Opioid epidemic leads to more organ donations
As her daughter Tristan lay braindead, Tammy Hackman frantically searched her oldest child’s belongings for a driver’s license. If doctors could not revive Tristan from the drug overdose that left her unresponsive, Hackman wanted to know if her daughter was an organ donor.
The past decade had not been easy for Tristan, a 2005 high school graduate and swimmer. Now, she would never have the fresh start her mother had hoped would come. But her death could give others that fresh start.
“Something told me you have to do something to make this positive,” said Tammy, thinking back on that May day
nearly three years ago. “Just to know she could help someone out was already making it easier to accept.”
Even though Tristan, who was 28, had a history of heroin use, she was still able to be an organ donor. In fact, she qualified as the fastest-growing type of organ donor: a healthy young person who’s considered “increased risk” because of drug use. Many in the transplant community are referring to the use of such organs as a “lifesaving legacy,” or a silver lining in the cloud of deaths.
In the past five to six years, the number of these donors has increased markedly. An article last week in the Annals of Internal Medicine studied statistics from nearly 300 medical centers across the country and found that transplants from donors who died by overdose have increased 24 times over since 2000.
Overall, organ donation has risen in the past five or six years. About 60% of the increase stems from increased awareness and improvements in the organ donation system, said David Klassen, chief medical officer of UNOS, the private non-profit that oversees the country’s transplant system.
About 40% of the increase stems from fatal opioid overdoses, which in the past decade have become the leading cause of death for those under 50, outstripping car crashes.
‘She was my daughter again’
Tammy Hackman doesn’t know when or why her oldest daughter turned to drugs. After high school, Tristan headed to the University of Evansville, where Tammy suspects friends introduced her to drugs. When she returned to Indianapolis, she reconnected with high school friends who also liked to party.
She found work in the restaurant business, tending bar or waitressing. In 2008, she gave birth to a son, Bryce.
As time went on, Tammy noticed a change in Tristan’s behavior. She could not sustain a conversation without drifting off.
“We realized there was something different going on. When she came around, she would be in just like another world,” Tammy said. “She would doze off and come back in.”
Tristan shrugged off her family’s concerns, saying she was tired, though she admitted taking some pills that might be contributing to her lethargy.
After Tammy noticed scratch marks on her daughter’s hands, Tristan brushed off her concern and told her she had injured herself while climbing a fence. As Tristan’s behavior grew more erratic, her parents started caring for Bryce in their own home.
Often, Tristan would disappear for weeks or months. Her parents did not know where she was living or what she was doing.
By 2012, whenever Tammy visited her grandson, Tristan would spend long stretches of time in the bathroom. She again would drift in and out of conversations. Finally one day, her parents confronted her. She confessed she was hooked on heroin.
With her parents’ help, she entered inpatient treatment for addiction. After a week and a half she came home, saying she was clean. She moved in with her parents and son.
“She was my daughter again for that time,” Tammy said.
For the next year, Tristan stayed clean. She went to Narcotics Anonymous. She returned to work. Tammy can’t explain what happened to her daughter next. She started using again. Her family kicked her out after she started stealing from them to support her habit.
In 2014 she was arrested for possession of drugs and theft and jailed for six months. Tammy said she felt a wave of relief, knowing Tristan no longer had access to drugs.
After she was released, with her family’s help, Tristan found an apartment she shared with a friend. Every two weeks Tristan had to have a drug test, and she was on house arrest. For the first time in a while, Tammy gave her alone time with Bryce.
The old Tristan seemed to be coming back. She celebrated her 28th birthday, and a few days later, Tammy took her to the courthouse for her drug test. She was clean.
On May 26, Tammy went to Tristan’s apartment. The two spent a few hours talking about plans for the summer.
An hour and a half after she left, the call came. Tristan’s roommate had come home and found her unresponsive. She was on her way to the hospital after paramedics had tried to revive her.
Doctors told Tammy they would do their best to save Tristan. With Tristan on life support, they cooled her body for 48 hours in the hope that would awaken her brain cells.
As friends and family prayed for a miracle, Tammy also started to think about donating Tristan’s organs.
After four days, Tristan’s doctors ap- proached her family and said there was one more test to run. They unplugged the machines to see if her brain would start working. There was no response.
“At that point we knew we had to let her go,” Tammy said.
Tristan died on May 31, 2015.
‘A bittersweet thought’
Two days later, as Jerry Gilliland sat at his desk in Kokomo, his phone rang. Tethered to oxygen, the Chrysler employee had suffered from a disease called idiopathic pulmonary fibrosis for the past seven years. His lungs had grown increasingly scarred.
Gilliland could not walk more than 20 feet without getting out of breath. After he had a bout of pneumonia, his pulmonologist recommended he think about a lung transplant.
Staff at Indiana University Health and the Cleveland Clinic asked if Gilliland would be willing to accept lungs from an increased-risk donor.
“I didn’t have any qualms at all,” he said. “In my opinion, if the doctors are comfortable saying they’re good, I’m comfortable with accepting them.”
Close to midnight on June 2, 2015, the eight-hour procedure to transplant Tristan’s lungs into Gilliland’s body began.
Recovery was slow. Gilliland, 62, spent more than two weeks in the hospital and months rehabilitating.
“The sad part of that whole thing, you’re depending on someone else’s tragedy to be able to live,” he said. “That was a bittersweet thought.
“I was very interested in finding out about the donor and the family and being able to personally thank them for saving my life.”
Three other people are alive today as a result of Tristan’s death. One has her heart, another has one of her kidneys, and the third the other kidney and her liver. Tammy has reached out to them all but has connected with only Gilliland. She understands why a recipient might not want to respond — the awkwardness, finding just the right words to say.
Whatever doubts Tammy might have had about donating Tristan’s organs were washed away a few months after her daughter’s death. As she was going through Tristan’s personal papers, she found the missing driver’s license.
“Sure enough, right there was that big red heart.”