The dead’s eyes, tissues and assorted parts are bringing new life to local patients

Medical Examiner Dr. Veena Singh used to be disappointed that her recently deceased patients would leave her office intact – especially when those patients and their families wished to help others by donating their organs, tissues and ligaments.

While that may sound macabre, Singh said it’s important to her that her office is making positive impacts in the region. That’s why she’s worked with the Spokane County Commissioners to ensure viable body parts are being put to good use in the region.

“It’s a way for the family to make something good come out of what’s usually not a great situation,” Singh said. “And then on the other side of it, the tissue itself can be life-enhancing or life-saving.”

Tucked away down a long hallway in the Spokane County Medical Examiner’s office in the East Central neighborhood is a compact, brightly lit room dedicated to harvesting skin, corneas, ligaments and assorted tissues for use in skin grafts, transplants, ACL repairs and more.

The office’s current location opened in 2020, and the room was part of the design of the site from the very beginning, Singh said. The intent was to provide a way to significantly increase the number of tissue donations in the region for use in medical and research settings.

But the room went unused for years, meaning those valuable tissues and bones left the office the same way they arrived: in the bodies of the deceased.

After spending the last year or so fine-tuning the procurement process with three tissue and eye banks, the Board of County Commissioners earlier this month named LifeNet Health the county’s exclusive partner for the “recovery of anatomical gifts,” the contract states.

The agreement allows the nonprofit tissue bank sole access to the bodies brought to Singh’s office for autopsies, the tissues they contain and the facilities they need to access, including the procurement room, the walk-in cooler where the bodies are stored and a nearby restroom.

Singh said partnering with one tissue bank will help streamline the process and ensure more viable body parts wind up in other bodies across the region.

The eye and tissue banks Lion’s World Vision Institute, LifeCenter Northwest and LifeNet Health would alternate under the previous agreement, and miscommunications would sometimes lead to failures in procuring viable parts from potential donors in the short window the work can be done.

Will Miller, northwest regional manager for LifeNet Health, said harvesting must occur within 24 hours of death. Any longer and the specimens may be unusable in medical settings, which Miller said is the primary use in the Northwest.

The organization does have a research arm centered on the East Coast, but Miller said that’s seldom the focus of the work he does in the Northwest.

Miller said his organization and others like it rely mostly on community partners to identify potential donors. Hospitals are required to notify a donation agency within an hour of someone’s death, but the vast majority of deaths don’t occur in a medical setting. Coroners, law enforcement, funeral homes and medical examiner’s offices like Singh’s notify donation agencies of deaths outside the halls of a medical facility.

“People just assume that all deaths happen in a hospital, which they don’t,” Miller said. “So working with these partners is very critical to our operations and helping families in need that want to donate.”

LifeNet partners with Lion’s World Vision Institute, which operates a call center covering much of Idaho, Washington and Montana, to begin the outreach to next of kin after being notified of a death. Miller said they have a better than 60% success rate in the region, which is higher than the national average.

“They want to help,” Miller said. “The Northwest is very good with that. We used to say, ‘People like to recycle, and what better way than through tissue donation?’ ”

Singh said she prefers to have the procurement take place once she and her staff complete an autopsy, but it can occur beforehand under certain circumstances. If a person dies on a Friday, for example, and the autopsy will not occur till Monday, Singh will give the go-ahead while the window for procurement is still open.

She places restrictions if there are areas she will need to examine as part of the autopsy, Singh said.

“That’s the nice thing about having the procurement occur here, is that we have control of what happens to the decedents in our care,” Singh said. “So at least they can’t just swoop in and take tissue without the people who are here in our facility.”

Each extraction can vary depending on the parts needed by the bank and the strict criteria LifeNet uses to determine who may be a viable donor, which includes a physical, an individual’s health history and social and family history.

With skin donations, for example, Singh said it can depend on the condition, whether there are existing injuries and the wishes of the family. The size of the areas harvested also can vary widely.

“It can be quite a lot,” Singh said. “Mostly they’ll take it from the back, and sometimes from the legs, but rarely from the arms.”

After a team of LifeNet specialists finish operating on the dead, the specimens they obtain are used to heal the living in a variety of ways.

Vascular tissues are surgically inserted to restore or replace faulty vessels, corneas are transplanted in place of cataracts, slivers of bones can help fill broken segments, heart valves are used in reconstructive cardiac surgery and connective tissues can give new life to a patient’s knees or hips.

“There are a lot of uses for it that can either, like I say, enhance people’s lives or restore mobility or function to them that I think is really important,” Singh said. “And it’s a nice thing to be able to be a part of.”

Miller said those in the tissue bank industry are constantly working to educate the public on the importance of tissue and eye donations, and how it can differ from donating one’s organs.

Organ donation, likely the more well-known aspect of donorship, requires a beating heart cycling blood through the body and therefore occurs mostly in hospital settings, Singh said. Tissue donation can occur after a person’s heart has stopped and can play a crucial role in medical interventions involving burns, reconstructive surgery and corneal transplants.

While an individual can register themselves as an organ donor, giving the go-ahead for tissue donation can be a bit murkier. Miller said those interested in donating tissues and assorted parts after their death should talk to their families beforehand to make their plans clear.

Registering to be an organ, eye and tissue donor can help, but LifeNet only moves forward with retrieval after express permission from next of kin, he said. A family can dictate what exactly the procurement process will look like, including which organ or tissues they wish to donate, reflecting personal, cultural or religious considerations.

“It’s important to communicate your wishes and for families to honor people’s wishes if they truly want to become an organ, tissue, eye donor,” Miller said.

The tissue bank stays in touch with donor families well after the harvesting and subsequent transplanting, and provides resources to process the grief of losing a family member. They also hold regular celebrations of life where families can mingle and share the memories of their loved ones.

Miller said it’s all part of the organization’s efforts to recognize the important contributions those families and the donor made to their communities.

“We are there, as a donation agency, for families,” Miller said. “We have families that are with us for five, 10-plus years, and they just like knowing that there’s a support network out there.”

Miller said time and time again, families point to that support, and the positive impact the donations have, as the reason behind their decision to participate. Singh said she hears the same thing.

“It’s really in the same sense as giving back to the community, helping those in need,” Miller said. “I think that’s the biggest thing. We always call the donors and the family’s heroes. If they see the need in the community, they want to help.”

Z’hanie Weaver, a member of The Spokesman-Review’s Teen Journalism Institute, contributed to this report.