Wednesday, March 17, 2004

Eyes donated to
enable another to see

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By MATT FURBER
Express Staff Writer

Wood River Chapel Funeral Director Russ Mikel successfully performed the "harvest" of a pair of eyes for a cornea transplant recipient last week. The procedure required timing and coordination of many players and the consent of the donor’s family to be successful.

The relatives of the donor and the recipient have chosen not to reveal their identities.

"Currently we do need a signature from next of kin to go forward with the procedure, even if the victim has a donor card," said Jay Lugo, coordinator for the Idaho Lions Eye Bank. "The main mission is to eliminate blindness in Idaho."

Clinical coordinators at all hospitals are required to call a (donor) referral line on all deaths. Families have the burden to accept or reject the option to donate if the individual body has viable organs and tissues for donation, Lugo said.

Mikel doesn’t particularly like the word harvest, but it is his job to get the tissue in a sterile environment ready for transportation. Typically, a dead person is kept on life support machinery and transported or held for a team of technicians if body parts are going to be salvaged, he said.

However, cornea transplants are not considered acute emergency procedures, though timing is still important. Eyes can remain viable for transplant procedures for up to 10 days. Most Idaho cornea transplants are completed within four days, Lugo said.

Mikel is one of 70 enucleators around the state, mostly funeral directors who are trained to support a donation system sponsored by the Idaho Lions Club. Saving organs and tissue from a dead person to help improve or save another’s life is not a new idea, but it is a complex process that Mikel and others help to facilitate on a volunteer basis. Mikel has been trained in the procedure for nearly 20 years.

The first successful human corneal transplant was performed in 1904. The first Eye Bank started in New York in 1945. Eye banking in Idaho began in 1969 at Saint Alphonsus Hospital in Boise, where technicians remove the cornea and screen them for HIV, Hepatitis and other diseases.

Since 1969, the Idaho Lions Eye Bank has been working to coordinate corneal transplants for patients whose eyesight is compromised by damaged or diseased corneas. In the last decade the Lions Eye Bank has reduced the waiting list of patients from 30 to 40 to three or four, Lugo said.

Corneas are avascular—they have no blood vessels—which means that the blood types of the donor and the recipient don’t need to be the same. Still, there is a matter of timing and matching.

There are about 6,000 people in the U.S. who are on a waiting list for new corneas, but in Idaho the list is essentially down to zero, Lugo said. "It is due to the good coordination of the program," he said. Extra Idaho corneas are sent as far away as Germany, Asia and South America. Eyes that are not suitable for transplant are often used for medical research or training.

"It’s a good feeling to know you can help in getting that done," Mikel said. Although Mikel has never recovered eyes before, he regularly gets requests and permission to save pacemakers. The pacemakers are redistributed through a program called Heart to Heart in Billings, Mont. Most pacemakers are sent to foreign countries because FDA regulations prevent them from being transplanted in the U.S.

Since St. Luke’s Wood River Medical Center does not have a morgue, Mikel got the call last week to recover the eyes of a deceased person at the hospital. His training in eye recovery and his skill as a funeral director made it possible for the victim’s eyes to be donated and still be ready for an open casket funeral service, Lugo said.

"Our success rate is 98 percent," Lugo said. "(Enucleators) do an awesome job."

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