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Giving life to another person through organ donation is one of the most selfless acts a human being can do. While many people think of organ donation as something that happens after death, doctors encourage organ donors to donate while they are still alive, and organ donations are desperately needed.
According to the Organ Procurement and Transplantation Network, 46,632 organ transplants were performed across the United States in 2023. Of these, 6,953 were from living donors. Currently, approximately 104,000 people are on the waiting list for an organ transplant. According to OPTN statistics, the organ most in demand for transplant patients is the kidney.
Military members, veterans and their families can receive transplant services at Walter Reed National Military Medical Center's prestigious Organ Transplant Service. As the only certified transplant center within the Military Healthcare System, the program is one of the oldest and most successful in the country, program physicians said. In 2023, the program performed 55 kidney transplants.
Walter Reed's program only performs kidney transplants in-house, but also treats patients who need other types of transplants, including livers, pancreases, hearts and lungs. Most service members and recipients don't know how to navigate the complicated transplant process, so they turn to Walter Reed for help. Doctors refer patients who need transplants other than kidneys to centers in the network. The Walter Reed team either performs the transplant surgery in the Washington, DC area or calls another hospital to write a referral and start the process.
“The reason I encourage [going through Walter Reed] For recipients, being able to manage all of their care themselves is a great thing. [military health] “This is a great system,” said Army Lt. Col. Dr. Jamie Diaz-Robinson, chief of organ transplant services and hepato-biliary-pancreatic surgery at Walter Reed Hospital, “and we think it's great for preparing our residents and future physicians who will be caring for our veterans.”
Living donors are the longest-lasting and most effective
The Walter Reed program performs about 30 percent of transplants. Living donorRobinson says kidney transplants are the most effective and longest-lasting, but a common misconception that kidney recipients, on average, only have another five to seven years to live leaves many people afraid to donate and thinking it's not worth it.
“People need to understand that a living kidney is the longest lasting. On average, a living kidney should last 18 years. At Walter Reed, we have patients whose living kidneys have lasted 30, 38 years,” Robinson said.
Some people need organs for many years, while others only need them for a short period of time. “We use organs that only last for two to three years. [years]”Sometimes, that's enough for some people,” Robinson said. “They may not have another five years to live, but it would be unfair to them to spend the rest of those five years on dialysis.”
She says the first advice she gives to eligible recipients is to find a living donor, whether that be a friend, family member or a stranger who has learned about your plight on social media.
“If you donate part of your liver or one of your kidneys, you can continue to live a normal, healthy life,” Robinson said. “You can return to full active duty, be fully deployable, be fully retired and not require any medical care.”
She says most studies have not found a decline in long-term survival or progressive kidney failure in kidney donors, and it's not a debilitating procedure: At Walter Reed, donors go home the day after surgery, while transplant patients go home three days later.
While living donors can only donate kidneys, parts of the liver, or certain other tissues, several other organs and tissues can be provided by brain-dead or cardiac-dead deceased donors. Patients may also receive cadaveric donations, but only tissues such as corneas, skin, and heart valves.
Can I donate if I'm not in the military? Is there a cost?
One thing Robinson wanted to emphasize was that anyone can be a living donor to a military member, veteran or other military beneficiary, though it's not strictly a military-to-military exchange and there's no cost to the donor.
“A lot of the testing to see if the donor is a qualified candidate is covered by the recipient's insurance,” Robinson said. “We pay for the cost of bringing the donor here, the workup to see if they're a qualified donor, and the overall donor service. … Even if the donor is ruled out at step 1 or step 17, it's a process that's covered by the recipient's insurance.”
There is also a fund available for Walter Reed transplant patients and donors to cover the cost of housing, transportation and food at Fisher House. Once the transplant procedure is complete, donors receive health insurance at Walter Reed for two years, for any reason, even if they are unable to travel to Walter Reed otherwise.
“We've had people fly in from other states for appendectomies,” Robinson said, “and if a kidney donor can save a life here, we take that very seriously. We always want to take care of them.”
Complex process
Robinson said the whole process from evaluation to transplant can take a long time for some patients because they have to gather all their medical records, run a ton of tests, and meet with all the people involved in the transplant process, including the surgeon, dietician, pharmacist, and social worker. These people determine if there are any social, economic, or medical barriers to the patient receiving a transplant and if they can safely receive one. If there are any medical barriers, such as blood sugar levels that are too high or an infection from a root canal, the team works to eliminate them. Once a patient is deemed eligible, they are added to a donor database and a waiting period begins to find a matching donor.
Walter Reed's transplant service works closely with the Department of Defense's Histocompatibility and Immunology Laboratory, commonly referred to as the HLA Laboratory, which performs virtual analyses to predict whether a donor's organs will be accepted or rejected by a potential recipient.
“They basically do blood testing on all the patients in the community, transplant patients, people who want to be donors. They keep a pool of all the blood and the historical data and look for antibodies that patients may have that would prevent them from receiving a transplant,” Robinson said. “Some matches just aren't a perfect fit.”
Potential recipients will have monthly blood tests to ensure their health remains up to date.
A glorious record
Despite the complexity of the effort, Walter Reed's transplant program has earned a five-star rating, with 100 percent of live kidneys surviving at least a year. In the most recent data assessing the performance of the nation's transplant system, Walter Reed exceeded expectations in several areas, including transplant rates, and the hospital is known for having shorter-than-average wait times for transplant patients, doctors in the program said.
“For some of our most medically complex health problems, we can get people ready and registered for transplant within a few weeks to a month or two,” Robinson said.
The Walter Reed program is one of the fastest to get patients from the evaluation stage to actual transplant, using cutting-edge robotic technology to ensure a good outcome. Robinson said much of its success is thanks to military and veterans specifically seeking organ donation.
“That sometimes gets patients off the list a little earlier than they would otherwise be, which is nice,” she said, describing watching them start a new life as “the most amazing experience I've ever had.” Donors, she said, often want to know the moment they wake up if the transplant was successful.
“All they want to think about is, 'Did it work? Did I do a good job?'” Robinson said. “And [recipient]and you think, 'Guess what? I'll never have to go on dialysis again.'”
Robinson said her team just recently transplanted a kidney into the spouse of an active duty military member who they had never met before. “Ten days later, they met for the first time in the clinic, hugged each other, shook hands,” Robinson said. “The husbands were in tears, and they were all saying, 'This is so emotional.'”
She said cases like these motivate her every day performing surgery on deceased donors and patients who will never meet them.
Thinking about saving lives
Robinson said healthy adults should consider becoming a donor, especially donating a kidney.
“We could really solve a national health care crisis by getting people to donate their kidneys in this country,” she said, reminding people that funding and resources are available.
Patients can self-refer or inquire about the transplant process by calling 301-828-7313 or emailing the transplant team. If you are enrolled in the military health system, your healthcare provider can issue a referral for transplant care.
if you want to Register as an organ donorThis can be done online through your state's registrar or at your local Department of Motor Vehicles.
