Star Tribune
Minnesota transplant centers seek to reduce delays, deaths through donor units
Minnesota’s organ donor agency is hoping to increase transplant surgeries and save more lives by having organs procured at the state’s two largest transplant centers.
LifeSource on Monday announced a reorganization under which deceased donors would be transferred to the University of Minnesota Medical Center in Minneapolis and Mayo Clinic in Rochester.
Transfers to special donor care units at these sites could reduce delays and missed opportunities that occur when organs are procured at community hospitals where donors die, said Kelly White, chief executive of LifeSource. The organization manages organ procurement in Minnesota, the Dakotas and western Wisconsin.
“The gift of organ donation is so scarce here,” she said. “Every opportunity counts for us.”
Minnesota set records in 2022 when centers conducted 1,078 transplants and 179 people donated organs upon their deaths. The number of people who died awaiting transplants in Minnesota also declined from 206 in 2014 to 111 last year, but White said a streamlined procurement process could drive that number lower.
Transplant recipients are matched under a federal system to organs based on whether they have the same blood type and physiology as donors, whether they are at greater need than others on the waiting list and whether they are close enough to receive the organs in time.
What happens next is a scramble. Specialists rush from transplant centers to hospitals to procure kidneys, hearts, lungs and other organs that have been matched to their patients. The travel alone can cause delays, especially if the hospitals are remote or the transplant recipients are in other states.
Community hospitals aren’t as equipped to deal with problems that can leave organs unusable, such as fluid buildup in the lungs when patients die, said Dr. Andrew Adams, executive medical director of solid organ transplantation for M Health Fairview.
“With the advent of donor care units … we can recondition the lungs to bring them back to an optimal status and now those lungs can be used for transplant,” he said.
Donor care units were first tried in St. Louis two decades ago, and research found that they lower costs and increase the number of organs procured per donor. A federal report last year recommended that all 57 U.S. procurement organizations open these units.
About half of deceased donors will be transferred at first to the new units, according to LifeSource’s estimates. Abbott Northwestern Hospital and Hennepin County Medical Center have active transplant programs in Minneapolis and can procure organs on their own.
Grieving relatives also can refuse the transfers, although Adams said many find comfort and closure in having deceased loved ones moved elsewhere. Logistical delays in procurement at community hospitals can prolong the time that brain-dead patients stay on life support, extending relatives’ grief or prompting them to refuse donation.
“Organ donation, from the time they get declared brain dead to the time when organ procurement occurs, sometimes that can be two, three, four days,” Adams said. “That puts the donor family almost in a limbo, like a holding pattern, where they are unable to move forward with the grieving process.”
Mayo already had been transferring in deceased donors this year at LifeSource’s request to help hospitals that had no open surgery suites or lacked experience in organ procurement. The U hospital will phase-in the donor care role before opening a dedicated unit on its West Bank campus next April.
Another benefit of the donor care units is that they will free up surgical and bed space in Minnesota hospitals that have struggled with overcrowding, said Dr. Julie Heimbach, director of Mayo’s transplant center.
“That has come to a head, especially with the pressures that have been placed on hospitals through COVID,” she said.
The units can procure organs and send them to transplant centers or the centers can still send their specialists to do that work, she added.
Researchers have looked for other ways to increase or hasten transplants. Allina Health and LifeSource have tested drone flights to reduce organ transport time. U of M researchers last month reported success in freezing and thawing organs in rats, which could one day dramatically increase the shelf life of human organs for transplant.
Heimbach said it would help for now if more people signed up as donors.
About 70% of Minnesota adults have committed to be organ donors through their drivers licenses or other documents, compared to about 60% nationally, according to LifeSource.
Less than 1% of deaths present opportunities for donation, though. Most donations involve brain death, which occurs when cardiac events or traumatic injuries leave patients with no brain function or ability to breathe independently. Even in that rare form of death, donors can be rejected if they have cancer or their organs have been damaged.
After months of maintenance problems and safety concerns in downtown St. Paul’s Lowry Apartments, city officials condemned the building, forcing dozens of tenants to abruptly relocate to hotels this week.
On Monday afternoon, city staff responded to a plumbing leak in the 11-story building at 345 Wabasha St. N. Officials reported significant damage and signs of vandalism, including copper wire theft that left electrical systems exposed. The leak also raised concerns about mold.
To make repairs, the building’s water must be shut off — a move that would leave tenants without boiler heat and fire sprinklers, Deputy Mayor Jaime Tincher said in a Tuesday email to state Rep. Maria Isa Pérez-Vega and City Council Member Rebecca Noecker, who represent the area.
After determining heat and water could not be restored quickly, Tincher wrote: “There was no other option than to conclude the building was not safe for residents to stay.”
Property manager Halverson and Blaiser Group (HBG) agreed to provide alternative housing for tenants for up to 30 days, Tincher said. City staff worked with Ramsey County’s Housing Stability team and Metro Transit to help 71 residents pack and move.
Before then, the building belonged to downtown St. Paul’s largest property owner, Madison Equities. After the January death of the company’s founder and longtime principal, Jim Crockarell, the dire state of the group’s real estate portfolio became apparent.
The Lowry Apartments, the sole property with a high concentration of low-income housing, quickly became the most troubled. Residents reported frequent break-ins, pest infestations, inoperable elevators and more, to no avail.
Star Tribune
Metro Transit allocated $12 million to boost security, cleanliness on Twin Cities light rail and buses
They will be soon. With more money to spend, Metro Transit plans to bring on 40 more this year. With their ranks growing, TRIP agents, clad in blue, have recently started covering the Metro C and D rapid transit lines between Brooklyn Center and downtown Minneapolis.
The big investment in public safety initiatives comes as Metro Transit is seeing an uptick in ridership that plunged dramatically during the COVID-19 pandemic and has been slow to recover. This year ridership has been a bright spot, the agency said.
Through October, the agency has provided 40.1 million rides, up 7% compared with the first 10 months of 2023. In September, the agency saw its highest monthly ridership in four years, averaging nearly 157,000 rides on weekdays, agency data shows.
At the same time, crime is down 8.4% during the first three quarters of 2024 compared to the same time period last year, according to Metro Transit Interim Police Chief Joe Dotseth. However, problems still persist.
On Nov. 29, Sharif Darryl Walker-El, Jr., 33, was fatally shot on a Green Line train in St. Paul. Just a week earlier, a woman was shot in the leg while on the train and taken to the hospital with non-life threatening injuries. Earlier this year, a robbery attempt on the Green Line in St. Paul left a passenger shot and wounded.
“Our officers are spending time on the system and sending a clear message to everyone: Crime will not be tolerated on transit,” Dotseth said. “And we will work to ensure those commit those crimes are held accountable.”
The ACLU of Minnesota has sued Otter Tail County, its sheriff and correctional officers at its jail, alleging unlawful punishment of a man known to them who has serious mental health issues.
Ramsey Kettle, 33, a member of White Earth Nation and lifelong Otter Tail County resident, was jailed in February on charges that were dropped two months later. The ACLU says that the sheriff’s office attempted to cover up the mistreatment, but a whistleblower working at the jail reported the abuse to the state. A 46-page lawsuit was filed this week in U.S. District Court of Minnesota.
“Mr. Kettle was subjected to extreme, punitive treatment in violation of his constitutional rights and standards for basic human dignity,” the ACLU said in a statement. “Otter Tail County officers, with approval of the acting jail administrator, kept Mr. Kettle locked up in solitary confinement for days without food, water, or appropriate medical and mental health care.”
Otter Tail County spokesperson Shannon Terry said in an email to the Minnesota Star Tribune that “Due to the impending litigation, Otter Tail County has no comment or statement at this time.” Terry did confirm that Kettle was released from custody April 24, when the charges were dropped.
Kettle was immediately placed in solitary confinement after he arrived at the jail Feb. 9, the lawsuit says. Jail staff didn’t assess Kettle’s poor mental health, which the ACLU says was well-documented and known to officers. The ACLU says Kettle “exhibited increasing signs of physical and mental distress” and officers allegedly “laughed at him, mocked him, and left him to suffer.”
Kettle had been booked at the jail multiple times before. In March 2022, he was convicted of making terroristic threats and sentenced to two years. On the day he was scheduled to be released from Rush City Correctional Facility after serving his full sentence, he was charged in Otter Tail with four counts of aggravated witness tampering stemming from the conviction.
“Rather than going home on February 9, 2024, as he had anticipated for nearly two years, he was transferred to Otter Tail County Jail to await trial on these new charges. The new charges were unfounded and intended solely to keep Mr. Kettle incarcerated,” the lawsuit states.
District Judge Johnathan Judd dismissed the charges as lacking foundation.
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