Heather Gardiner hopes her newly-received research grant will help more people receive organs.
In the United States, 95 percent of adults support organ donation, but only 54 percent are registered organ donors, according to the United States Department of Health and Human Services.
Gardiner, the director of the Health Disparities Research Lab, and Laura Siminoff, the dean of the College of Public Health, received a three-year $1.5 million grant from the U.S. Department of Defense in September to study vascularized composite allograft, an emerging type of organ transplantation that involves transplanting external body parts and systems of bone, nerves, skin and tissue.
Traditional solid organ transplantation involves internal organs like kidneys and hearts, according to the American Society of Transplantation. Gardiner and Siminoff are now examining how organ procurement organizations, like the Gift of Life Donor Program, develop protocols to explain VCA.
Gardiner and Siminoff are also creating a research-based training program to help organ procurement organizations better discuss VCA donation with patients and their families.
The Department of Defense is specifically investing in VCA research to benefit veterans who have suffered injuries in combat.
In 2012, the department launched the Reconstructive Transplant Research Program, which furthers research on VCA procedures and aims to help veterans overcome injuries. During the 2018 fiscal year, the Department of Defense Reconstructive Transplant Research Program had $12 million to allocate to funding VCA research projects.
“For military men and women who have been deployed in active duty and have stepped on these landmines, [the transplants] are invaluable,” Gardiner said. “They may not always restore full functioning, but you get mobility and you get a better self-esteem and quality of life.”
Patients and families may be more reluctant to donate organs using the new procedure because people are more emotionally attached to the organs involved in VCA, Siminoff said. Certain donations affect the possibility of an open-casket funeral.
VCA transplants include body parts like hands, feet, reproductive organs and faces, she added.
There are only about 90 documented cases worldwide of VCA transplantation in the past decade, as it’s a relatively new technology, according to the AST.
“These are things that are culturally and symbolically highly personal,” Siminoff said. “There are sometimes you can really know somebody by their hands.”
One notable VCA transplant occurred last year when 21-year-old Katie Stubblefield became the youngest fact transplant recipient in U.S. history after suffering a self-inflicted gunshot wound that severely disfigured her face, CNN reported.
Stubblefield’s transplant was funded by the Department of Defense due to the similarity of her injuries to those sustained by veterans.
“Obviously, people want their appearance to improve from these injuries, but it’s so that people can talk again so that they can breathe properly, so they can eat properly,” Siminoff said. “Some of these injuries…you can’t imagine how anyone could have even survived an injury like that. It’s really the technology that we have that drives this, which has driven the entire field of organ donation.”
Gerard Alolod, the director of research operations at the Siminoff Research Group in the College of Public Health, is organizing the research effort.
The first step is that researchers will conduct phone interviews and focus groups to collect data from the public, previous donors’ families and organ procurement organizations about their perceptions of VCA donations.
“Our hope is to really understand what they find beneficial,” Alolod said. “Do they see any difference between this new type of transplant versus what they have done, or the types of organs or tissues that they’ve asked for in the past?”
Using this feedback, the research team will develop training strategies for family support coordinators, who work at organ procurement organizations and assist grieving families with the organ donation process.
“We want to actually develop something that is useful and accepted by the organ request community, and hopefully have something that can be disseminated more broadly,” Gardiner said.
“My perspective is either, regardless of if I’m cremated or in the ground, the organs are going to be wasted if they don’t go to somebody who can use them,” she added.