[Congressional Record Volume 148, Number 14 (Thursday, February 14, 2002)]
[Senate]
[Pages S857-S859]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself, Mr. Dodd, Mr. Hutchinson, Mr. 
        Jeffords, and Mr. Enzi):
  S. 1949. A bill to amend the Public Health Service Act to promote 
organ donation, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. FRIST. Mr. President, on this Valentine's Day, National Donor 
Day, I rise to speak on the critical issue of organ donation. It is 
with great pleasure that I join with my colleagues Senators Dodd, 
Hutchinson, Jeffords, and Enzi to introduce the Organ Donation and 
Recovery Improvement Act.
  This far-reaching, comprehensive legislation includes a number of new 
steps intended to improve organ donation and recovery efforts 
nationwide and increase the number of organs available for transplants 
each year. This legislation is further complemented by a resolution 
that I, and a number of my colleagues are introducing today to 
commemorate today as National Donor Day and call attention to the 
important issue of organ donation.
  This year, more than twenty-two thousand Americans will receive an 
organ transplant. This is due to the rapid and tremendous advancements 
in our knowledge and in the science of organ transplantation. As a 
heart and lung transplant surgeon before coming to the Senate, I have 
had the opportunity to watch the field develop tremendously over the 
past three decades. I remember my own experiences, of conducting some 
of the first transplants using hearts and lungs, and know the 
tremendous progress that has been made since that time. And I know the 
hundreds of my own patients who have benefitted from improved lives due 
to advances in transplantation.
  Advances in our knowledge and the science have allowed us to 
transplant individuals who were once not considered candidates. But 
such advances have meant a staggering increase in the number of 
patients waiting for a transplant, while the number of donated organs 
has failed to keep pace. In fact, there are almost 80,000 patients 
waiting for a transplant today, a four-fold increase from just over a 
decade ago. Many of them may die before they can receive a transplant.
  More needs to be done. We must look for other ways to improve organ 
donation, to identify eligible organs and work with families to help 
them better understand the value of donation.
  Secretary Thompson already has made great progress in this area. I 
commend him for making organ donation a top priority at the Department 
of Health and Human Services. His initiative holds great promise. In 
particular, I applaud his call to recognize donor families through a 
medal of honor, something I have long supported through my own 
legislation, the Gift of Life Congressional Medal Act. I also welcome 
the Secretary's commitment to more closely scrutinize the role that 
organ donor registries play in the donation process.
  The legislation I am introducing today builds on these efforts 
through a broad range of initiatives intended to improve organ donation 
and recovery, enhance our knowledge base in these fields, and encourage 
novel approaches to this growing problem.
  The Organ Donation and Recovery Improvement Act is designed to 
improve the overall process of organ donation and recovery. The bill 
also seeks to remove potential barriers to donation, while identifying 
and focusing on best practices in organ donation.
  Let me briefly highlight a few key provisions of the legislation. 
First, the bill establishes a grant program for demonstration projects 
intended to improve donation and recovery rates and

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ensures that the projects' results will be evaluated quickly and 
disseminated broadly. The bill also provides for the placement and 
evaluation of organ donation coordinators in hospitals, a model that 
has worked with success in other countries.
  In addition, the legislation expands the authority of the Agency for 
Healthcare Research and Quality to conduct important research, 
including research on the recovery, preservation and transportation of 
organs and tissues. As we all know, the science of organ 
transplantation has been improved and refined over and over again since 
its inception. Yet all too often organ donation efforts are conducted 
under the same conditions and understandings as they were twenty years 
ago. This must change, and the legislation Senator Dodd and I are 
introducing today will help establish a strong evidence-based approach 
to enhance organ donation and recovery and improving our understanding 
of this process.
  The bill also includes several important provisions affecting living 
organ donation. First, it attempts to reduce potential financial 
disincentives toward serving as a living donor by allowing for the 
reimbursement of travel and other expenses incurred by living donors 
and their families.
  Importantly, the bill also takes steps towards evaluating the long-
term health effects of serving as a living donor by asking the 
Institute of Medicine to report on this issue, as well as through the 
establishment of a living donor registry intended to track the health 
of individuals who have served as living organ donors. There remain 
important questions surrounding how this registry should be structured, 
and I look forward to working with my colleagues and the experts in the 
field to finalize the details before any legislation is enacted.
  Finally, I would like to address the issue of prospective organ donor 
registries. I am supportive of donor registries and feel they have an 
important role to play in improving organ donation rates. Moreover, I 
am pleased by the actions taken by some states to establish and enhance 
such registries. However, I am concerned that too great a focus has 
been placed on registries at a time when a number of questions 
surrounding registries remain unanswered and their effectiveness has 
not been fully evaluated. Therefore, the bill establishes an advisory 
committee to study this question and to report to Congress on the 
usefulness and success of organ donor registries and potential roles 
for the federal government to play in encouraging and improving such 
programs.
  The Frist-Dodd Organ Donation and Recovery Improvement Act is 
supported by a wide range of patient and organ transplantation 
organizations. I am pleased that the bill is supported by the American 
Society of Transplantation, National Kidney Foundation, American Liver 
Foundation, North American Transplant Coordinators Organization, 
Patient Access to Transplantation Coalition, TN Donor Services, New 
Mexico Donor Services, and Golden State Donor Services. I thank them 
for their hard work and dedication to this issue.
  Organ donation is one of the most important issues before us today. 
Each year, thousands of donors and families make the important decision 
to give consent and give the gift of life. We must recognize and honor 
their sacrifice, and, in so honoring, work to increase donation rates 
and allow more families to receive this gift of life each year. 
Hundreds of my own patients are alive today because of this gift. Let 
us work together to allow more patients and families to experience this 
miracle.
  I thank Senators Dodd, Hutchinson, Jeffords and Enzi for joining me 
in this effort, and look forward to working with them and my other 
colleagues to pass this important legislation this year.
  Mr. DODD. Mr. President, most of us know February 14 as Valentine's 
Day, but for the past few years, it has shared that date with another 
vitally important, and unfortunately less well-known, event: National 
Donor Day.
  Thanks to the selflessness of thousands, February 14 has become our 
Nation's largest one-day donation event. On a day that celebrates 
giving the gift of life, we should make a commitment to increasing our 
donation rates and saving even more lives.
  Today, I am pleased to introduce legislation with Senator Bill Frist 
to do just that. The Organ Donation and Recovery Improvement Act will 
bring attention to this critical public health issue by increasing 
resources and coordinating efforts to improve organ donation and 
recovery. I am proud to be working with my friend and colleague, 
Senator Frist, whose leadership and professional experience as a heart 
and lung transplant surgeon has been critical in making this issue a 
priority.
  At this very moment, more than 80,000 people are waiting for an organ 
transplant, and one person is added to this list every thirteen 
minutes. This has increased from 19,095 people on waiting lists a 
decade ago. Unfortunately, the discrepancy between the need and the 
number of available of organs is growing exponentially. From 1999 to 
2000 transplant waiting list grew by 10.2 percent, while the total 
increase in donation grew by 5.3 percent. Tragically, in 2000, 
approximately 5,500 wait-listed patients died waiting for an organ.
  Undoubtedly, the task before us seems daunting. However, each person 
who makes the decision to donate can save as many as three lives. These 
are our mothers, fathers, brothers, sisters, friends. None of us wants 
to imagine the anguish of watching a family member or a friend wait for 
an organ transplant hoping that their name reaches the top of the list 
before their damaged organ fails or having to bear the emotional, 
physical, or financial costs of undergoing a transplant procedure. For 
those that do, and for all of those that will, we must improve and 
strengthen our systems of organ donation and recovery. We must also 
work to remove the barriers that stand in a donor's way as he or she 
seeks to help another person continue life. States need the resources 
to determine for themselves how best to increase donations and a vital 
part of increasing donations lies in education and public awareness 
initiatives.
  We must work to improve the science of donation and recovery and 
address legal issues relating to donation, including consent. More than 
20 states currently have registries that may prove indispensable in 
ensuring that we honor a donor's wishes. We should study the benefits, 
and potential shortcomings, of these arrangements and work to create a 
national sense of urgency that matches the national need for donors.
  I would like to recognize the invaluable support and guidance we 
received, in drafting this bill, from the American Society of 
Transplantation, the American Liver Foundation, the Patient Access to 
Transplantation Coalition, North American Transplant Coordinators 
Organization, and the National Kidney Foundation. I would be remiss not 
to mention the Association of Organ Procurement Organizations and the 
OPOs nationwide that have worked so tirelessly to bridge the gap 
between the immense need and the inadequate supply. In my home state of 
Connecticut, we are well served by the tremendous work of the Northeast 
Organ Procurement Organization and the New England Donor Bank.
  Finally, I look forward to working with my colleagues, including 
Senator Kennedy, Senator Gregg and Senator Durbin, whose commitment to 
this issue has been unparalleled. I urge Congress to take swift action 
on bipartisan legislation aimed at increasing organ donation and saving 
lives.
  Mr. JEFFORDS. Mr. President, today, Valentine's Day, provides a 
wonderful opportunity for me to offer my support for the Organ Donation 
and Recovery Improvement Act. I commend my colleagues, Senator Frist of 
Tennessee and Senator Dodd of Connecticut, for their leadership and 
commitment to this important issue. Organ transplantation provides 
perhaps the clearest example where scientific research has been 
translated and applied to modern medicine. Not too many years ago organ 
transplantation was associated with inconsistent success and numerous 
complications. Today these procedures have advanced to the point where 
success is commonplace. Not only the duration of life, but the quality 
of life, is improved.
  I have carried an organ donor card in my wallet for more than twenty-
five years, and I am a long-time organ donation supporter. In my home 
State of

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Vermont, Representative Johannah Donovan has introduced a bill to allow 
for the creation of a donor registry through the Department of Motor 
Vehicles. It is an excellent example of trying to make the organ donor 
process easier and more efficient. So, I am proud to join my colleagues 
as an original sponsor in this effort to increase organ donation at the 
national level. Even though great strides have been made in organ 
procurement and distribution, problems remain, and those issues are 
addressed by this legislation. This proposal would establish a federal 
inter-agency task force to coordinate organ donation efforts and 
transplant research; expand the Federal organ-donation grant authority 
and provide funds to educate lay professionals in issues surrounding 
organ donation; expand the Agency for Healthcare Research and Quality 
authority to review and improve organ recovery, preservation, and 
transplantation; provide for two important Institute of Medicine 
studies to review and document issues associated with live organ 
donation; and establish an advisory committee to make recommendations 
regarding costs, benefits, expansion, availability, and other issues 
involving transplantation.
  In Vermont, we are fortunate to have Fletcher Allen Medical Center. 
This state-of-the-art institution provides quality transplantation 
services to the residents of my state and surrounding areas. However, 
despite a wonderful facility and a well-trained and experienced staff 
of health professionals, Fletcher Allen is limited, like all similar 
institutions, by the high demand for donor organs and the limited 
supply. This legislation will move us closer to the day when all 
individuals who would benefit from transplantation are able to receive 
appropriate care in a timely manner. I urge all of my colleagues to 
join me in supporting this important legislation.
                                 ______