November 1986
March 1993 (reaffirmed)
February 1997 (revised)
November 2000 (revised
November 2003 (revised)
November 2006 (revised)

Statement of the Issue

Medical advances have provided a tremendous opportunity to save or improve lives through organ, tissue, blood, and marrow transplantation. Though tens of thousands of lives are saved each year through transplantation, thousands more continue to be tragically lost because need outpaces availability. Even when there is consent for organ donation, the actual number of organs utilized is suboptimal, with a failure to transplant nearly half of all organs available for transplant. Thus, waiting lists for these resources continue to grow at unprecedented levels.

Significant opportunities exist to increase both the percentage of eligible donors who become donors and the number of organs transplanted per donor. Donations and transplantation can be increased through:

• Specific hospital procedures that are developed in cooperation with affiliated organ and tissue procurement organizations to work with patients and families in maximizing donation rates.

• Best practices for increasing the donation conversion rate and the number of organs transplanted per donor, such as those developed by the Health Resources and Services Administration’s (HRSA) Organ Donation and Transplantation Breakthrough Collaboratives.

• Heightened public and professional awareness of the problem and distribution of information related to potential solutions.

Though governments, medical professionals, hospitals, procurement organizations and insurance companies can provide resources that support donation, only individuals and their families have the ultimate power to offer the gift of life.

Policy Position

The American College of Healthcare Executives (ACHE) believes that all healthcare executives should work to increase the supply of available organs, tissues, blood, and marrow for transplantation. ACHE recognizes donation as a critical component of life-saving technology and end-of-life decision making and supports voluntary efforts to increase organ, tissue, blood, and marrow availability.

As business and community leaders, healthcare executives have the influence and credibility to motivate individuals and families to consider donation of organs, tissues, blood, and marrow. ACHE encourages its affiliates to actively pursue the following:

Establish Protocols and Information Programs

• Together with their affiliated organ and tissue procurement organization, establish effective and compassionate protocols for working with patients and their families. Families of dying patients should be provided with the option to donate. Many appreciate the opportunity to ease their personal loss with a selfless, giving act.

• Develop strong, ongoing public information and education programs that help people understand the process of organ and tissue donation and the importance of sharing with their families the decision they have reached. When individuals make their wishes known in advance, they ease the decision-making burden placed on their families during a difficult and vulnerable time. Usually it is the family that is asked for final consent for organ and tissue donation.

• Develop strong, ongoing public information and education programs that help people understand the process of blood donation and how to become a potential marrow or peripheral blood stem cell donor.

Encourage Donation

• Encourage members of the medical community to develop protocols reflecting the best practices in the field to maximize organ, tissue, blood, and marrow donation, availability and transplantation.

• Consider serving as role models by publicizing their own personal decisions to sign donor cards, participate in blood drives or join the marrow registry. Healthcare executives can provide leadership in the resolution of this important social problem by encouraging their staff to follow their lead and in coordinating community efforts.

• Participate in national, state and local government and private-sector initiatives to promote organ, tissue, blood, and marrow donation.

The issue of organ, tissue, blood, and marrow donation and transplantation reaches beyond the limited availability of these precious resources in the face of growing demand, but one issue is clear: Transplantation cannot save lives and promote well-being unless caring individuals donate. ACHE encourages its affiliates to develop an environment that fosters this opportunity.

Note: Information on the Health Resources and Services Administration’s (HRSA) Organ Donation and Transplantation Breakthrough Collaboratives can be found at: http://www.organdonor.gov/collaborative.htm

Approved by the Board of Governors of the American College of Healthcare Executives on November 6, 2006.