If you are one of the 55.15% of Cumberland County residents who are a designated organ donor on your driver’s license or state identification card, changes in state regulations have occurred which may impact your decisions regarding certain specifics of organ donation.
In Pennsylvania, the opportunity to register as an organ donor upon obtaining or renewing a driver’s license or state identification card has existed since 1994. Many older adults may overlook this opportunity due to a belief that their advanced age or health history makes them ineligible to become a donor. In fact, there is no age limit for organ donation, and a determination about the suitability of organs for transplant is made primarily at the time of death.
Organ donation is typically thought of as the donation of organs (heart, lungs, kidneys, liver, intestines, and pancreas) and/or tissues (corneas, tendons, valves, veins, skin, and bones) between two people. This type of transplant is called an allograft when the two individuals are not genetically identical.
Advances in medical science now enable physicians to transplant additional parts of the body, such as an entire limb, a hand, or even a face. This type of transplant is known as a vascularized composite allograft (VCA).
In October of 2018, the Commonwealth of Pennsylvania revised and expanded organ donation guidelines in part to address this medical advance. The following regulations are now effective regarding VCA.
- A designation for organ donation on a driver’s license or state identification card DOES NOT include VCA. In all potential donor situations, consent for VCA must be obtained separately from consent for organ and tissue donation.
- Consent for VCA can be obtained several ways. A potential donor can make the decision. If an individual who is age 18 or older has died in a hospital or if death is imminent, authorization for VCA will be accepted from the following persons in this order: spouse, adult child, parent, sibling, grandchild, grandparent, any other relative, or a guardian; unless it is known that the individual would not have consented to this type of transplant.
- A Health Care Power of Attorney document and/or a Living Will may be used to permit or deny VCA. An agent under a power of attorney can authorize VCA only if this specific authority is granted in the power of attorney document.
Individuals who are considering becoming a VCA donor should keep in mind that becoming a donor may impact end of life care. Measures such as mechanical ventilation may be necessary to prolong life and maintain viability of the body parts which are to be donated. VCA may also impact funeral and burial arrangements, such as plans for an open casket viewing. Finally, a donor’s identity may not be completely protected due to the presence of birthmarks or fingerprints with VCA transplants.
PennDOT’s website currently contains general information about making or revoking an organ donation designation on a driver’s license/photo ID. Under the updated regulations, the Department of Transportation will be adding information about VCA, the risks and benefits of all donations, and the laws surrounding donation to its website. Mailings of camera cards for license renewals will also contain an insert about organ/tissue/VCA donation.
Although 95% of Pennsylvanians claim to support organ donation, only about 48% are registered donors. Approximately 7500 Pennsylvania residents are currently on the waiting list for an organ transplant. The Commonwealth’s updated regulations support increased awareness and education about organ donation, as well as provide protections for those who are considering or have become a designated organ donor. To review all of the provisions of Act 90 of 2018, visit https://www.legis.state.pa.us/cfdocs/legis/li/uconsCheck.cfm?yr=2018&sessInd=0&act=90 .
Karen Kaslow, RN, BSN