People of the undecided
Dr. Andrea Bannert has been with since 2013. The doctor of biology and medicine editor initially carried out research in microbiology and is the team's expert on the tiny things: bacteria, viruses, molecules and genes. She also works as a freelancer for Bayerischer Rundfunk and various science magazines and writes fantasy novels and children's stories.
More about the experts All content is checked by medical journalists.Almost everyone is for organ donation - in principle. But only a few carry an ID. Volunteers get on the hesitation. Your weapon: reconnaissance.
“My pancreas comes from Belgium - I'm a bit of a foreigner now,” jokes Thomas Fischer with a serious face in a fully occupied lecture hall. The 60-year-old with his brown-gray curly hair, round, friendly face and mustache leans casually against the desk, the microphone in front of his chest - like a lecturer who is used to giving lectures. Fischer was a nurse and is now in early retirement. “I have three new organs. First I needed a heart and a kidney, three years later I got the pancreas, ”he continues. His audience is not students, but 16-year-old schoolchildren who listen to Fischer so carefully that you could hear a pin drop. “After the operation, I first asked the nurse for a dark wheat beer, it was like an orgasm on the mucous membrane. Today I feel really good, ”he says, and then a smile crosses his face. Some of the students grin cautiously.
At the bottom of Europe
Serious diabetes (type 1 diabetes) had destroyed Fischer's blood vessels, and finally the left ventricle had almost completely failed due to a heart attack. Without the organ donation, he would have died. Fischer was lucky: In Germany, 11,000 people are waiting for a life-saving organ. Some in vain. Because the number of organ donations in Germany reached a low last year: Only 876 people donated organs, another 16 percent less than in 2012. “The transplant scandal is to blame. Confidence has been destroyed, both among doctors and among the population, ”says Dr. Thomas Breidenbach, managing doctor of the German Organ Donation Foundation (DSO). Because there are so few donor organs, some doctors falsified their patients' data in 2012 so that they could move up the waiting list.
In Germany there are more and more people who want to do something about the falling number of organ donations. People like fishermen who have already benefited from organ donation themselves. Or people who simply find that they don't know enough about the subject themselves. In 2003 the association “Junge Helden” was founded in Berlin. You want to be informed. "Education is the only way to improve the situation," says Fischer.
The event "Schoolchildren in the transplant centers" in the Großhadern Clinic in Munich shows how something like this can work. The information day for young people is taking place for the 99th time. Since 2001, more than 6,000 schoolchildren and 500 teachers have been educated there about the subject of “organ donation”. Fischer was there almost from the start. Despite the commitment of the educators, according to the DSO, only an estimated ten percent of the population have an organ donor card with them - without it it would probably be even fewer.
Extreme situation for the relatives
Thomas Fischer and colleagues do not want to convert. Your goal: Everyone should make a decision - and document it on an organ donor card. Because if you don't do that, you shift the responsibility onto your relatives. And they then have to make a decision in an extreme situation: right after they find out that someone close to them has passed away. “In two thirds of the cases, the bereaved have no idea how the deceased felt about this question. Often they decide against it so as not to go wrong, ”reports Fischer's doctor, Dr. Helmut Arbogast.
Majority in favor of organ donation
If you ask people on the street, most of them are in favor of organ donation - 78 percent, according to a survey by the Federal Center for Health Education. Then why don't they get some ID? “Many just don't take the last step,” says Loretta Stern from “Junge Helden”. “In everyday life you think: I should actually need an ID card like that. Where do you get it from again? Oh, I have to go, my bus is driving. "
In other countries, on the other hand, it is necessary to become active when one of one's organs not want to donate. Only those who register in an objection register or who have ticked “no” on an organ donor card are excluded from this. "If you go to Austria, Belgium or Spain, you are automatically an organ donor," explains Arbogast to the young people.
Against the gray area feeling
What often prevents people from completing an organ donation card are diffuse fears. “The gray area feeling has been intensified by the transplant scandal,” Stern observed. The concerns are always the same: “Many are afraid that in the event of an accident, everything will not be done for them. Others fear that they will feel something if their organs are removed, ”reports DSO man Breidenbach. There are also questions about intensive therapy, which is necessary after death to keep the organs alive. "People want to know: what exactly will happen to me when I become an organ donor?"
In order to prevent abuse, many actors are involved in organ donation and they control each other. The superordinate coordination office is the DSO. Doctors report to her when there is a potential organ donor in her clinic. “The decision as to whether someone becomes an organ donor is never made at the scene of the accident, but always in an intensive care unit,” explains transplant doctor Arbogast. Organ removal is usually carried out in the hospital where the donor died. Breidenbach: "For the medical professional, this means additional work that is not paid for separately." So there is no financial incentive for the doctor to report a potential organ donor.
Doctors in specialized clinics, the so-called transplant centers, decide which patient is on the waiting list. They regularly report laboratory values from possible organ recipients to Eurotransplant. Since the transplant scandal there has been a "six-eyes principle": no longer one doctor alone, but at least three doctors measure the patient data and pass it on. Eurotransplant then decides which patient on the waiting list will receive an organ from the donor - depending on the urgency and the chances of success.
"Brain dead no longer get up"
There is also uncertainty among the students. When Arbogast gives the opportunity to ask questions, fingers up immediately. "What if I'm not really dead yet ...?" Asks a schoolgirl with a long, brown braid.
Arbogast replies that only someone who is definitely brain dead can become an organ donor. To be brain dead means: the entire brain has failed: cerebrum, cerebellum and brain stem. In most cases, the cause is not an accident, but a sudden bleeding in the brain. "A brain-dead person definitely no longer feels pain," emphasizes Arbogast.
The diagnosis of “brain death”, however, must be made by two different doctors, independently of each other. Both may not be involved in organ removal or transplantation. The doctor recognizes brain death from the fact that the patient in the coma lacks pupil, gagging and pain reflexes and he no longer breathes independently. Electrical activity in the brain can no longer be measured using electroencephalography (EEG). Blood flow to the brain can be checked with additional imaging tests. "There is not a single case in which a brain-dead person has gotten up again," says Arbogast.
Organs need to be taken care of
For the relatives, however, the time before the organ removal can become a psychological stress test: the loved one is actually dead, but receives intensive medical treatment. Ventilation causes the chest to rise and fall regularly, the skin feels warm, and the heart is still beating. All of this is necessary so that the organs are supplied with oxygen and the blood in them does not come to a standstill. How long such intensive therapy may last is not regulated by law. Sometimes it takes days before brain death is diagnosed - for example, when the effects of medication that have been used by the emergency doctor have to wear off.
Health insurance companies should help
The legislature has drawn conclusions from the transplant scandal and its consequences. In 2013, an amendment to the Transplantation Act was passed. It obliges the health insurances to provide regular and active information about organ donation. By October 2013, all policyholders were sent brochures with an organ donor card attached. So people like Fischer, Arbogast and Stern have supporters in their educational work.
Celebrations for organ donation
The “Young Heroes” have a completely different strategy of getting young people enthusiastic about the topic: The association regularly organizes parties in Berlin that focus on the topic of organ donation. “We want to create an atmosphere that is pleasant and in which you can feel life,” says Stern.
The Berlin club Ritter Butzke is bursting at the seams. Small white lamps shine like stars from the black ceiling, and a disco ball rotates in the middle of the rectangular room. The electronic dance music is driven by deep bass and the atmosphere is boiling. It could be an ordinary evening in one of Berlin's hippest clubs - if the white T-shirts of the “young heroes” weren't flashing everywhere: at the entrance, behind the bar, on the dance floor. They are carried by volunteers and celebrities such as the actors Jürgen Vogel and Matthias Schweighöfer.
On this evening, the guests are allowed to ask holes in your stomach - they know about organ donation. Also unusual are the small, orange-colored cards that guests get pressed into their hands at the entrance and that are located at the bar and on every table: organ donation cards.
It works out - almost all guests take an ID card with them, some even a whole stack. “They want to distribute them at work or among friends,” says Stern happily. The “Young Heroes” don't know whether they really do it. “Nobody has to make a decision that evening,” emphasizes Stern. “We just want to say: Hey, deal with the topic, talk to your friends and family about it. This is important."
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You can print out an organ donation card here: www.houseofgoldhealthproducts.com/Service/Downloads/Organspendeausweis-d281.pdf Thomas Fischer recorded his experiences in poems: "finSTERNis, about my life or my survival", Wagner Verlag |
