:02.440 --> 0:19:05.159 two minutes where your brain was starved of oxygen was 0:19:05.280 --> 0:19:10.439 enough to to create real brain death if you weren't before. Wow, 0:19:11.240 --> 0:19:14.480 think about that. This is why they call you supplementary 0:19:14.480 --> 0:19:17.359 research man, right, That's why that's your superhero. And can 0:19:17.680 --> 0:19:20.399 you hear like people fast forwarding through to get through this, partners, 0:19:20.400 --> 0:19:24.479 It's like Josh, josh h Josh. Okay, So we have this, 0:19:24.800 --> 0:19:28.000 we have this new definition of brain death. And when 0:19:28.640 --> 0:19:32.480 the second apnea test happens, and you're declared brain dead. 0:19:33.040 --> 0:19:37.880 What they anesthetize you, they inject you with anti paralytics. 0:19:38.800 --> 0:19:41.560 Will you into that hospital room and they harvest your organs, 0:19:41.560 --> 0:19:44.280 so you actually die from a lack of organs present 0:19:44.359 --> 0:19:49.440 in your body. So that's that it's a ghoulish matter. 0:19:49.640 --> 0:19:52.760 And these people who are in charge of making sure 0:19:52.840 --> 0:19:56.920 that people donate and keeping the image of organ donation 0:19:56.960 --> 0:20:00.360 as a gift of life alive have to battle with 0:20:00.440 --> 0:20:03.919 this the fact that it's a very ghoulish process. Right, 0:20:04.040 --> 0:20:07.360 you're right, So who's who's in charge of this stuff? Uh? 0:20:08.880 --> 0:20:14.680 For what? For that whole soapopsh feel anytime, buddy, Yes, Josh. 0:20:14.720 --> 0:20:16.720 That would be called an O p O, which is 0:20:16.760 --> 0:20:22.080 an organ procurement organization and they are federally designated nonprofits 0:20:22.119 --> 0:20:25.240 and they are local all over the country. There's usually 0:20:25.400 --> 0:20:28.119 UM one in the central location of a state and 0:20:28.119 --> 0:20:31.000 then different satellite office is obviously because you need to 0:20:31.040 --> 0:20:33.959 be close by, you know, you can't be hopping all 0:20:33.960 --> 0:20:35.879 over the country to get these organs, although that happens 0:20:35.920 --> 0:20:41.440 as well. And they basically responsible for awareness, recruitment, evaluation, 0:20:41.800 --> 0:20:45.760 UM organ removal and transportation. So they're the people that's 0:20:45.760 --> 0:20:48.760 standing there with a cooler waiting to drop your organ 0:20:48.760 --> 0:20:51.520 in there and rush it to the recipient. They're also 0:20:51.560 --> 0:20:54.280 the people that talk to the family generally well. Sure, 0:20:54.560 --> 0:20:59.400 so anytime somebody dies you, the hospital is legally obligated 0:20:59.440 --> 0:21:02.560 to note a by the organ procurement organization. Right, and 0:21:02.600 --> 0:21:03.880 you know this, This is a good point to bring 0:21:03.880 --> 0:21:05.680 this up. If you want to be an organ downer, 0:21:05.760 --> 0:21:07.840 or if you are, you really need to tell your 0:21:07.840 --> 0:21:10.199 family the stuff, and you should have it all in 0:21:10.240 --> 0:21:14.200 your living will because things can get a little ugly. Um. 0:21:14.320 --> 0:21:17.040 For instance, let's say you are from a very strict 0:21:17.800 --> 0:21:21.479 religious background. Maybe your family doesn't want you cut up. 0:21:21.520 --> 0:21:23.600 They think that would be a bad thing, but you 0:21:23.640 --> 0:21:26.760 want it. You gotta have that, you know, in paper 0:21:27.040 --> 0:21:29.080 on paper, in writing, right, you need and if you 0:21:29.119 --> 0:21:32.200 have a documented um in a lot of cases, even 0:21:32.240 --> 0:21:34.560 if you if your family is like, no, we don't 0:21:34.600 --> 0:21:37.760 want to donate the organs, the organ procuman organization will say, 0:21:37.960 --> 0:21:40.639 you know what, ts sorry, he want he or she 0:21:40.680 --> 0:21:42.640 wanted to be an organ owner. So and the last 0:21:42.640 --> 0:21:44.679 thing you want after you die is for your spouse. 0:21:44.760 --> 0:21:46.560 Let's say, to have to mountain this campaign against your 0:21:46.600 --> 0:21:49.320 family like a tug of war like that. You gotta 0:21:49.320 --> 0:21:53.719 have it all spelled out. Um, So where are we? 0:21:53.840 --> 0:21:56.760 The United Network of Organ Sharing that's another group. This 0:21:56.840 --> 0:21:59.080 is where that's where you got the kidney statistics. We're 0:21:59.080 --> 0:22:01.320 gonna go back on and look at right. Yeah, they're 0:22:01.320 --> 0:22:04.480 in Richmond, Virginia, and they are responsible for placing donated 0:22:04.640 --> 0:22:08.200 organs um and maintaining the waiting list like you just said. 0:22:08.200 --> 0:22:12.080 And they never close No. Seven three sixty five, which 0:22:12.080 --> 0:22:13.760 is how it should be. Obviously, we should try calling 0:22:13.840 --> 0:22:16.240 them right now to see if they're open. Let's not 0:22:16.320 --> 0:22:18.800 do that. I'm sure they're open. And then chuck, there's 0:22:18.840 --> 0:22:23.040 the Scientific Registry of Transplant Recipients right, Yes, the s 0:22:23.160 --> 0:22:26.280 R t R. And they basically maintain like every amount 0:22:26.320 --> 0:22:29.760