Giving to the Living

Megan Sargent had the sort of outgoing personality that would wow you. As a first grader in Trenton, Megan had friends from kindergarteners to eighth-graders. She was only six-and-a-half years old when, in 2002, she fell out of a vehicle and suffered irreversible head trauma and died at Eastern Maine Medical Center. Her mother, Carol, didn’t think twice about donating her daughter’s corneas, heart valves, and other tissues. “It’s something Megan would have wanted,” she says.

Carol Sargent now volunteers at EMMC, where she speaks to nursing students about organ donation from the donor’s perspective. Carol hopes she is dispelling the notion that proposing organ donation to a grieving family is an invasion.

“Once an accident happens, you only get one chance to decide to donate. Families should have that option so they aren’t left with any regrets,” Sargent says. “Megan is gone, but there are parts of her out there helping other people.”

For the second year in a row, EMMC has been awarded an organ donation Medal of Honor by the U.S. Department of Health and Human Services. This award is given to hospitals and organ procurement centers across the country that sustained a donation rate of at least 75% of eligible donors. Last year, 18 donors from EMMC donated 59 organs.

The two awards are currently sitting in Diane Bubar’s office, waiting for a new trophy case to be built on the second floor of the hospital. Bubar is the director of performance improvement for EMMC and also a member of the Organ Donation Collaborative. The collaborative stays constantly aware of possible organ donor patients and is in charge of taking a sensitive yet aggressive approach to getting consent for donations. They also educate hospital staff and help foster a community of empathy, confidence, and open-mindedness about organ donation.

“The collaborative is not only about organ donation—it’s a support system for families, and for professionals learning how to deal with these families at such a vulnerable time,” Bubar says. “It’s a delicate balance to be both sensitive and up-front.”

“You’d be surprised who is an organ donor and who has been a recipient of an organ donation,” Bubar adds.

Vanessa and Charlie Koch of Milford never thought about organ donation until their son, Andy, was diagnosed with biliary artresia as an infant. Andy’s bile ducts were obstructed because of their failure to develop normally in the womb. This causes liver failure and requires a transplant for survival.

Andy was going to receive half of Vanessa’s liver, but an 18-month-old donor was found in time. A very yellow and bloated six-month-old Andy and his parents flew to Boston for the procedure.

Today Andy is a boisterous two- year-old who likes to play with his older brother, Sam, is fascinated with zippers, and is in the top percentile for his age and weight. Because Andy has to be very careful not to get sick and weaken his immune system, Vanessa and Charlie are very careful to keep him as healthy as possible. With day care out of the question, Vanessa is now a stay-at-home mom.

A University of Maine graduate, Vanessa wants to go back to school for nursing once the boys get older and are in school full-time. Yet even now she and her husband are working hard to spread the word. “We are big organ donation advocates. Where we never thought about it before, we now ask people about it.” The Kochs now know a number of people who never considered organ donation in the past who have changed their minds because of Andy.

Despite its impressive donation rate, Eastern Maine Medical Center only recovers organs, like the liver that saved the life of Andy Koch; it has no transplant facility. Because of the state’s population, there is only one transplant center—Maine Medical Center in Portland. For EMMC to receive the Medal of Honor is a testament to the hard work and dedication put forth by the Organ Donation Collaborative and the two representatives from the New England Organ Bank (NEOB) who work on-site, Laura Huckestein and John Macone.

In 2003, the U.S. Health Resources and Services Administration (HRSA) launched the Organ Donation Breakthrough Collaborative with a goal to spread “known best practices to the nation’s largest hospitals to achieve organ donation rates of 75% or higher.” While EMMC is certainly not one of the nation’s largest hospitals, these best practices have taken hold here in central Maine. According to Huckestein and Macone, the culture and support at EMMC today didn’t exist 10 years ago. “In 1999, there were four donors from EMMC,” Huckestein says. “Last year there were 18.”

And, though the EMMC team has been recognized for its hard work, it’s not resting on its laurels. A hospital can procure eight organs per donor by law, yet the average number of organs per donor out of EMMC is between 3.5 and 3.75. Huckestein would like to see that average grow to four. One way this can be done is by convincing smaller area hospitals to send more patients who have consented to organ donation to EMMC so their organs can be saved.

“I can’t stress enough the importance for people to communicate their wishes for organ donation with their family members,” Bubar says. Even if a driver’s license indicates the desire for organ donation, when it comes down to it, the surviving family members have the final say. “When someone dies, you don’t want to be having this family conflict,” says Bubar.

Each day 17 people die waiting for a lifesaving organ transplant—deaths that could be prevented if more people and professionals were committed to the importance of organ donations. “It’s easy now to look back on how sick Andy was,” Vanessa Koch says. Andy sits on his dad’s lap, looking at photos of himself when he was a baby. “But we nearly lost him.”

“Want to see a cool trick?” her husband, Charlie, asks. “Hey, Andy, where are your kidneys? Your liver? Your spleen?” After each question Andy excitedly points to the correct part on his little body. “Now how many two-year-olds can do that?”