When the nonprofit LifeLink Foundation educates people about organ donations, Public Affairs Coordinator Tracy Ide has the usual colorful upbeat brochures and bookmarks embellished with Bible verses and inserts for church bulletins.

She has found pastors and churches to be very influential in explaining that, for a person of faith, donation can be a legacy of love.

"We even celebrate National Donor Sabbath on Nov. 13-15 to raise awareness," Ide says. "No major religion opposes organ donation."

Nationwide, 51 percent of Americans over age 18 who could be potential organ donors are registered in a national database; 61 percent of all Georgians are registered, but only about one-third of eligible Tennesseans are.

Most Americans, including Tennesseans and Georgians, register as organ donors at the Department of Motor Vehicles when they get licenses. Every state offers an online registration form.

"A person must be declared brain dead in order to donate a vital organ," Ide says. "Hospitals are required to notify LifeLink or the nearest organ donation facilitator when a patient is declared brain dead."

A heart is no longer viable for transplant if much longer than four hours elapses from time of death. The donor stays attached a ventilator to keep the heart pumping blood while the organ facilitator checks the national registry to see if the deceased is an organ donor.

"Even if it's tattooed on his forehead that he wants to donate his organs, the family still has to give permission and it has the right to revoke," says Dr. Shelley Hall, director of heart transplantation at Baylor University Medical Center in Dallas. "Once the family gives permission, the facilitator runs through the list of organs they want to donate: corneas, lungs, heart, so on.

"Hospitals with transplant centers are alerted a heart is available, starting with the closest and going out 500 miles. Hospitals have 30 minutes to respond."

Blood tests are run on the donor to ensure that the person does not have HIV or hepatitis or some illness that is not presenting obvious symptoms. Imaging is done of the donor's chest and thorax so doctors can look for masses that may indicate cancer.

Despite all the precautionary testing, a couple of times patients at Baylor have gone into the operating room for a transplant, awoke to find the skin on their chests stitched and joyfully assumed they had new hearts. Hall was forced to tell them the transplant never happened because flaws were discovered in the donor heart after the patient's chest was opened.

Half of all hearts come from people the U.S. Centers for Disease Control calls "high-risk donors," people whose psychosocial history could mean they are not in the best of health. Some hospitals reject hearts from high-risk donors. But Hall says refusal is hard when your patient is weeping in a hospital bed, afraid to die.

Hall's work includes patient consultations and bedside CPR, not just surgery. She has become fond of some patients and finds her own heart broken when they do not find a donor match.

But she sees many of her patients leaving with a better life. Baylor's survival rate for the crucial first year after a transplant is 85 percent; a heart transplant patients can add as much as 13 years to a patient's life.

In the past, many hospitals refused to consider transplant patients older than 60, but the aging baby boomer population is changing attitudes. Hall says Baylor has considered patients over 70 for heart transplants.

She believes there will be technology in about 10 years that keeps a device in the heart charged long enough for a patient "to swim, take a bath or have sex without that battery pack on his waist." And some day, far into the future, perhaps there will be an artificial heart that beats without the battery pack.

"That is the Holy Grail," she says.

Contact Lynda Edwards at ledwards@timesfree or 423 757-6391.