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How Organ Donation Works · Stuff You Should Know

0:01
Speaker 1: Welcome to Stuff you should know from house stuff Works
0:04
Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh
0:13
Speaker 1: Clark with me as always as Charles W. Chuck Bryant,
0:17
Speaker 1: who I assume has two functional kidneys. I do, but
0:22
Speaker 1: I would give one up for your brother. Wow, would
0:25
Speaker 1: you really? Well? Maybe I think I think that through
0:28
Speaker 1: Chuck as a living donor. Maybe not. But if I died,
0:31
Speaker 1: then sure you get thanks. Man. What about your liver,
0:33
Speaker 1: because I'm pretty certain I'm gonna need somebody's livers. I
0:37
Speaker 1: don't know that you would want mine either, to be honest.
0:39
Speaker 1: Oh yeah, yeah, that'd be like getting Mickey Mantle's liver.
0:41
Speaker 1: I need like a we need a virginal liver, don't I? Yeah,
0:45
Speaker 1: so I can just start over again, wash it in vodka.
0:48
Speaker 1: So what are we talking about, Josh? We're talking about
0:51
Speaker 1: organ donation, Chuck perfect, which I find absolutely fascinating. UM.
0:58
Speaker 1: Back in nineteen let me take you back a little
1:01
Speaker 1: bit here, the first successful living human to human organ
1:07
Speaker 1: donation took place. It was a kidney. Yeah, it was
1:09
Speaker 1: a great story. Kidneys actually remained the most commonly donated
1:15
Speaker 1: and UM received organs. But this was actually a couple
1:23
Speaker 1: of twin brothers, one of whom was dying of chronic nephritis. Yeah,
1:28
Speaker 1: Richard and Ronald Herrick. And Richard was the one dying,
1:32
Speaker 1: and Ronald was in good shape right, and Ronald said, well,
1:34
Speaker 1: you know what, you're my twin brother, and I don't
1:36
Speaker 1: really want you to die young, so I'm going to
1:38
Speaker 1: give you one of my kidneys. And um. There have
1:41
Speaker 1: been uh some other transplants before that. They didn't work
1:45
Speaker 1: out though, well some of them did, but it wasn't
1:47
Speaker 1: live human to human um like. For example, the first
1:51
Speaker 1: I think, the first organ, the first donation or transplant
1:55
Speaker 1: that ever took place, was way back in sixteen where
1:59
Speaker 1: they few was part of a dog's skull under a
2:02
Speaker 1: human's head, crazy and that graft worked. H. We have
2:06
Speaker 1: taken testicles from monkeys and successfully in playing them into humans.
2:11
Speaker 1: A pig kidney was successfully transplanted into a human vein transplants, uh,
2:16
Speaker 1: and a lamb kidney was put into a recipient in
2:20
Speaker 1: ninety three and that person lived for nine days. But
2:23
Speaker 1: nineteen fifty four finds the first time a living person
2:27
Speaker 1: donated an oregon to another living person and it was successful.
2:31
Speaker 1: And the reason why they think was because they're twins,
2:35
Speaker 1: there was a very low chance of rejection, right. Yeah.
2:38
Speaker 1: And the story is great because Richard, you know that
2:40
Speaker 1: the dying brother had a moment, a clear moment where
2:44
Speaker 1: he literally, like the day before, said don't do this. Man,
2:46
Speaker 1: get out of here right now. And the brother said, no,
2:49
Speaker 1: I'm gonna give you my kidney like it or not, chump,
2:52
Speaker 1: and he did and it was a great story. Yeah.
2:54
Speaker 1: And they actually both lived to ripe old ages reproduced,
2:58
Speaker 1: so they fulfilled their deskin these humans. And since then, Josh,
3:01
Speaker 1: there have been more than a half a million of
3:03
Speaker 1: these organ transplants performed. Right, We've gotten a lot better
3:07
Speaker 1: at it. Yeah. Um, as I was rambling off that
3:10
Speaker 1: list of stuff that took place before nineteen fifty four,
3:12
Speaker 1: we have gotten exponentially better. Uh. In two thousand three,
3:16
Speaker 1: we successfully transplanted a tongue. YEA, I saw that which
3:19
Speaker 1: I could use A tongue transplanted slightly thinner tongue would
3:22
Speaker 1: would do me a lot better. I think you had
3:24
Speaker 1: a fat tongue. Yeah. And do you remember the um,
3:29
Speaker 1: what do we do the face transplant? Um? That woman
3:33
Speaker 1: actually remember she got her face from a suicide victim
3:37
Speaker 1: that was in two thousand five and in two thousand six,
3:40
Speaker 1: so I know it's coming. A cadaver's penis was transplanted
3:44
Speaker 1: onto a living human. Yeah, and that man gave it back, Yes,
3:48
Speaker 1: and I love The reason they gave was because of
3:51
Speaker 1: it caused psychological problems between the man and his wife,
3:55
Speaker 1: which I can let your imagination run with that one. Yeah, Yeah,
3:58
Speaker 1: that's just UH would say the same thing would happen
4:01
Speaker 1: in my household. So thanks to a better understanding of
4:04
Speaker 1: how the human body works, of blood type, of the
4:08
Speaker 1: development of anti rejection drugs, like Chuck said, we've hit
4:12
Speaker 1: about half a million transplant surgery so far. Right, so
4:16
Speaker 1: Chuck actually is hot and heavy. Uh to to give
4:20
Speaker 1: out a stat and this is a very special stat
4:23
Speaker 1: because it's actually most likely going to change by the
4:26
Speaker 1: end of the podcast. Yes, these are taking away. These
4:29
Speaker 1: are current stats. If you go to the website U
4:32
Speaker 1: n O s dot org, the United Network for Organ Sharing,
4:36
Speaker 1: they actually have up to the minute statistics on who
4:39
Speaker 1: needs what and who's giving what and what operations are
4:42
Speaker 1: being performed. And I didn't realize this, but it's up
4:45
Speaker 1: to the minute because earlier in the day I checked
4:47
Speaker 1: on kidneys, and the number actually dropped by three about
4:50
Speaker 1: an hour later on the waiting list, So three people
4:53
Speaker 1: got kidneys in that like half hour span. So I'm
4:56
Speaker 1: just gonna read a couple now and then we'll check
4:57
Speaker 1: back in for fun in twenty minutes and see if
5:00
Speaker 1: that's changed at all. Okay, I'm gonna write this down
5:03
Speaker 1: to check because we'll never remember it. This is the
5:05
Speaker 1: first time we've ever used a laptop in the studio
5:07
Speaker 1: and a pen usually just us in our mouths. Uh. Total, Josh,
5:12
Speaker 1: we got one oh five hundred and five thousand, two
5:16
Speaker 1: d eight people are waiting for organs, and we'll do
5:19
Speaker 1: kidney because that's the most popular. Eight three thousand and
5:22
Speaker 1: twelve people are waiting for a kidney as of two
5:26
Speaker 1: oh three pm. All right, and we'll check that in
5:29
Speaker 1: twenty minutes and hopefully those numbers have gone down. Yeah,
5:33
Speaker 1: because that will mean that either the people on the
5:36
Speaker 1: waiting list have died or they received a transplant. I
5:39
Speaker 1: guess we could put those two, we could compare against
5:42
Speaker 1: one another, and maker we could surmise for So, Chuck,
5:47
Speaker 1: what are organs? Yeah? I had a feeling you're going
5:50
Speaker 1: to ask me that, Josh, gohad no, okay. Organs are
5:54
Speaker 1: systems of cells, josh and tissues, and they all are
5:58
Speaker 1: in our body for a very specific reason, each one.
6:00
Speaker 1: And what I like about the organs is that they
6:02
Speaker 1: are all over equipped, which is what you're looking for
6:06
Speaker 1: in an organ. You don't want, like the heart to
6:08
Speaker 1: be like boy, if it beats one beat less, you're
6:10
Speaker 1: really screwed. So um, our heart. Actually, a twenty year
6:14
Speaker 1: old's heart beats pumps about ten times more than the
6:18
Speaker 1: amount of blood we need, and uh, we we have
6:21
Speaker 1: this reserve capacity in all of our organs as young
6:24
Speaker 1: lads and lasses. Right. But as Tom Schif, who you
6:28
Speaker 1: know as my bff, who wrote this article, he points
6:32
Speaker 1: out that the corneas, when you talk about eye transplants
6:35
Speaker 1: there they're talking about corneal transplants. Um, they actually don't
6:40
Speaker 1: necessarily deteriorate like all the other organs. Yeah, that's pretty cool. Um,
6:43
Speaker 1: So the corneas of seventy five year old donor are
6:47
Speaker 1: just as good, considering you know, there's not more wear
6:51
Speaker 1: and tear than say a twenty year old. Yeah, you
6:54
Speaker 1: could put a seven year old person's cornea inside of
6:57
Speaker 1: a young person and there would be no difference. Right,
6:59
Speaker 1: But for organs, they deteriorate with age. Well that's the
7:02
Speaker 1: bad news, right, Um, so eventually you may need one,
7:06
Speaker 1: right Well, yeah, because what happens is, let's say one
7:09
Speaker 1: organ can deteriorate while the rest of your body remains
7:11
Speaker 1: pretty healthy. That's actually best case scenario, as weird as
7:15
Speaker 1: that sounds, because that means you can just swap that
7:18
Speaker 1: sucker out and you'll be fine again. Right. Well, that
7:21
Speaker 1: that's in a very ideal, utopian world. That's exactly what happens.
7:25
Speaker 1: The problem is, there is a lot more people in
7:27
Speaker 1: need of organs than there are organs available, right right,
7:30
Speaker 1: there's um a waiting list. Some aren't so bad. I
7:33
Speaker 1: think kidneys go pretty quick, as you're you're talking about earlier.
7:36
Speaker 1: The longest wait I found, um was the old heart
7:39
Speaker 1: lung combo. That median wait time was six point seven years.
7:44
Speaker 1: It's a long time to wait for a heart and
7:46
Speaker 1: a long if you need it. Yeah, a long time
7:48
Speaker 1: because nobody goes I'm probably gonna need a heart and
7:50
Speaker 1: a long combo. Eventually, I'll just put myself on the
7:52
Speaker 1: waiting list. Now you need it, like the moment you
7:55
Speaker 1: go onto that waiting list and you have to wait
7:58
Speaker 1: six point seven years until you get it. Yeah, and
8:00
Speaker 1: that's why. Um, the mortality rate while waiting for a
8:04
Speaker 1: heart is, which is that's not as bad as I
8:07
Speaker 1: would I would like, and um, the liver actually is
8:14
Speaker 1: the worst. Oh good, yeah, sorry, Um. There's two ways
8:20
Speaker 1: you can get organs from a live person or a
8:22
Speaker 1: dead person. Yes, Traditionally we don't take organs like the
8:27
Speaker 1: heart from a live donor because they would be a
8:29
Speaker 1: dead donor. After that, you can take things like, uh,
8:33
Speaker 1: the liver pancreas uncommonly, but it can be done. A
8:38
Speaker 1: portion of the intestine, um, blood, blood, stem cells, bone, marrow, bones,
8:45
Speaker 1: all and bones. Yeah, which giving up a bone that's
8:49
Speaker 1: really something like, I mean, after that you just kind
8:51
Speaker 1: of have this floppy arm, but somebody else has a bone,
8:55
Speaker 1: you know, I mean, that's pretty nice. You Know. What
8:57
Speaker 1: I thought was interesting about the kidney deal, like why
8:59
Speaker 1: you can give up one kidney and still be okay,
9:02
Speaker 1: is that most of the times when your kidneys are affected,
9:05
Speaker 1: they are both affected at the same time, so one's
9:09
Speaker 1: never gonna go down. And you'd be like, oh, I
9:11
Speaker 1: wish I still have my healthy kidneys because they both
9:14
Speaker 1: would have been unhealthy. And uh, all right, I think
9:17
Speaker 1: we've arrived at the liver. Chuck. This is fascinating to me.
9:21
Speaker 1: It is where where should we start? Well, let's just
9:23
Speaker 1: start by saying that the liver can grow. It's like
9:28
Speaker 1: the starfish of oregan. Yeah, it can regenerate itself, which
9:31
Speaker 1: is just freaking amazing. Um. So, for instance, let's say
9:36
Speaker 1: you wanted to split your liver in half and transplant
9:39
Speaker 1: that into two different people. You could do that. You could.
9:43
Speaker 1: And actually, if you're an adult donor, they can cut
9:46
Speaker 1: off a portion, a child sized portion, uh, which is
9:51
Speaker 1: I think the same as like a child sized meal
9:53
Speaker 1: where you get like three chicken nuggets from uh and
9:56
Speaker 1: give it to a kid, and chuck, this is so great.
10:00
Speaker 1: It grows along with the kid right to a full
10:04
Speaker 1: size liver once again, but in step with the kid's maturation. Right,
10:08
Speaker 1: that's just mind boggling. Let's say you needed a piece
10:12
Speaker 1: of your liver. Let's say you needed your liver replace
10:14
Speaker 1: and I cut half of my liver off and gave
10:15
Speaker 1: it to you. My liver would eventually grow to full
10:18
Speaker 1: size once again. Yeah, if I live that long, so
10:21
Speaker 1: mine would grow and yours would grow. And the cool
10:23
Speaker 1: thing is with the liver, you don't even have to
10:25
Speaker 1: take out the old liver. You can just put in
10:27
Speaker 1: the new one. It's like the best organ on the planet.
10:30
Speaker 1: It really is, and our favorite organ because of the
10:33
Speaker 1: function that it serves. So Chuck, like I said, you
10:36
Speaker 1: can neither be a dead donor or a living donor.
10:38
Speaker 1: A dead donor can donate anything, right, including your yeah,
10:43
Speaker 1: and your eyes, um, heart, lung, all that stuff that
10:47
Speaker 1: you can't really take from a living donor. Um. But
10:51
Speaker 1: there are some exceptions. If you have HIV or disease
10:56
Speaker 1: causing bacteria in your blood streamer tissue there and I
11:00
Speaker 1: gonna be taking your organs um. And if you are
11:03
Speaker 1: a practitioner of the Shinto religion, there's not gonna be
11:06
Speaker 1: a lot of organ donation going on there either, right. Yeah,
11:09
Speaker 1: not only that, but if you are Amish, they might
11:12
Speaker 1: support your donation if there is a certainty relative certainty
11:16
Speaker 1: of success, but they're more reluctant if it's uh less
11:20
Speaker 1: probable of success. Right. And Tom actually mentioned why the
11:23
Speaker 1: Gypsies don't agree with organ donation. They believe that, um,
11:27
Speaker 1: you need your body for the first year to get
11:30
Speaker 1: around the afterlife. Apparently after that you got it down
11:32
Speaker 1: pat and you don't really need it any longer. Um.
11:35
Speaker 1: But he didn't mention Shinto, but I looked it up. Uh.
11:38
Speaker 1: They believe that the corps is impure. The body becomes
11:41
Speaker 1: impure after death. So would be like, here, take this
11:44
Speaker 1: rotting piece of flesh that will save your life, but
11:47
Speaker 1: you're going to be impure while you live. Interesting, So,
11:49
Speaker 1: as a result in Japan, uh doing, donation rates are
11:54
Speaker 1: like really really low copared to like the USA. Yeah,
11:58
Speaker 1: and Jehovah's witnessed. We should cover them because we're we
12:00
Speaker 1: always like to talk about them. Uh, they're not opposed
12:03
Speaker 1: to it, but they have one rule which I thought
12:05
Speaker 1: was interesting. You can donate your organ as long as
12:07
Speaker 1: they drain all of the blood out of the organ
12:09
Speaker 1: first before giving to someone else. So I guess they're
12:12
Speaker 1: not big on transfusions. I don't think so that would
12:15
Speaker 1: be my guess. Yeah, okay, Um, how do you register Chuck? Well,
12:40
Speaker 1: it's pretty easy. Actually in most states. You can do
12:42
Speaker 1: it at the d m V, which I always found interesting.
12:45
Speaker 1: You can do it right with there when you're getting
12:46
Speaker 1: your new driver's license, and uh, here in Georgia. Actually,
12:50
Speaker 1: we used to have the one of the highest donor rates,
12:54
Speaker 1: or I should say, one of the most expansive donor
12:56
Speaker 1: registries in the country. And the reason was when you
13:00
Speaker 1: went to go get your driver's licenses. I'm sure you remember, Um,
13:03
Speaker 1: they'd knock seven bucks off of your driver's license. Love that.
13:07
Speaker 1: So you were an idiot if you didn't sign up.
13:09
Speaker 1: The problem is that there's not supposed to be any
13:13
Speaker 1: kind of compensation whatsoever for being Even though this was
13:18
Speaker 1: legal under state law. UM. The Georgia organ Procurement Organization,
13:23
Speaker 1: which we'll talk about a minute, UM, they were very
13:26
Speaker 1: hesitant to draw from the Georgia donor list because they
13:30
Speaker 1: weren't sure if the person was just looking for the
13:32
Speaker 1: seven bucks off or else if they really wanted to
13:34
Speaker 1: be an organ donor. So actually, the contribution rates were
13:40
Speaker 1: very low in comparison of the size of the registry
13:43
Speaker 1: in Georgia until two thousand five when they stopped and
13:46
Speaker 1: they stopped it, I think to actually give you a
13:47
Speaker 1: T shirt too that says I've sold my lungs for
13:49
Speaker 1: seven dollars that's illegal, and all I got was this
13:51
Speaker 1: lousy T shirt. Yeah. No, under a um law. You
13:56
Speaker 1: can't have any valuable compensation for organ procurement. Right. Well,
13:59
Speaker 1: we'll get to that too, the whole black market deal. Okay,
14:03
Speaker 1: So Chuck, if you're a dead donor, how do you donate?
14:05
Speaker 1: There's two ways, right, Uh? Two ways sure, two ways
14:10
Speaker 1: of death, brain death and cardiac death. Yeah, is that
14:13
Speaker 1: what you mean? Obviously, cardiac death is um a little
14:19
Speaker 1: trickier because you only have a certain amount of time
14:21
Speaker 1: to get the organs from the body. Brain death a
14:24
Speaker 1: lot easier in one sense, because um, there could be
14:28
Speaker 1: as you know, weeks to find a match and to
14:30
Speaker 1: prepare the organ for donation and get it carried out.
14:34
Speaker 1: But there's a wrinkle there. Oh, there's a lot of
14:36
Speaker 1: wrinkles there. Let me let me say something about cardiac
14:39
Speaker 1: death first, right, Um this there are there are no
14:44
Speaker 1: laws really governing organ procurement. It's not a case by
14:48
Speaker 1: case basis, and basically everybody involved in the organ procurement
14:52
Speaker 1: process does their best to walk a very cautious line
14:57
Speaker 1: while harvesting organs to try to of other lives, right, yeah,
15:01
Speaker 1: because there's families involved greeting obviously, um, with cardiac death,
15:07
Speaker 1: there was a board I think out of Harvard in
15:09
Speaker 1: the late nineties that established a five minute wait time
15:13
Speaker 1: from the cessation of a heartbeat. Right, So, you you
15:17
Speaker 1: take somebody off the life support, wait for the heart
15:19
Speaker 1: to stop beating. Five minutes after and while this this
15:23
Speaker 1: the heart's winding down, you're prepping the patient for surgery.
15:26
Speaker 1: Five minutes after, Uh, somebody pronounces the person dead and
15:29
Speaker 1: they cut them open and take the organs. But in
15:32
Speaker 1: five minutes, the heart is useless pretty much at that point.
15:36
Speaker 1: Some of the other organs, like the liver, the kidneys,
15:39
Speaker 1: maybe the lungs can survive that five minutes, but the
15:41
Speaker 1: heart's gone. So if you have a cardiac death, you
15:44
Speaker 1: have a useless heart, even though the heart might have
15:46
Speaker 1: been perfectly healthy five minutes ago. Right. So, there was
15:50
Speaker 1: this doctor in Colorado that said, you know what, there's
15:52
Speaker 1: no law whatsoever that says I have to wait five minutes.
15:56
Speaker 1: This guy did a lot of research and found in
15:59
Speaker 1: the medical latter sure the longest duration between the cessation
16:03
Speaker 1: of a heartbeat and the spontaneous regeneration of a heartbeat
16:06
Speaker 1: ever recorded with sixty five seconds. So he started a
16:10
Speaker 1: sixty five second rule. Got the pants suit off of him.
16:14
Speaker 1: It was an unsuccessful lawsuit, and now all of a sudden,
16:17
Speaker 1: the president has been set and now there's a sixty
16:20
Speaker 1: five second rule out there that some people adhere to.
16:22
Speaker 1: That is how organ procurement has been established in the US.
16:26
Speaker 1: Somebody pushes the envelope, they get sued if they if
16:30
Speaker 1: the cases uh isn't one by the by the plaintiff,
16:34
Speaker 1: then you have a new rule. And then weird, there's
16:37
Speaker 1: like zero guidance for organ procurement except that the person
16:40
Speaker 1: has to be dead. We don't have any real definition
16:43
Speaker 1: for death. Well that's where brain death gets really really true. Exactly.
16:48
Speaker 1: Take it, Chuck, Well, I don't. I mean, you're the
16:50
Speaker 1: you're the expert here. I don't. I can't weigh in
16:52
Speaker 1: morally because I don't know what I think. Really Nah,
16:56
Speaker 1: I mean I know what I might believe for myself,
16:58
Speaker 1: but I don't know about establishing guidelines for others. But
17:02
Speaker 1: we need them, though, don't we? Yeah? But I don't
17:04
Speaker 1: want to make up those rules to you know, and
17:07
Speaker 1: apparently the federal government doesn't either. Um. Every once in
17:10
Speaker 1: a while, I think Carter assigned a panel to create
17:13
Speaker 1: a white paper on this, and I guess George Bush
17:16
Speaker 1: did right before he left office, because there was one
17:18
Speaker 1: that came out in two thousand and eight. Either Bush
17:21
Speaker 1: did right before he left office or it was like
17:23
Speaker 1: the first thing Obama did when he came into office.
17:26
Speaker 1: But there was a very recent white paper that came
17:28
Speaker 1: out that said, Okay, here's how we feel about brain death. Right,
17:33
Speaker 1: here's the problem. Back in the fifties, I think we
17:36
Speaker 1: came up with this thing called the ventilator. And with
17:38
Speaker 1: the ventilator, you can keep somebody who for all intents
17:41
Speaker 1: and purposes dead, You could keep their organs functioning, so
17:45
Speaker 1: you're masking death. We have no idea what would happen
17:49
Speaker 1: if that ventilator wasn't there. Would the person die? And
17:52
Speaker 1: if the person does die, how long do we have
17:54
Speaker 1: to wait until we say that that person is dead? Right,
17:57
Speaker 1: So the ventilator made it so we could procure organs
18:01
Speaker 1: more easily in brain death because we can keep them alive.
18:04
Speaker 1: At the same time, it blurred the line between life
18:06
Speaker 1: and death. Well, now they came out with this recommendation
18:09
Speaker 1: that said brain death is disengagement of no the um
18:14
Speaker 1: end of meaningful engagement with the rest of the world,
18:18
Speaker 1: which really widened the scope of who exactly is dead.
18:23
Speaker 1: And so when you have a brain dead patient and
18:25
Speaker 1: you procure their organs, what what you actually do is
18:28
Speaker 1: you have to run them through this battery of tests
18:30
Speaker 1: where you are um shining lights in their pupils. Uh,
18:34
Speaker 1: there's an ice water injection into the ear canal to
18:38
Speaker 1: see if you move toward or away from the stimulus um.
18:41
Speaker 1: And there's this battery of tests to establish brain death.
18:44
Speaker 1: And then here's the clincher. They do an apneas test
18:49
Speaker 1: where they take you off the ventilator for two minutes
18:51
Speaker 1: and see what happens. And see what happens. Inevitably the um,
18:57
Speaker 1: the heartbeat is going to slow down, and then after
18:59
Speaker 1: two minutes they put the ventilator back on. But that
19:02
Speaker 1: two minutes where your brain was starved of oxygen was
19:05
Speaker 1: enough to to create real brain death if you weren't before. Wow,
19:11
Speaker 1: think about that. This is why they call you supplementary
19:14
Speaker 1: research man, right, That's why that's your superhero. And can
19:17
Speaker 1: you hear like people fast forwarding through to get through this, partners,
19:20
Speaker 1: It's like Josh, josh h Josh. Okay, So we have this,
19:24
Speaker 1: we have this new definition of brain death. And when
19:28
Speaker 1: the second apnea test happens, and you're declared brain dead.
19:33
Speaker 1: What they anesthetize you, they inject you with anti paralytics.
19:38
Speaker 1: Will you into that hospital room and they harvest your organs,
19:41
Speaker 1: so you actually die from a lack of organs present
19:44
Speaker 1: in your body. So that's that it's a ghoulish matter.
19:49
Speaker 1: And these people who are in charge of making sure
19:52
Speaker 1: that people donate and keeping the image of organ donation
19:56
Speaker 1: as a gift of life alive have to battle with
20:00
Speaker 1: this the fact that it's a very ghoulish process. Right,
20:04
Speaker 1: you're right, So who's who's in charge of this stuff? Uh?
20:08
Speaker 1: For what? For that whole soapopsh feel anytime, buddy, Yes, Josh.
20:14
Speaker 1: That would be called an O p O, which is
20:16
Speaker 1: an organ procurement organization and they are federally designated nonprofits
20:22
Speaker 1: and they are local all over the country. There's usually
20:25
Speaker 1: UM one in the central location of a state and
20:28
Speaker 1: then different satellite office is obviously because you need to
20:31
Speaker 1: be close by, you know, you can't be hopping all
20:33
Speaker 1: over the country to get these organs, although that happens
20:35
Speaker 1: as well. And they basically responsible for awareness, recruitment, evaluation,
20:41
Speaker 1: UM organ removal and transportation. So they're the people that's
20:45
Speaker 1: standing there with a cooler waiting to drop your organ
20:48
Speaker 1: in there and rush it to the recipient. They're also
20:51
Speaker 1: the people that talk to the family generally well. Sure,
20:54
Speaker 1: so anytime somebody dies you, the hospital is legally obligated
20:59
Speaker 1: to note a by the organ procurement organization. Right, and
21:02
Speaker 1: you know this, This is a good point to bring
21:03
Speaker 1: this up. If you want to be an organ downer,
21:05
Speaker 1: or if you are, you really need to tell your
21:07
Speaker 1: family the stuff, and you should have it all in
21:10
Speaker 1: your living will because things can get a little ugly. Um.
21:14
Speaker 1: For instance, let's say you are from a very strict
21:17
Speaker 1: religious background. Maybe your family doesn't want you cut up.
21:21
Speaker 1: They think that would be a bad thing, but you
21:23
Speaker 1: want it. You gotta have that, you know, in paper
21:27
Speaker 1: on paper, in writing, right, you need and if you
21:29
Speaker 1: have a documented um in a lot of cases, even
21:32
Speaker 1: if you if your family is like, no, we don't
21:34
Speaker 1: want to donate the organs, the organ procuman organization will say,
21:37
Speaker 1: you know what, ts sorry, he want he or she
21:40
Speaker 1: wanted to be an organ owner. So and the last
21:42
Speaker 1: thing you want after you die is for your spouse.
21:44
Speaker 1: Let's say, to have to mountain this campaign against your
21:46
Speaker 1: family like a tug of war like that. You gotta
21:49
Speaker 1: have it all spelled out. Um, So where are we?
21:53
Speaker 1: The United Network of Organ Sharing that's another group. This
21:56
Speaker 1: is where that's where you got the kidney statistics. We're
21:59
Speaker 1: gonna go back on and look at right. Yeah, they're
22:01
Speaker 1: in Richmond, Virginia, and they are responsible for placing donated
22:04
Speaker 1: organs um and maintaining the waiting list like you just said.
22:08
Speaker 1: And they never close No. Seven three sixty five, which
22:12
Speaker 1: is how it should be. Obviously, we should try calling
22:13
Speaker 1: them right now to see if they're open. Let's not
22:16
Speaker 1: do that. I'm sure they're open. And then chuck, there's
22:18
Speaker 1: the Scientific Registry of Transplant Recipients right, Yes, the s
22:23
Speaker 1: R t R. And they basically maintain like every amount
22:26
Speaker 1: of data you could possibly want on transplants, right, for
22:29
Speaker 1: like policy makers and doctors and drug makers and that
22:33
Speaker 1: kind of stuff. Yes, And there was one more called
22:36
Speaker 1: the organs uh sorry, the Organ Procurement and Transplantation Network,
22:41
Speaker 1: and they're they're just another network that matches people with
22:44
Speaker 1: recipients and has waiting list that kind of thing, right,
22:47
Speaker 1: So this is actually a pretty um lean, mean, streamlined machine. Yeah.
22:52
Speaker 1: The procurement and donation network. It has to be right. So, Chuck,
22:56
Speaker 1: you were saying, like they can't be hopping all over
22:58
Speaker 1: the country, but they have to sometime times. So what
23:00
Speaker 1: happens with like, let's say somebody dies in Sacramento and
23:06
Speaker 1: they have the perfect heart that somebody in Tampa needs.
23:09
Speaker 1: What happens, well, they will put it into a cooler
23:12
Speaker 1: and fly it to uh what was the destination? Tampa? Tampa?
23:16
Speaker 1: They fly to Tampa. Apparently like the hospital in Tampa.
23:20
Speaker 1: Those people will go fly to Sacramento, take possession of it,
23:23
Speaker 1: and fly it back unless there's somebody in the like
23:27
Speaker 1: like let's say somebody in Sacramento needed it and somebody
23:30
Speaker 1: at the Sacramento General Hospital died, that's when that cooler
23:34
Speaker 1: comes in. Which have you seen the one that's at
23:36
Speaker 1: the office. We have an organ transplant cooler. Yeah, it's
23:40
Speaker 1: pretty cool. Roxane keeper tab in it ap probably. Uh.
23:45
Speaker 1: You know what I thought was really cool is if
23:46
Speaker 1: you were on the organ donation list as a living donor,
23:51
Speaker 1: you are actually given consideration if you need an organ
23:55
Speaker 1: transplant yourself. And they said that they won't like bump
23:58
Speaker 1: you to the top of the list, but they will
24:00
Speaker 1: give that a little bit of extra weight, which I
24:02
Speaker 1: think is that's only right. Did you also see that? Um,
24:06
Speaker 1: if you are a living donor and you usually your
24:10
Speaker 1: insurance company won't raise your rates after that. But if
24:13
Speaker 1: you move to another insurer change like plans, they'll hit
24:17
Speaker 1: you with a pre existing condition. That's how evil and
24:21
Speaker 1: seriously you sign up for listening. I will give someone
24:23
Speaker 1: my kidney as a living human, and the insurance companies
24:26
Speaker 1: are like, oh, well, you might have to charge a
24:28
Speaker 1: little extra for that. Don't you think we should start
24:30
Speaker 1: publicly executing CEOs of insurance companies. It should be part
24:34
Speaker 1: of the healthcare reform package? Right, of course we don't
24:37
Speaker 1: mean that. Thanks for the CEO, so Chuck. When when
24:41
Speaker 1: you're talking about people running around with coolers and all that,
24:44
Speaker 1: it kind of creates this harried pace right in your mind. Um,
24:48
Speaker 1: and that's very much true. You have a very short
24:51
Speaker 1: amount of time for an organ to survive. Remember I said,
24:53
Speaker 1: like even five minutes can kill a heart once it's
24:57
Speaker 1: deprived of oxygen, which it stops beating. Right. Um, what
25:02
Speaker 1: happens when you die too? The body undergoes all these
25:05
Speaker 1: huge changes. Um, that happened almost immediately, like, um, there's
25:10
Speaker 1: this uh, parasympathetic flood of chemicals right, um, which is
25:16
Speaker 1: like kind of fight or flight on steroids. So I
25:20
Speaker 1: guess it's a sympathetic flood. Like dopamine levels increase eight
25:24
Speaker 1: hundred percent, epinephrin levels increase, nor EEF levels increase, So
25:31
Speaker 1: all these chemicals that are meant to like either speed
25:34
Speaker 1: you up or slow you down or just flooding your body.
25:37
Speaker 1: That's why you have to take the drugs right most times, Well, no,
25:41
Speaker 1: this is when you die. So when they're trying to
25:43
Speaker 1: harvest these organs, they're like trying to get them out
25:45
Speaker 1: of the body before this flood just damages these I
25:49
Speaker 1: thought you meant as a recipient that would happen. No,
25:52
Speaker 1: that'd be pretty awesome though, to have your dopamine levels
25:55
Speaker 1: raised eight percent, right, But it's not as easy as
25:57
Speaker 1: just throwing the new heart in there either and sewing
25:59
Speaker 1: you up and say good luck with your life. No, no,
26:02
Speaker 1: it's not. And uh there's also some expectation that you
26:06
Speaker 1: lead a very healthy life after that. You're not supposed
26:10
Speaker 1: to be drinking or smoking or swearing, and um, you
26:13
Speaker 1: have to stay away from call girls and things like that. Yeah,
26:16
Speaker 1: you shouldn't get a new liver and then like dive
26:18
Speaker 1: into the vodka bottle. You're you're pretty much signing a
26:21
Speaker 1: contract to become ned Flanders after you get your organ donation. Yeah. Actually,
26:25
Speaker 1: just over Christmas heard of a friend of a friend
26:29
Speaker 1: of a family member that was a candidate for I
26:33
Speaker 1: think a liver transplant and they would not do it
26:36
Speaker 1: because he wouldn't enter um rehab. Really yeah, wow, so
26:42
Speaker 1: that's hardcore. Yeah, that guy's dedicated to the booze, isn't it. Yeah,
26:46
Speaker 1: pretty much. Um. And also you're if you are a recipient,
26:52
Speaker 1: there's some expectation that you pay like for the lodging
26:57
Speaker 1: and travel expenses of the person who donated. Yeah, it's
26:59
Speaker 1: kind of an a written rule from what I understand
27:01
Speaker 1: well and have to be real, you know, it's kind
27:03
Speaker 1: of against the law really well, but it makes sense though,
27:05
Speaker 1: because if you're let's say, you want to donate a
27:07
Speaker 1: kidney to someone that lives across the country and you're
27:10
Speaker 1: spending money off from work and flying out there and
27:12
Speaker 1: putting yourself up, it's gonna cost you some dough and
27:15
Speaker 1: a kidney. Yes, you'd have to be a really nice
27:18
Speaker 1: person to be in an anonymous living donor. Yeah, that'd
27:23
Speaker 1: be cool. All right, So Chuck, you want to talk
27:49
Speaker 1: about the black market? Yes, the black market does exist.
27:53
Speaker 1: Isn't that crazy? Um? Yeah, but not surprising. No, but
27:57
Speaker 1: it's pretty interesting. Um. It obviously exists, Um, typically outside
28:03
Speaker 1: of the United States, although there have been some cases
28:06
Speaker 1: inside the United States. Usually it's like, and this is
28:09
Speaker 1: what's so sad. Usually it's impoverished nations. And what will
28:13
Speaker 1: happen is there will be a couple of countries involved.
28:16
Speaker 1: You'll take someone out of a really poor country, offer
28:18
Speaker 1: them like five thousand dollars for their kidney, and then
28:21
Speaker 1: the middleman will get, you know, a hundred thousand dollars
28:23
Speaker 1: for that kidney. And you know that it's not like
28:26
Speaker 1: these are done in professional surgical rooms. It's a lot
28:30
Speaker 1: of time, it's it's the back room, if you know
28:32
Speaker 1: what I mean. And that's actually exactly what happened in
28:36
Speaker 1: two thousand three in South Africa. Yeah, they were importing
28:39
Speaker 1: people from uh, I guess the city of God in Brazil. Yeah,
28:43
Speaker 1: slums of Brazil. Yeah, and um, giving them five grand
28:47
Speaker 1: for their kidney and then turn around selling it for
28:49
Speaker 1: a hundred k Yep. That's nuts yep. And uh where
28:53
Speaker 1: else did it happen? Villagers in India so that they
28:55
Speaker 1: were getting they weren't getting nearly. They were getting about
28:59
Speaker 1: eight hundred dollars for their organs, which is just unbelievable.
29:02
Speaker 1: And at one time the Israeli organ brokers were obtaining
29:08
Speaker 1: these from Soviet Bloc nations and doing the operations in Turkey,
29:12
Speaker 1: and this one guy made a middleman, made about four
29:15
Speaker 1: million dollars before he was called, which is not bad
29:18
Speaker 1: harvesting organs, although I imagine being an illegal organ broker
29:22
Speaker 1: is a fairly stressful job. Yeah, and it happens in
29:25
Speaker 1: the US too, although customarily it's um an organ broker
29:30
Speaker 1: and a nefarious funeral director who harvest organs before cremation.
29:35
Speaker 1: Did you know this happened? No? I didn't either, And
29:38
Speaker 1: I saw all the six feet under of course you did. Uh.
29:42
Speaker 1: Did you see the movie Trista's No, that wasn't very good.
29:46
Speaker 1: That was the the deal there though kids are like
29:50
Speaker 1: captured in the jungle. No, but it was like an
29:54
Speaker 1: Eli Roth movie. It was like hostile, except they were
29:57
Speaker 1: harvesting organs basically instead of blind torture uh. And speaking
30:03
Speaker 1: of that, thereristas that actually does happen in the world.
30:06
Speaker 1: It's not just old wives tales. Kidney theft does happen,
30:15
Speaker 1: It really does. Mohammed, what do you say. His name
30:17
Speaker 1: was Selim Khan. Yes, he lived in Delhi, India, and
30:22
Speaker 1: he was looking for a day's work and agreed to
30:23
Speaker 1: go to a house under the premise that he would
30:26
Speaker 1: get about four dollars a day for performing uh work.
30:29
Speaker 1: Their construction work. All is on the up and up
30:31
Speaker 1: so far. Then he has held at gunpoint for several
30:34
Speaker 1: days along with two other day labors. They were taken
30:37
Speaker 1: to an operating room drugged and they awoke with a
30:41
Speaker 1: horrific pain in their side and minus one kidney. And
30:46
Speaker 1: when they took him to the hospital. When he went
30:48
Speaker 1: to the hospital, he checked him out and he had
30:49
Speaker 1: indeed been down one kidney. Not an urban legend. That
30:54
Speaker 1: really happens, although it makes me wonder if the urban
30:56
Speaker 1: legend gave rise to the actual practice. Oh, yeah, you know,
31:00
Speaker 1: maybe so. And Josh, the one US case that was
31:03
Speaker 1: in here was really interesting too. Yes, Michael Master Master Marino.
31:08
Speaker 1: There's an oral surgeon in New York and he opened
31:10
Speaker 1: a company called Biomedical Tissue Services with an embalmer, which
31:15
Speaker 1: should have been a real red flag that he partners
31:18
Speaker 1: up with an embalmer. And this is in the year
31:19
Speaker 1: two thousand, not even that long ago. Actually it was
31:21
Speaker 1: ten years ago. I'm old. Uh. For many years though,
31:25
Speaker 1: they harvested human tissue provided by funeral homes and sold
31:28
Speaker 1: it to research facilities. And one of those bodies belonged
31:32
Speaker 1: to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater.
31:37
Speaker 1: So he was chopped up and given to unwitting Well,
31:40
Speaker 1: I don't know about recipients. They did harvest some of
31:43
Speaker 1: his tissue. Yeah, yeah, how about that? It's pretty awesome.
31:47
Speaker 1: So where are we now? We are I think we're
31:50
Speaker 1: at the point where we checked those stats. I have
31:52
Speaker 1: them written down here as of two oh three pm.
31:56
Speaker 1: What time is it now? Chuck's gotta get out of
31:59
Speaker 1: his Josh is one okay? To thirty one? I gotta
32:03
Speaker 1: telling me disappointed If this number hasn't gone down, I
32:06
Speaker 1: think all of our listeners will be too. So we
32:10
Speaker 1: started out Chuck with a total of one hundred and
32:13
Speaker 1: five thousand, two hundred eighty eight on the waiting list.
32:16
Speaker 1: What are we at one oh five. Okay, nothing has
32:20
Speaker 1: changed in twenty minutes with the kidney. We are at
32:24
Speaker 1: eighty three thousand twelve. Well, it would be the same
32:27
Speaker 1: because that was the master stat so the kidney didn't
32:30
Speaker 1: change either. Let's just hope Jerry didn't put a drum
32:32
Speaker 1: roll in anywhere, right. But I will say though, don't
32:34
Speaker 1: be disappointed, because, like I said earlier this morning, UM,
32:37
Speaker 1: three people received kidneys that were in search. That's awesome.
32:41
Speaker 1: Or else they died waiting. Yeah, let's let's like to
32:44
Speaker 1: think the other scenario panned out. Are you a donor?
32:48
Speaker 1: I don't remember. I was. At one point in time,
32:51
Speaker 1: I was that seven bucks off, But UM, I think
32:56
Speaker 1: I'm going to go ahead and do it. Yeah, this
32:58
Speaker 1: article inspired me because I'm a the belief that the
33:00
Speaker 1: human body after you die is like worm dirt. So
33:05
Speaker 1: I have no problem with donating my entire body or
33:08
Speaker 1: all my organs, none of that. Yeah. Well, if you
33:12
Speaker 1: want to learn more about organ donation, you can read
33:16
Speaker 1: Tom Sheave's article on how Stuff Works dot com. UH.
33:19
Speaker 1: You can also check out the UM what is It?
33:22
Speaker 1: Chuck the Organ Procurement Network UM for their side of
33:26
Speaker 1: the story. But I think you should also check out
33:29
Speaker 1: the Life Guardian Foundation. They have a very much opposing
33:32
Speaker 1: view of organ donation, So such a controversial topic should
33:37
Speaker 1: probably um get all of the facts before you make
33:40
Speaker 1: the very um important decision of whether or not you're
33:43
Speaker 1: going to be a dead donor. And if you decide
33:46
Speaker 1: that you want to be, like Chuck said, let everybody know,
33:49
Speaker 1: tell everybody, tell strangers on the streets. Just anytime you
33:53
Speaker 1: meet a doctor, go I'm going to be an organ donor.
33:55
Speaker 1: And you may want to make the decision with your
33:56
Speaker 1: loved ones as well, even though ultimately it is it
33:59
Speaker 1: is your right. So good luck with being a rag
34:03
Speaker 1: doll in the afterlife. Which leads us, of course to listener. Now, Yes, Josh,
34:11
Speaker 1: I am going to call this uh interesting cleptomania story
34:15
Speaker 1: from Sarah okay um hi, Josh, Chuck and Jerry, And
34:19
Speaker 1: she even spelled it correctly. Wow. I think that deserves
34:23
Speaker 1: a T shirt, don't you? Oh? Actually she didn't, Sorry
34:26
Speaker 1: to ours Okay close though. Uh here's a story that
34:29
Speaker 1: I always think of when you hear anything about kleptomania.
34:32
Speaker 1: A while ago, I was working in a large independent
34:34
Speaker 1: bookstore that had been a city institution for years. Like
34:37
Speaker 1: any retail establishment, they had experience about ten theft loss
34:42
Speaker 1: a year, nothing too unusual. However, one day in the
34:44
Speaker 1: late eighties they received a thick, densely written journal which
34:48
Speaker 1: detailed to the day, our moment, weather condition, et cetera,
34:52
Speaker 1: every single book this person ever stole from the bookstory.
34:55
Speaker 1: But this guy turned it in. Uh. They showed it
34:57
Speaker 1: to us in sales training. It was written in a
34:59
Speaker 1: cramped hand and all pages front and back, which is
35:02
Speaker 1: really creepy. When you're writing on front and back, you're
35:04
Speaker 1: either really green or you're like a serial killer. That's
35:08
Speaker 1: what I think. Uh. Sometimes a clipping or a picture
35:11
Speaker 1: from one of the stolen books is taped to it. So,
35:13
Speaker 1: of course the bookstore said, huh, maybe we should prosecute.
35:16
Speaker 1: Since they confessed basically to stealing over a period of
35:19
Speaker 1: twenty years, adding up to thousands of dollars is recognition.
35:23
Speaker 1: They contacted the people that returned address, and it turned
35:25
Speaker 1: out the person who wrote in was a son or
35:28
Speaker 1: daughter the very prominent local family active in politics and
35:31
Speaker 1: big charities and the like, the kind of family they
35:34
Speaker 1: named Wings of Hospitals after food Sarah say, so, of
35:37
Speaker 1: course they didn't want their good name, dragted the mud,
35:39
Speaker 1: and apparently settled out of court for an undisclosed Some
35:43
Speaker 1: money can do that. I guess that journal was something
35:46
Speaker 1: to behold though, So, um, that's what Sarah says. That
35:49
Speaker 1: is definitely that's awesome. Yeah. Cool, Well, if anybody's ever
35:55
Speaker 1: sent you a cryptic or disturbing journal and you want
35:58
Speaker 1: to tell us about it, or if you just want
36:00
Speaker 1: to say hi, you can send us an email at
36:02
Speaker 1: stuff podcast at how stuff works dot com. For more
36:11
Speaker 1: on this and thousands of other topics, is it how
36:13
Speaker 1: stuff works dot com. Want more how stuff works, check
36:17
Speaker 1: out our blogs on the how stuff works dot com
36:19
Speaker 1: home page. H