Monday, April 18, 2005

ohn Klopfer Jr. of Marbury, Md., rarely was sick, so it was a surprise when the 6-foot-2, 240-pound ironworker collapsed and died on the job one morning last August. The 49-year-old was felled by a brain aneurysm — a headache his only warning.

His grieving wife, Patty, then had to decide whether his organs and tissues could be used for strangers in need. They were healthy organs and tissues, untouched by disease, which made them especially valuable. But until she was approached by Elizabeth Spencer, a clinical recovery coordinator for the Washington Regional Transplant Consortium at Inova Fairfax Hospital where Mr. Klopfer had been declared brain dead, Mrs. Klopfer had not known about her husband’s wish to be a donor. She found out when she saw that he had a heart symbol on his Maryland driver’s license.

“We never talked about it,” she says. “I checked mine. I didn’t know I was, too.”

Nor did she know that the symbol on the small, plasticized card does not automatically make a person a donor. Next-of-kin in Maryland must authorize the act. (But in Maryland as most other states, if no relative is available or can be found, the donation process is decided by the individual’s stated intention on a license or organ donation card.)

And time is of the essence in this delicate matter of obtaining permission from grieving relatives so that transplant procedures can proceed. Most organ operations take place within 24 hours after brain death and family consent.

Mrs. Klopfer, a lively, expressive woman of 49, was still reeling from the trauma of the day when the family was approached by Ms. Spencer informing her of the possibilities and what it would mean to have her husband offer what WRTC calls “the gift of life.”

The consortium, which is based in Falls Church, is the authorized organ and tissue procurement organization in the Greater Washington area. There are no costs for the donor’s family; recipients’ insurance pays for the procedures, according to Cindy Speas, WRTC director of community affairs.

Furthermore, Mrs. Klopfer was told that by law, doctors handling emergency or critical care cases have nothing to do with transplant programs, and an organ procurement organization is not alerted by hospital staff until all lifesaving efforts have failed and brain death has occurred.

The situation was doubly traumatic for Mrs. Klopfer since her husband’s death was so unexpected. Mr. Klopfer had mentioned having a headache when he left for work that morning and called asking his wife for her opinion on whether he might take two more Tylenol to ease the pain.

His job was welding 100-foot columns for the overpass at the Mixing Bowl in Springfield, one of the many large building projects he has been part of in the Washington area. The couple were just shy of their 30th wedding anniversary.

Mr. Klopfer was hit by a seizure, she learned when she got to the hospital. It took a while for the sensitively stated consortium appeal to sink in. “That was the last thing I wanted to think about,” she says. “We were all numb, you know, but it was the fitting thing to do.” She was persuaded to give consent by talking it over with sons Johnny, 28, who works for the D.C. Department of Transportation, and Joey, 26, a Navy lieutenant. “He had helped other people so this was the best thing to do.”

Mr. Klopfer, a devoted baseball fan and local team leader, had been working 100 yards from where the Pentagon was hit on September 11, 2001, and, according to Mrs. Klopfer, had taken a frantic, shoeless Charles County woman — a total stranger — home from the site in his pickup.

Shortly after that, in an unrelated incident, he rescued another stranger, an elderly woman driver, from an upturned car in a local swamp and refused an award.

Mrs. Klopfer’s brother was at the hospital and also instrumental in her decision. “I was opposed to — I don’t know if this is the right way to say it — picking through his body,” she recalls. She finally allowed removal of organs but not tissues or corneas.

“I was in the ICU room this one time when [hospital staff] were checking him. I should not have gotten up but they lifted up one eyelid and I thought ‘I can’t give them up.’ Someone else could have used them, but when I saw those brown eyes I said I can’t [do it.] I was disappointed that his lungs and heart were damaged. I would have loved to see someone get his heart.”

She insisted on staying overnight while tests were done and surgeons operated, taking four hours to remove kidneys, liver and pancreas.

David DeStefano, consortium director of recovery services who was in the operating room, came out afterwards, telling her “with tears in his eyes,” she says, that “[my husband] had the greatest organs — he had the biggest liver.”

She laughs at the memory: “Johnny liked his beer and took Advil for his arthritis and always worried what Advil would do to his liver, not the beer.”

The WRTC sponsors an annual Donor Family Gathering, the 14th of which took place April 10 at the National Presbyterian Church. Donors’ family members and recipients who attend are recognized publicly and invited to take part in a ceremony that includes an exhibit of quilts made by the donor families in honor of their loved ones.

Mrs. Klopfer already is thinking of how she wants her portion of next year’s quilt to look. She plans to use part of her husband’s jeans and a piece of a cotton pullover she had given him for Christmas that is decorated on the front with the American flag.

According to the WRTC Web site (, as of March 10, 1,690 patients in the Washington area awaited a kidney transplant, 365 a liver, and 89 a kidney and pancreas. More than 60,000 people in the United States, including the Washington area, needed a kidney, 17,256 a liver, and 2,434 a kidney and pancreas. The Washington area last year had 120 donors, up from 86 in 2003, and the authorization rate had risen to 59 percent from 53 percent, Ms. Speas says.

“Every person can be a donor, and I mean that sincerely — either for transplant or research,” she says.

Virginia is the only state in the area with an online donor registry at www.SAVE7 (at least seven patients can be helped locally or nationally by a single donor, according to WRTC), but most people do so initially by checking a line on their driver registration application.

In time, Mrs. Klopfer hopes to meet the recipients whose lives might have been saved by the donation of her husband’s organs: “It’s going to be hard but I want to do it, and I know Johnny and Joey want to do it, too. I know it is somebody [one or more persons] from the Washington area. I know these people are doing real well: one person with his liver and another with his kidneys had been on dialysis. I want to give them a big hug.”

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