Organ donation organizations shift recovery efforts in-house
Ventilators keep their hearts beating and blood flowing.
The patients are brain dead, even though it might seem like they're sleeping. Often in the darkness of night, they arrive at buildings far removed from any hospital.
Welcome to the new direction of organ recovery, where donors are shipped to slick, multimillion-dollar buildings to have their organs and tissue removed for transplant.
The Pittsburgh region has joined a small but growing number of cities where organ procurement organizations do in-house surgeries to remove tissue from bodies.
O'Hara-based Center for Organ Recovery & Education in October began recovering tissue such as bone and skin in a $10 million addition to its building in the RIDC business park. Tissue donors are not hooked to breathing machines.
Within months, officials plan to begin recovering organs. Donor patients who die anywhere in the CORE region — which includes the western half of Pennsylvania, West Virginia and a small part of New York — could be sent to Pittsburgh for organ recovery.
“It's really been an improvement for efficiency for CORE to now bring the patients to our team and do the recovery right here,” said CORE President Susan Stuart.
The addition, named for former CORE President Brian Broznick, includes two operating rooms and two intensive care units.
When tissue removal is completed, the nonprofit organ procurement organization transports the bodies to funeral homes, crematoriums or wherever the families designate. It will do the same when organs such as livers and hearts are removed from donors.
Recovering organs and tissues in a central location, rather than hospital operating rooms, might cut costs and take advantage of the limited time that doctors have to act, proponents contend.
But critics, including some hospital officials, say the move is a way for the nation's 58 procurement organizations to gain more control over revenue from organ collections.
Fifty-one procurement organizations collected revenue of $1.2 billion and recovered more than 80,000 body parts in 2011, a Tribune-Review investigation revealed. Seven procurers are within hospitals, so their recovery information and budget spreadsheets were unavailable.
Procurement organizations say recovering organs is an expensive undertaking, and fees paid to surgeons and hospitals escalate annually. CORE paid nearly $800,000 in operating room fees in 2011, according to a report it filed with the federal Centers for Medicare & Medicaid Services.
“Sometimes, it becomes increasingly prohibitive in the hospital for us to pay for the OR time and do it in a way that we can afford to provide organs to recipients without compromising access,” said Charlie Alexander, CEO of The Living Legacy Foundation in Baltimore and former president of United Network for Organ Sharing, a Virginia nonprofit the government designated to oversee and track organ transplantation in the United States.
In addition to CORE, several other procurement organizations run their own operating rooms, said Stuart, who is president of the Association of Organ Procurement Organizations, a Virginia-based trade group.
The first was Mid-America Transplant Services in St. Louis, which built a facility to recover tissues in 1998. Officials spent $3 million in 2001 to expand the facility, which has two operating rooms and an intensive care unit where surgeons recover organs.
Diane Brockmeier, Mid-America's chief operating officer, said removing organs in its facility instead of the hospital cut costs in half. It allowed the organization to stabilize so-called standard acquisition fees it charges transplant centers for organs.
“Because we control the process, we have had the opportunity to recover more organs out of each donor,” she said, estimating Mid-America recovers organs from about 1,100 donors every year. “It has helped in increasing our yield or organ per donor.”
The organization collected $34 million in revenue from organ procurement in 2011. It posted a $10 million surplus that year, according to the latest available filings with the IRS. The nonprofit recovers organs in eastern Missouri, southern Illinois and northeast Arkansas.
Brockmeier said the surplus from collections largely pays for educational and bereavement programs.
Dr. Abhi Humar, chief of transplantation at UPMC, said advantages and disadvantages exist to procurement organizations having independent operating rooms.
One advantage is that those facilities might be better equipped to handle complex surgeries to remove organs because their surgeons and staff have more experience, he said.
“When you're going to a small peripheral hospital, they may never have done a procurement,” Humar said. “It's not unusual that we go out to these hospitals to remove organs, and, often, they happen in the middle of the night. There's not adequate staffing in the middle of the night.”
Donors whose organs are recovered in hospitals with transplant centers, such as UPMC Presbyterian in Oakland and Allegheny General Hospital in the North Side, will not be transported to the O'Hara facility, Stuart said. In those cases, the organs might go to recipients in the hospital where the donor died, which should lessen an organ's time outside a body.
“For that scenario, to send them out to another place doesn't make a lot of sense,” Humar said. “You can almost make it like a live-donor procedure.”
Editor's note: This is the second story in an occasional series on organ donations.
Luis Fábregas and Andrew Conte are staff writers for Trib Total Media. Fábregas can be reached at email@example.com or 412-320-7998. Conte can be reached at firstname.lastname@example.org or 412-320-7835.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Corbett, Wolf resort to sticks, stones to attract attention
- Komen acceptance of drilling-linked money raises ire
- 15206Project finds goals for rain
- Curry Hollow Shopping Center has buyer
- Review: Tortelier’s golden touch full of personality, grandeur
- Public servants honored in Pittsburgh for extraordinary responses
- Film Office announces two Downtown road closures Monday
- Wilkinsburg couple arrested after baby girl dies following beating
- Port Authority steps closer to linking Oakland and Downtown, makes switch from Highmark to Aetna
- State’s ‘public-private’ transportation deal will replace 53 bridges in Allegheny County
- Bridge work to close Cliff Mine Road this weekend