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Buffalo's reputation as a community of generosity gains more luster with a new report showing area residents among the nation's leaders in organ donations.

Western New Yorkers lead the nation this year in the percentage increase in three categories: number of organ donors, number of organs procured and number transplanted.

In doing so, Upstate New York Transplant Services, the agency covering the eight area counties, beat 61 similar agencies across the country.

The number of organs procured from area donors and later transplanted somewhere in the nation, for example, climbed from 38 in the first six months of last year to 99 in the first six months this year -- a 161 percent increase.

And Western New York ranks second in the nation, next to the Philadelphia area, in the number of organ donors per capita so far this year.

An aggressive education effort, closer ties with local hospitals, increasing support from donors' families and new state and federal laws all have contributed to the huge increase.

"These figures are quite a tribute to the entire Western New York community," said Mark J. Simon, chief executive officer of Upstate New York Transplant Services. "We're definitely changing people's reluctance to discuss this sensitive and often difficult subject."

That's the good news.

But the news is mixed about who's receiving the life-saving organs.

Statewide distribution of hearts and livers -- without regard to where they are donated -- continues to drain those organs from upstate to the larger New York City transplant centers with longer waiting lists.

So while many more Western New Yorkers are giving the gift of life, that gift often travels hundreds of miles to its recipient.

Here's where those major organs are going:

No liver transplants are performed in Western New York, so almost all the livers are being transplanted in New York City or Rochester.

Only a handful of locally donated hearts are transplanted here, in Kaleida Health's Buffalo General Hospital. Most go to New York City or out of state.

Kaleida's heart-transplant program has been on its own life-support system. In March, state officials threatened to decertify the program because it had not performed enough surgeries to maintain high standards.

That could change, though, as a result of a three-year agreement still being negotiated that would strengthen the program.

The three-year waiver from current state Health Department regulations would allow more donor hearts to be transplanted locally.

Under the proposed agreement, the state would be divided into four regions: Buffalo, Rochester, Albany and New York City. Hearts procured in any of the three upstate regions would be offered first to critically ill patients in that area, then to other upstate patients before being shipped to New York City.

"The rationale is to allow the upstate programs an opportunity to build an experience that will allow them to get full approval of their programs," explained Dr. Michael F. Noe, Kaleida's vice president for medical affairs. "Unless we have the waiver, it will be difficult for any one of these programs to compete with a larger regional program," such as New York City's.

Pending federal regulations, however, could prevent that agreement from taking effect.

Kidneys remain the major bright spot in the local transplant story.

"At our current rate of transplant procedures, we're anticipating a record number of kidney transplants performed locally," Simon said.

The current record: 66 transplants in 1995. Doctors at Erie County Medical Center and Children's Hospital have performed 54 through August this year. The current pace would result in about 80 such transplants.

About 125 people in Western New York are waiting for a local kidney transplant, while 15 or so are awaiting a heart transplant, officials estimate.

Many other Western New Yorkers are on waiting lists outside the local area, in Pittsburgh, Rochester, New York City and other places.

On the donor side, Upstate New York Transplant Services has compiled some dazzling numbers so far this year.

In the first six months, its number of donors has doubled to 26 from 13, the number of organs procured has jumped 130 percent to 101 from 44 and the number of organs transplanted has risen to 99 from 38.

So far this year, Upstate has compiled an annual rate of 34.7 organ donors per million people, second only to the Philadelphia area's 36.8, and far ahead of Rochester-Syracuse, Albany and New York City, all of which are below 20 per million.

Why the staggering numbers?

Public education, a strong relationship with local hospitals and a reliance on new state and federal laws all have helped.

The state and federal laws, which both took effect last year, require hospitals to notify organ-procurement programs of every death and every patient on life-support facing imminent brain death.

"The agency has formed a very close relationship with all the area hospitals," Simon said. "The nursing staffs and medical staffs have cooperated with the law and worked with us to identify potential organ donors."

Edward J. Kraus, Upstate's director of organ recovery services, and Dr. Sidney Anthone, its medical director, have gone to all the local hospitals, meeting with medical directors and attending medical staff meetings to hammer away at the idea that several local lives could be saved with one referral.

When a local hospital puts an accident victim on life-support, the hospital calls Upstate's communications center, which is staffed around the clock.

A coordinator, after conferring with doctors and nurses, then approaches the family.

That's no easy task, but the coordinators know what's at stake.

"We know we have the opportunity to save four lives out of every organ donation," Simon said.

The coordinators -- nurses trained in Intensive Care Unit operations -- also emphasize that donating a loved one's organs can serve as a consolation to some families.

"It's the one opportunity they have to make something positive out of a tragic situation," Kraus said.

And when organs are donated, Kraus hits the phones, calling all over the nation, if necessary, to try to make sure no procured organs are wasted.

Through last week, 122 of the 129 organs procured by Upstate so far this year have been transplanted, somewhere in the nation.

"We will go to whatever lengths necessary to place an organ anywhere in this country," Kraus said. "If the family is kind enough to consent to donation, we feel it's our obligation to make sure as many organs as possible are transplanted."

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