Medical choices in the 90s: transplantation and donation.

Heart transplantation is a growing field that offers the promise of meaningful life extension to individuals in end-stage organ failure. This technology is not only costly but dependent on limited access to cadaveric donor organs. Although advances in transplantation biology may someday allow for reduced cost and easy access to organs from nonhuman sources, today the "most readily available" source remains those organs which are donated by human donors. But despite the fact of being the "most readily available" they are far from being readily accessible. Due to these advances in transplantation, physicians are able to offer the "choice" of transplantation to their patients in whom end-stage organ failure exists. As more patients are referred for transplantation, the need for donor organs grows. And because of this need, physicians must begin to consider how to offer another choice, the "choice" of organ donation. In order to offer this option, knowledge of patient selection, evaluation, and suitable time of referral is important if the practitioner is to counsel potential donor families. This article provides a background and brief description of the Louisiana donor process.