Five Questions With: Dr. Paul E. Morrissey

Dr. Paul E. Morrissey, who was recently honored by his peers as an outstanding physician at Rhode Island Hospital, is a renowned transplant surgeon. In honor of National Organ Donation Month, Morrissey spoke with PBN about organ donation issues. 



 / WILLIAM MURPHY/LIFESPAN
Dr. Paul E. Morrissey, who was recently honored by his peers as an outstanding physician at Rhode Island Hospital, is a renowned transplant surgeon. In honor of National Organ Donation Month, Morrissey spoke with PBN about organ donation issues. / WILLIAM MURPHY/LIFESPAN

Dr. Paul E. Morrissey, associate professor of surgery at The Warren Alpert Medical School of Brown University, is program director of the division of organ transplantation at Rhode Island Hospital. A resident of Providence, he is the co-recipient of the 2015 Milton Hamolsky Outstanding Physician Award at Rhode Island Hospital for his contributions to developing and ensuring the success of kidney transplant procedures. At the New England Organ Bank, he serves as surgical director, division of organ transplantation, and assistant medical director. His clinical expertise is in organ transplantation, general surgery and dialysis access surgery.

Morrissey, who maintains a private practice at University Surgical Associates, talked with Providence Business News about National Organ Donation Month, which occurs in April, his work as a transplant surgeon and the need for organ donors.

PBN: Can you explain the organ and tissue donation process from the perspective of a donor and a recipient?

MORRISSEY: A deceased person may be eligible to donate tissue – skin, tendons, corneas, bones, heart valves, etc. – and/or solid organs – heart, lungs, liver, kidneys and pancreas – for transplantation. What organs and tissues are usable depends on the donor’s age, general health, organ quality and consent, either from the family or directives from the deceased individual, before death. We consider donors up to age 85.

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Organs for transplantation are recovered from patients who are brain dead (no function in the brain or brain stem; in fact, there is a permanent loss of blood flow to the brain) and from individuals whose mechanical ventilation was stopped at the request of the family. Organs recovered within minutes after death (when breathing and heartbeat have ceased) are usable for transplantation.

Tissues are much more resistant to injury and can be recovered many hours after the heart stops beating and death is declared.

All of these donations require permission from the donor while alive, such as in a donor registry, or from the donor’s family.

PBN: What is the transplant situation in Rhode Island; what organ transplant surgeries can be performed in a Rhode Island hospital and which organs are in most demand here?

MORRISSEY: Both solid organs and tissues are in demand, but solid organs are especially in short supply. As a result, the wait time – while someone is receiving dialysis before getting a kidney transplant ¬– is between four and five years. At Rhode Island Hospital, we transplant some 50 to 60 kidneys every year and also do a few pancreas transplants to correct diabetes. The surgeries are performed in people with kidney failure, including children as young as 1 and those who are elderly.

Rhode Islanders benefit from other solid organ transplants (heart, liver, lung, for example), but they must travel to Massachusetts or Connecticut for those surgeries. Much of their post-surgical aftercare is provided at Rhode Island Hospital.

PBN: Why is there such a shortage of organs for donations and what can be done to increase people’s willingness to be an organ donor?

MORRISSEY: The shortage is the result of two factors: First, the tremendous success of organ transplantation, which leads to rising demand; second, an inadequate supply of organs. Approximately 40 to 50 percent of eligible donors do not donate any organs because their family refuses. It is understandable that, in the setting of unexpected loss of a loved one, the decision to allow organ donation is a difficult one. However, if during his or her lifetime, the potential donor indicated on his or her driver’s license or through a donor registry, the willingness to donate tissues and organs at death, the family is unburdened by the decision. In those instances, we are able to proceed more often with organ recovery and transplantation. So, we encourage people to register as organ donors and make their preference known to their immediate family.

PBN: How meaningful is National Organ Donation Month and what sorts of promotional efforts occur during the month of April?

MORRISSEY: Promotional events range from local efforts in schools, hospitals and churches to national events sponsored by the National Kidney Foundation and similar organizations. These efforts are successful; in 2015, more than 30,000 solid organ transplants from deceased donors were performed in the United States.

PBN: What new developments in technology or antirejection drugs make transplants more viable and successful?

MORRISSEY: Transplant immunosuppression is one of the great scientific and medical achievements of the 20th century. Further refinements make transplantation even safer. Current efforts are focused on restoring organs to suitable function so that “marginal” organs can be repaired and transplanted successfully.

The future for transplantation is bright, but we need continued “grassroots” efforts and the cooperation of so many generous donors to continue our work. Naturally, on behalf of our patients, we are extraordinarily grateful to the donors and their families.

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