[Congressional Record Volume 146, Number 128 (Friday, October 13, 2000)]
[Extensions of Remarks]
[Pages E1787-E1788]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 2000 ORGAN COORDINATOR IMPROVEMENT ACT AND ORGAN DONOR ENHANCEMENT ACT

                                 ______
                                 

                            HON. JAY INSLEE

                             of washington

                    in the house of representatives

                       Thursday, October 12, 2000

  Mr. INSLEE. Mr. Speaker, today I rise to introduce two bills to 
address organ scarcity, The Organ Coordinator Improvement Act and The 
Organ Donor Enhancement Act. These bills complement each other in their 
purpose to increase the number of recoverable organs and make the best 
use of available organs for transplant.
  Every 14 minutes, a new person is added to the list of patients in 
need of an organ transplant. This list is 72,000 patients long today. 
Last year, we recovered over 21,000 organs for transplant from just 
over 10,000 individuals. In the same amount of time, we added 38,850 
people to the list. These numbers illustrate the urgency behind this 
issue. Ten people die every day because there was no organ available 
for transplant. The single greatest barrier to saving lives with organ 
transplants is the scarcity of available organs.
  I realize that we are at the end of session and the likelihood of 
these bills being enacted is minimal. But it is a crucial time to 
introduce these concepts and ask for support on this vitally important 
legislation. I am hopeful we can use this time between now and the 
start of the new Congress to build consensus on these initiatives. I 
want to gather opinions and expertise from my fellow members and the 
patients, organizations, and experts in their districts. The sooner we 
can get the ball rolling on this issue, the faster we will be able to 
save lives. We must act now to make progress on this heartbreaking 
inadequacy.
  The problem is easy to define. There are simply not enough organs to 
meet the needs of the patients waiting for them on the transplant 
lists. The challenge before us is to maximize the number of available 
organs and to maximize the recovery of organs available for donation. 
When an organ becomes available for transplant, we must spare no 
resource to ensure that it is delivered to a patient in need. We can do 
this in three ways. We must first educate more people about organ 
donation and encourage them to become organ donors. HHS should be 
congratulated for their efforts in this regard. Next we must invest in 
research and resources for hospitals and medical schools to improve the 
success rates of organ donation and options available to those who are 
in need of organ transplants. Finally, we must make absolutely sure 
that no organ goes to waste. Currently only a fraction of organs 
available for donation are actually recovered and made available for 
transplant. That's where this legislation comes into effect.
  Today I rise to introduce the Organ Coordination Improvement Act, 
which would dramatically improve the organ recovery rate. I asked the 
experts in hospitals and in organ procurement organizations what the 
single best thing Congress could do to assist with organ recovery 
efforts. The answer was simple: provide more staff in the hospital 
dedicated to this effort. This deceptively simple answer points to a 
greater truth. Only a very few hospitals and Organ Procurement 
Organizations actually have specifically trained and dedicated staff in 
the very setting that they are needed most--the front lines of our 
health care system, When those staff do exist, they make a dramatic 
difference. A pilot program through HHS to put specifically trained 
Organ Coordinators in hospitals in Maryland and Texas had a dramatic 
effect. In one year, Organ Coordinators more than doubled the recovery 
rate for organs. By placing Organ Coordinators in the hospitals, 
hospital consortiums or OPOs with the greatest potential for organ 
coordination, there is a tremendous opportunity to double the number of 
lives saved through organ transplants.
  This legislation does just that. The bill provides grants to fund 
staff positions for Organ Coordinators. A person in this position would 
be charged with coordinating the organ donation and recovery efforts 
within a hospital, or in some cases, a group of hospitals.
  Half of Organ Coordinators would be employed by hospitals and the 
other would be employed by Organ Procurement Organizations (OPOs). Both 
hospitals and OPOs are leaders in organ recovery efforts and both 
should be involved in this process. To build on this positive 
partnership, a control board would be established to coordinate the 
activities of the Organ Coordinators. The control board would have 
representation from both the hospital and the OPO, irrespective of 
which entity received the grant.
  By placing Organ Coordinators in the hospitals, hospital consortiums 
or OPOs with the greatest potential for organ coordination, there is a 
tremendous opportunity to double the number of lives saved through 
organ transplants. Hospitals and OPOs share an important goal and this 
bill will serve to augment local success stories and local partnerships 
that already exist in our communities.
  The second bill that I am proposing is the Organ Donor Enhancement 
Act, which would establish a national living donor registry based on 
the National Bone Marrow Registry. Last year, 10,538 people made their 
organs available for transplants. Of these, 4,640 people were living 
donors. Last year there were 9,237 kidney transplants performed, 4,441 
transplants from living donors. Clearly, organ transplants have 
progressed to the point where nearly 45 percent of all kidney 
transplants done in 1999 were from living donors.
  Mr. Speaker, no longer must a patient on the transplant list wish for 
an organ to become available from a horrible accident. Now kidneys and 
livers may be transplanted from one person to another and we have an 
obligation to help save the lives of the more than 62,000 people 
waiting for them.
  The National Bone Marrow Registry has operated successfully since 
1986 by registering people who are willing to donate their bone marrow 
to save somebody's life. Sometimes these are family members, friends or 
even strangers who possess the courage and compassion to be a living 
organ donor. While maintaining the highest privacy protections for 
registered volunteers, doctors are able to search and locate potential 
organ matches. The sheer scale of a national organ registry will 
enhance the practice of organ transplantation with increased speed and 
efficiency that no other resource could offer.
  The National Living Donor Registry aims to break down the largest 
barrier to organ transplantation. It increases the number of potential 
donors and establishes a mechanism for doctors to match organs to 
patients. Here in the shadow of the Capitol Dome, the Executive 
Director of the Washington Regional Transplant Consortium reports that 
more than 2 people a week contact her and inquire about becoming a 
living organ donor. Currently, living donors comprise 45 percent of all 
kidney transplants that are performed. The availability of living 
donors means particularly strong hope for liver and kidney transplants, 
especially because kidney patients make up two-thirds of the transplant 
wait list. The time is now for a voluntary, national list to enable 
these everyday heroes to become life-savers.
  In the midst of a tragedy, an organ transplant can create something 
awesome. A tragedy can save a life. For grieving families, it

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can be consolation that death has not struck in vain, and that indeed, 
their loved one continues to give energy and life. For thank everyday 
heroes who seek to become living donors, their gifts are the greatest 
gift of all. It is wondrous that medical technology has brought us so 
close to the miracle of life through organ transplant. Transplants have 
been performed since the 1960's and are now performed for 11 organs. 
Just last year, new types of liver transplants were being performed.
  We must work to maximize our resources and make the most efficient 
use of them. There is no doubt about the need for organs. The potential 
lives that could be saved should encourage us to work on these two 
pieces of legislation to increase the number of recoverable organs and 
maximize the potential of available organs.
  Lastly, I must offer my gratitude to the numerous patients, doctors, 
hospitals, organ procurement organizations and other individuals who 
offered valuable feedback on these bills. Many people have already put 
much time and effort in assisting me with the best ways to address 
organ scarcity. They have provided invaluable assistance and counsel, 
advice and criticism, and I thank them for their help. I ask my 
colleagues and others interested in organ recovery, organ donation and 
organ transplantation to examine these bills and provide me with their 
comments.
  It is my hope that by introducing these bills, more patients and 
professionals in the field will be inspired by these efforts to work 
with me. It is essential that they continue to be generous in their 
comments, opinions, questions, criticism, and ultimately, support. I 
welcome the response of my colleagues on these two bills and look 
forward to further discussion next session.

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