Jeff Trageser runs a nonprofit in Mission Valley that acquires organs for transplants from deceased donors in San Diego and Imperial counties. As the only agency in the region authorized by the federal government to do this job, his 85-strong team tries to turn death into life.
Some of the results are on display this week at the Transplant Games of America, a biennial gathering of organ recipients, donor families, living donors, transplant specialists and health care providers. About 10,000 people from across the country are expected to attend athletic competitions, tribute ceremonies and other events.
Trageser, 53, was born in Ohio and raised in San Diego. He worked as an intensive care nurse before joining Lifesharing, where he is the interim director. Lifesharing sends nurses and social workers to local hospitals for one of the toughest jobs in medicine: asking the families of dying loved ones for permission to remove organs and tissue.
According to Lifesharing, in 2021 organs donated by a record 146 people who died in this region saved 413 lives.
The Union-Tribune sat down with Trageser to discuss the challenges and rewards of obtaining organs for transplants. The conversation has been edited for length and clarity.
Q: I’m sure every family is different, but is there a common message you bring to all of them?
A: If you look at some of the studies out there, over 90 percent of Americans say they strongly or very strongly support donation. But talking about it with someone who just makes a breeze is very different from when you’re in ICU and someone you love very much has just passed away. You are not in the best place to make that decision.
Our team works very hard to make sure you make the decision you’ll be happy with six months from now, even if you can’t handle it right now. We try to help them get into the space where they can decide what’s best for their family.
Q: What happens when a family says yes?
A: Our work is just beginning. It’s non-stop for the next 24 to 48 straight hours. Our team works long nights at the hospital, looking after someone so they can donate their organs.
Finding recipients for the organs is another very difficult part. We make a lot of calls to different transplant centers across the country to find the best match for each organ. And they ask questions, push us to other timelines – can we go tomorrow, can we go tonight – and try to make it work for everyone.
All this while taking care of the family, who are still in mourning. It’s very complex. I’ll tell the nurses you’re actually wearing three hats at once. You are a social worker for the family. You are like an ICU resident and you do all the medical care for the donor. And then you’re also allocating organs and you have to be like a businessman and twist and deal to make it work for everyone.
Q: How is this region doing in terms of organ donation?
A: In fact, we are really successful both in having many registered donors (almost 2 million people in the two provinces signed up to donate organs) and in having the families of those who never signed up say “yes” when we approach them. Our qualifying authorization rate is close to 80 percent, which is higher than the national average of 75 percent.
Q: What does the Eligible Authorization Rate mean?
A: One thing to keep in mind is that only about 1 in 300 hospital deaths are eligible to be an organ donor. You have to die in a very specific way. So the agencies that run us say, OK, of the hospital deaths that qualify, 75 percent of the time you talk to the family about donations, they should say yes. That’s the threshold. We’ve been higher here.
Q: One in 300 – you’re really threading a needle.
A: Everyone dies, but only a very small percentage can be donors. So we need to focus on finding those people and then talking to their families. And because it’s rare, we really want and hope that those families choose what’s right for them.
If a family says, “No, we talked about that and he said, never let me be a donor,” that’s a good reason to say no. And that’s fine with us.
What we don’t want is a family saying, “He really wanted to be a donor, but we’re really busy right now, we have a lot to do and we’re just not going to do it.” Because I’ve met those families, who come up to me six months later and say, ‘I’m really sorry we didn’t donate. We really wanted to. We wish we had. But we couldn’t see our way clear.”
We need to figure out what they need, what’s important to them? Of course we advocate donation. We’re not trying to convince anyone who doesn’t want to. We advocate for it because we know it helps families heal, and of course it helps the recipients. Our goal in that terrible moment is to help people get to that place where they can make the decision that’s best for them.
Q: Do families find out what happened to the organs after they donate?
A: We have Family Service Specialists who will contact you. We cannot give too much information about the recipient to protect their privacy. But we do provide basic information. A young woman in Southern California was given the heart. A man in his fifties in Arizona got the liver. Those kind of things.
We also have a program where if the donor’s family wants it, we can give more information to the recipient, and the donor family can also get information from the recipient.
All letters come in through us. A recipient might write, “Thank you so much for your gift. I am alive today because of your loved one’s generous donation. I have a new liver and now I play golf and spend time with my grandchildren.”
The same goes for the donor family. They could write back and say, ‘Your liver donor also liked golf and he had some grandchildren and he would have liked to know this. So thank you.”
These are really powerful letters. And on rare occasions, if all goes well, the two families can meet in person. We pull out a stethoscope so the donor family can listen to their loved one’s heart in the other person. It’s really emotional and powerful. Some families have become very close after those meetings, have attended their children’s weddings, things like that.
But not everyone wants to do that. Some recipients are very private. They feel guilty knowing that someone has died, and they may not want to write that letter. Some donor families feel the same way.
BY FIGURES
Organ Transplants in San Diego and Imperial Counties
1.943: Local residents on the national waiting list for a transplant (from 26 July)
1,694: People waiting for a kidney
165: Waiting for a liver
40: Waiting for a heart
27: Waiting for a kidney and pancreas
10: Waiting for a lung
6: Waiting for a pancreas
1: Waiting for heart and lungs
Source: Lifesharing
Q: What are the biggest public misconceptions about organ donation?
A: I think the biggest thing I find frustrating is the belief that if you’re an organ donor and you go to the hospital, they won’t take care of you because they just want your organs. It couldn’t be further from the truth.
First of all, the doctors and nurses have no idea whether you have registered as a donor. They just don’t. People say, “Well, it’s on your driver’s license.” They don’t take your driver’s license to the IC. The stuff goes in a safe. So that’s just a fact: nobody knows if you are a donor.
And the second thing is, if they really just want your organs, they have to take good care of it and try to save your life. What they do to save someone’s life is what the organs need. So suggesting that someone wouldn’t take good care of you because they want your organs to be retarded. It wouldn’t work.
Then there are misconceptions you hear about how rich people can get to the front of the line. They can’t. It’s impossible. You can’t buy your way to the top. It’s very egalitarian. It’s just like the RDW: you have to stand in that queue together, rich and poor.
Transplants are based on blood type, on tissue type – so many factors that have nothing to do with income level. But when a celebrity gets a transplant, there’s always that assumption, “Well, I know how they got to the front of the line.” No, they waited just as long as anyone else.