“That’s my heart,” she said.“It’s still beating for me.”
Although she had just met Mr. Lourenco, she had known his heart for a long time. It had belonged to her husband, Julio, who died from abrain hemorrhagein March 2010, at the age of 38. Mrs. Garcia donated her husband’s organs, and the family’s loss led to a second chance for Mr. Lourenco, 57.
But he was not the only one. Seven or eight other people who urgently needed transplants also received organs from Mr. Garcia, an unusually large number. (The average from organ donors is about three.) Even more unusual, his family and a group of recipients met on Wednesday in a highly emotional gathering at the Manhattan headquarters of theNew York Organ Donor Network, which coordinated the transplants.
The story of the Garcias and the people whose lives were saved by one man’s donated organs provides a close look at the charged world of transplants and organ donation, where people on the transplant list know they may die waiting, and the families of brain-dead patients are asked, at perhaps the most painful time in their lives, to look beyond their own grief and allow a loved one’s organs to be removed to help strangers.
There are nowhere near enough donor organs for all the people who need transplants. Nearly 111,000 are on waiting lists in the United States, but last year, only 28,663 transplants were performed, according to theUnited Network for Organ Sharing, which oversees the transplant system nationwide. This year, 6,000 to 7,000 people are expected to die waiting.
Last week, Mrs. Garcia and her children, 5, 11 and 18, who all live in Stamford, Conn., met four of the recipients of her husband’s organs for the first time. A fifth recipient also attended, one of two people withrenal failure, both members of the Garcias’ church, whom Mrs. Garcia chose to receive kidneys.
Mrs. Garcia addressed a room packed with recipients, families, doctors, nurses, her minister and his family and network employees. She spoke briefly through an interpreter. She said her husband had had a big heart and would be very proud“to give life after death.” No one would ever forget him, she said.
Elaine R. Berg, president of the donor network, said:“These meetings don’t happen that frequently. I’ve been here 11 years, and if it’s once a year that’s a lot. I’ve never met five recipients from one donor. It’s highly unusual.”
In many cases recipients or donor families, or both, choose to remain anonymous, Ms. Berg said. Recipients may send thank-you letters through the network, but they and donors do not often choose to meet.
“It’s pretty intimidating and pretty emotional,” Ms. Berg said.“Some people cannot bear it.”
But she said that meeting the recipients can bring solace to donor families.
Mr. Garcia was so young and strong that his corneas and six organs were healthy enough to transplant: his heart, one lung, his pancreas, both kidneys and his liver, which was divided to save two people, an adult and a child.
In photographs, Julio Garcia was handsome, with a mischievous smile. His wife said he loved to joke and laugh. But he was also deeply religious, and as a pastor at their evangelical church in Stamford he did a lot of preaching and marriage counseling. He earned his living as a carpenter. Both he and his wife, originally from Guatemala, became naturalized citizens.
For many years, he had suffered periodically from severe headaches, but he had been told they were migraines. The headaches were unusually bad during the week or so before March 17, a Wednesday. That day, his head hurting, he told his children he loved them and went to work.
He called his wife that afternoon, saying the pain was terrible and he was going numb all over. She wanted to call an ambulance, but he asked her to pick him up instead. She drove him to a hospital in Stamford. A major hemorrhage andswellingwere putting pressure on his brain. Doctors tried to relieve the pressure, and then transferred Mr. Garcia to NewYork-Presbyterian/Weill Cornell hospital in Manhattan.
By the time he arrived there on Wednesday night, he was in a deepcoma, needed a ventilator to breathe and had extremely lowblood pressure— all signs of a large hemorrhage affecting the brain stem, according to Dr. Axel Rosengart, the director of neurocritical care. Doctors stabilized him and tried again to reduce the pressure on his brain, but scans showed extensive, irreversible damage, Dr. Rosengart said.
Dr. Rosengart said he was not certain but suspected that the bleeding was caused by an arteriovenous malformation, a blood vessel abnormality that Mr. Garcia may have had from birth.
By Thursday, Dr. Rosengart said, he began to warn the family that Mr. Garcia was heading toward brain death. Later that day, the diagnosis was made twice, by two different physicians, in accord with state law. A patient with brain death is legally dead. At that point, there were two priorities, Dr. Rosengart said:“the family and their emotional survival, and preserving the organs.”
Brain-dead patients can become medically unstable, and intensive treatment is often needed to prevent their organs from failing.
Dr. Rosengart and a social worker from the New York Organ Donor Network asked Mrs. Garcia about organ donation.
At first, Mrs. Garcia recalled, she could not accept the diagnosis of brain death. Still hoping a miracle would save her husband, she asked them to wait.
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