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Billy Snyder, a Lifesharing organ procurement specialist, relates brain death to pregnancy.

“Either you’re pregnant or you’re not. Either you’re brain dead or you’re not,” he says. “There’s no wiggle-worming gray area. When someone’s brain dead, they have complete cessation of their entire brain system and all those functions that go along with it: respiratory drive, pupillary response, cornea response, any pain response, any receptor in the body.”

After brain death has been declared, Lifesharing first tries to place all organs locally. Today, over 1600 people in San Diego are waiting for organ transplants. Because the length of time an organ can live outside the body differs, the allocation varies. For example, hearts and lungs tend to stay local because they have only four or five hours of viability. Kidneys, on the other hand, can last as long as 48 hours with the use of a perfusion pump, which stimulates optimal body function for the kidney and increases the success of its transplant. If someone on the list is a perfect match, that kidney will bypass local transplant centers because it has the best chance of functioning in the body of a person with “zero mismatch.” In other cases, if Lifesharing can’t find a suitable match for organs in San Diego, they expand the search to Los Angeles, Northern California, Arizona, Nevada, and so on.

∗ ∗ ∗

Outside the doors of the conference room, past the reception desk, a narrow hallway leads to the Lifesharing staff offices. The walls of this hallway are hung with five “donor quilts,” each bearing 20 squares dedicated to the dead, whose organs and tissue live on in the bodies of strangers like those around the conference room table.

Crystal, We miss you is embroidered in white thread on a red square.

Sarah Elaine Schonhoff is stitched in green above a picture of a smiling, thin-haired baby, along with the dates 1-21-2004 and 2-10-2006.

The right half of the backside of a pair of jeans (including belt loops to just below the pocket) fills the square next to little Sarah’s. Poker chips and pictures of dice, running shoes, and a tool belt create a collage of significant mementos, along with the words “husband” and “father” spelled out in tiny Travel Scrabble letters.

On his 39th birthday, Mario Pinedo signed up to be an organ donor during his driver’s license renewal at Chula Vista DMV. Eight months later a massive brain aneurism killed him.

Mario Gerardo Pinedo does not yet have a quilt square. The 39-year-old owner of a National City auto-detailing shop died of a massive brain aneurism in 2006, and his sister, Letty, who sits next to Rita at the Lifesharing volunteer meeting, says the square is something she and her four sisters have been meaning to get around to. During a recent conversation, they did come to a couple of decisions. They want a Chargers background, and something about the Padres, for sure — maybe a picture — and also, perhaps, a couple of lines about Pinedo.

In July 2005, a few days before his 39th birthday, Mario went to the Chula Vista DMV to renew his driver’s license.

“They asked him if he wanted to be an organ donor, and he said yes,” Letty said on the evening we sat together with Rita, Michael, and two of Mario’s other sisters in the Pinedo siblings’ childhood home. “He comes home all excited because he was going to be a donor. My parents were telling him, ‘Are you crazy? You’re 38 years old. What are you thinking?’ And he was, like, ‘When I die, what are they going to do with it? Everything’s going to turn into a worm. I’m going to be eaten up. No. I’m going to give it to somebody. You never know, Mami. You never know whose life you can save.’”

Seven months later while at a Friday-night barbecue, Mario suffered a massive brain aneurism and was admitted to Scripps Chula Vista Hospital around 10:00 p.m. Two days later, he died.

“We all ran to the hospital, though my parents weren’t here. They were in Mexico,” Letty says. “Pretty much right away, [the doctors] told us he was brain dead. At that point, it wasn’t even what are we going to do, it was how are we going to tell our mom, and who’s going to make that call?”

Within hours of Mario Pinedo’s death, Belen Bell (above) obtained the consent of his family to donate his liver to a critically ill Michael McCrerey.

It was at this point that Belen Bell, family-services specialist at Lifesharing, introduced herself to the Pinedo family. The now 57-year-old Bell, fond of brightly colored sweater sets, establishes and maintains eye contact when she explains her job to me one afternoon in another, smaller conference room. It’s been a week since the volunteer meeting.

Although Bell has several responsibilities, one of them is to obtain consent from family members for the procurement of organs. She had been at the hospital following Mario’s case but did not approach the family right away.

“We follow from a distance,” she says. “We check their labs, and we check their neurostats, to see if they’ve worsened or gotten better. We don’t go near the families until the right moment. Never do we want a family to feel that we’re hovering.”

Once a family has been informed by physicians that their loved one is brain dead, they need time to grieve, Bell says.

“What we normally listen for is ‘What is our next step? Should we be looking for a funeral home? What should we do now?’” she explains.

In the case of Mario Pinedo, this happened around 5:30 on Saturday morning, when his sisters began to discuss how they were going to tell their parents that Mario was gone. The first thing Bell did after introducing herself to Mario’s family was to ask after his mother. When his sisters informed her that their mother was in Mexico and didn’t yet know what had happened, Bell told them to call her and tell her that he was ill, not that he was dead, so she wouldn’t go into shock before the long trip home. Bell then helped the sisters decide who would drive to Tijuana to pick their parents up from the airport and drive them back into San Diego.

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Comments

monaghan Sept. 7, 2011 @ 3:57 p.m.

Liver transplants for alcoholic 62-year-old men like Michael McCrerey are one of the reasons American medical care is astronomically more expensive than in any other developed country. No one mentions if McCrerey has quit drinking. Furthermore the litigiousness of American society makes it all possible -- as in the "denial of medical care" statute that Rita threatened to use against Kaiser Hospital.

Hey, whatever works.

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liveradvocate Sept. 10, 2011 @ 4:12 p.m.

FYI - too bad they left out the part where Michael quit drinking over 8 years ago and is now active in the local community to help others quit and stay sober. As far as the denial of medical care issue, there is much more to it than what was printed. But in a nutshell, KP was sending him to LA for the transplant, where because there are so many patients waiting he would never have received one and everyone knew it. However, here in his hometown, he stood a decent chance of getting one - but no guarantees of course. So why would a medical provider insist on sending a patient far from home with a definate bad outcome? It was easier for them to say such things as "that's where we send our transplant patients" and "all we have to do is send you where they do them and our obligation is met" - we are happy to report that after our case, KP designated Scripps Green as a Center of Excellence and sends their patients where they stand the best chance of receiving a transplant. BTW - we have received excellent medical care thru KP and have been members there for over 40 years.Thanks for your comments and hope my reply clears a little up for you.

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calgal Sept. 10, 2011 @ 3:36 p.m.

What a great story on a subject we don't really hear much about. I was glad to read some of what goes on behind the scenes and about both the families. I'm sure there is much more to this story than what was printed, each family could probably write a book. Thanks for an interesting read - I'll keep the pink donor dot on my drivers license just in case!

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kgbarnett Sept. 11, 2011 @ 4:27 p.m.

Thank you for sharing your story. My friend, Barbara just had her first fluid removal...10.3 liters removed. She has no family and can not work. Can anyone recommend what kind of assistance is available. She lives in San Diego County. She is 57 years old and has applied for SSI but this will take many months. She, too, needs a liver transplant.

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liveradvocate Sept. 11, 2011 @ 11:11 p.m.

Scripps Green Hospital/La Jolla has a wonderful support group meeting for Liver & Kidney patients on the 1st Wednesday of every month, free service, open to all and no sign in. From 6pm -7pm always a very informative speaker which changes monthly - 7pm to 8pm sessions for kidney patients, Hep C patients, liver pre & post transplant &/or caregivers. Please pass the word in case your friend does not know about it.

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Liz79 Sept. 11, 2011 @ 6:36 p.m.

What an amazing story! Thanks for bringing this important subject to the attention of your readers. Please bring more interesting stories like this to your magazine.

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Obo Sept. 12, 2011 @ 8:08 a.m.

Yes, it was an amazing process! That's my sister all right. She doesn't back down from anything once she sets her sights! Perseverance and conviction and look out! Had it not been for her, Mike would probably not be here anymore. And we are glad he is! Just a real good lesson in not giving in and rolling over. Everyone on this branch of the family tree are now donors thanks to Rita!

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alyman Sept. 12, 2011 @ 9:28 a.m.

Thank you for this wonderfully informative and touching article. It's amazing how little we hear about organ donation and the lives it saves in the media. Great article, I'd love to learn more!

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CertainTrumpet Sept. 12, 2011 @ 10:27 a.m.

To readers for whom this is the first exposure to lifesaving organ transplants this may be a difficult subject to wrap your head around.Most of us are not familiar with this area of medicine unless a friend or loved one has faced the choice of death or a transplant. The vast majority of conditions which make a transplant necessary are either genetically acquired, metabolic disorders, trauma, injury or nutrition deficiencies. Some are of unknown origin. The 4 principal transplant centers in San Diego, UCSD, Sharp, Scripps Green and Rady Childrens saved the lives of 339 people in 2010. These included kidney, liver, heart, lung and pancreas transplants. 12 children are among those saved. The lives saved and improved by the efforts of Lifesharing staff far exceed these 339 people because some recipients are outside the San Diego area, and other factors. Big Thanks to Elizabeth Salaam and the Reader for increasing awareness of the "Gift of Life" through transplantation.
I have a question for readers: If, at no cost or risk to you, you could save the life of another person(s)or give sight to a blind person, would you do so? If, through accident, injury or unexpected illness, you needed a lifesaving transplant, would you want another person to have made such a lifesaving donation? Thank you to all the people who are a part of this article and to the exceptional medical professionals who make transplants a reality. "Life is Good, Lifesharing Made it Happen"

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cvgal Sept. 12, 2011 @ 11:43 a.m.

What an amazing group! I'm totally inspired and will share with many I know. Sometimes, life takes unexpected turns and what a gift to know people I love could help or be helped.

Rita, you rock!! Your hubby is sooo lucky to have you!

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