Medical advances have made it possible to transplant a number of tissues and organs from one human being into another to improve and save lives. The first corneal transplant was performed in 1905, the first blood transfusion in 1918, the first kidney transplant in 1954, and the first heart transplant in 1968. Today, medical technology also enables the transplantation of skin, heart-lung combinations, lung, pancreas, liver, bone, and bone marrow.

Every month, dozens of Americans die simply because there are no organs available - and organ waiting lists increase dramatically each year. The Health Resources and Services Administration (HRSA), through its Division of Transplantation, is meeting the challenge of increasing awareness of the need for donations.

You can help save the lives of those who desperately need an organ transplant. According to the Uniform Anatomical Gift Act, effective in all 50 states, anyone over the age of 18 can indicate his/her desire to be an organ donor by signing a donor card or indicating on their driver's license their intent to donate. For more information about donor cards, call 1-800-355-SHARE. Certain organs, including the kidney, liver, and parts of the lung and pancreas, can be transplanted from living donors. It is most important to tell your family and your physician that, in the event of your death, you want to become a donor. Encourage family and friends to be organ donors as well. Donor families are not charged for expenses associated with donating a loved one's organs.

As part of the National Organ Transplant Act of 1984, Congress authorized the Organ Procurement and Transplantation Network and the Scientific Registry. The latter is a system and database designed to follow all transplant recipients in the United States from the time of transplant until failure of the graft (organ) or death of the patient. The Network operates a nationwide, 24-hour, 7-day-a-week computer system that matches organ donors and recipients, ensuring equal access to organs by critically-ill patients in need. HRSA administers both.

Did you know?

• More than 54,000 patients are waiting for an organ transplant. While approximately 2,000 new patients are added to the waiting list each month, 1,000 patients are removed due to transplantation or various medical reasons.

• From January 1, 1992, to October 1996, there has been a 75 percent increase in the number of persons waiting for a kidney transplant, a 64 percent increase in the number awaiting a heart transplant, and a 329 percent increase in the number waiting for a liver transplant.

• In 1996, an average of 9 people a day or about 3,800 individuals on the national waiting list for transplants died while waiting for an organ to become available for them. These deaths could have been avoided if there were a sufficient supply of donor organs.

• In 1996, 30 percent of kidney donors were live donors.

• Most States have laws which require that family members be given the option to donate a deceased loved one's organs and tissues for transplantation.

• All costs related to the donation of organs and tissues are paid by the donor program; however, the cost of funeral arrangements remains the responsibility of the donor's family.

• There were 5,400 donors in the United States in 1996.

• Organ transplant recipients are selected on the basis of urgency of need and compatibility of body size and blood chemistries, not race, sex, or creed.

• The average 1-year survival rate for a heart recipient is 82.3 percent and for a liver recipient, 81.6 percent.

• Before 1980, fewer than 100 heart transplants were performed annually. In 1996, 2,342 were performed.

• Signing a donor card is important, but you also must inform your family of your desire to be an organ and tissue donor. Physicians will ask for your family's consent at the time of your death.

Based on information from various sources, answers to some frequent questions follow:

Q: Does my religion support organ and tissue donation?

A: Organ and tissue donation is consistent with the beliefs of all major religions. If you have any questions, please discuss them with your rabbi, priest, or minister.

Q: What organs and tissues can be donated?

A: One person's gift can benefit several people. The majority of needed organs are donated by individuals at the time of death. Needed organs include corneas, middle ears, blood vessels, kidneys, hearts, livers, lungs, and pancreases. Tissue donations include eyes, skin, heart valves, bone marrow, and bone. In certain circumstances, kidney or bone marrow are donated by "live" donors, with no detrimental effects to the donor's remaining life.

Q: If I decide to become an organ donor, will that affect the level of my medical care?

A: Absolutely not. For someone to be eligible for organ donation, they must be declared "brain dead." The determination of brain death is made based on strict medical and legal standards. This determination must be made by a physician who is NOT involved with organ donation or transplantation. Organ recovery takes place only after every effort has been exhausted to save the life of the patient.

Q: What is brain death?

A: The brain has stopped functioning and artificial life support systems are used to maintain heartbeat and breathing. If these support systems are removed, all vital body functions stop. Brain death is irreversible, and is an accepted medical, ethical, and legal principle.

Q: Do I need to mention organ/tissue donation in my will?

A: No. Your will may be read too late to make organ and tissue donation possible.

Q: What is "Required Request" or "Routine Inquiry?"

A: It is a policy by which hospitals must provide the opportunity for organ and tissue donation to next-of-kin when a family member has died. The laws also allow a family to exercise its right to be asked about organ donation.

Q: Can my family refuse permission for organ and tissue donation even though I have already agreed (annotated driver's license or a donor card)?

A: Yes, they can, but usually they respect the wishes of the deceased. It is important to remember that the medical team treating the potential donor is also treating the family in its grief. Part of the medical team's role in giving care is respecting the feelings of those who are grieving. Ethically and morally, the medical team will do only those things that the next-of-kin authorize.

Q: Can anyone designate their organs for donation?