Performing transplants: television and movie portrayals of organ harvesting are discouraging donors.

WHEN Hollywood dramatizes a medical problem, it is usually accurate and sympathetic in its treatment of the subject. Doctors and nurses are portrayed as honest and ethical in caring for their patients.

But it's a different story when it comes to the donation and transplanting of human organs. Those who are involved in the procurement of organs are almost always shown in a bad light.

This is deeply troubling to me as chief executive of OneLegacy, the organ recovery organization in Los Angeles that serves seven counties in Southern California. My organization works hard at educating the public about the benefits and safeguards involved in organ donation. This paid off last year for OneLegacy, enabling us to arrange for a record 1,300 people to receive life-saving organs.

But that number fell far short of the need; in Southern California nearly 10,000 people were, and are, on waiting lists for vital organs. So every dramatized falsehood about donation and transplantation hinders our efforts.

Some might say that my involvement in this field has made me overly sensitive to anything negative about it in movies or on TV. Now, though, independent research proves that I'm not exaggerating the problem.

According to a report just issued by Purdue University, organ donation was portrayed in more than 80 TV episodes in 2004 and 2005, but in none of those instances was it presented in an accurate or positive light. Even more disturbing was the Purdue researchers' finding that these inaccuracies stopped people from registering as organ donors.

Here's a recent example of what I'm talking about. In the new ABC TV series "Heart land," the procurement coordinator--the person who obtains permission from next-of-kin to have an organ donated--appears to work for the transplant center. The logical inference to be drawn from this depiction is that the transplant center has something to gain as a result of the coordinator's efforts.

That's totally inaccurate and misleading. Procurement transplant coordinators--PTCs for short--are all employees of the local organ recovery organization. They are sent to hospitals to monitor the condition of terminally ill patients and, when a patient dies, to seek permission from the next of kin to donate the patient's organs. The hospital has nothing to gain from donation of organs.

Lack of awareness

I hasten to add that I don't lay all the blame on Hollywood for the fact that demand for donated organs far exceeds the supply. Much of this gap stems simply from misconceptions, misunderstanding and a general lack of awareness about what's involved in the donation of organs and the designation of donors.

I will also acknowledge that there have been abuses of the donation and transplant process, as at UC Irvine, which turned down donated organs while ailing patients awaited them. But these problems have been resolved and are unlikely to occur again.

Operationally, the donation process works like this:

Under federal law, hospitals receiving payments from Medicare--and that includes almost all of them--are required to notify the nearest organ procurement organization, or OPO, when any patient who has suffered severe brain injury and is on a ventilator, or whose heart has stopped.

When an OPO receives such a notification, it alerts the Procurement Transplant Coordinator who serves the reporting hospital. The PTC has no authority to intervene in a patient's treatment until two conditions are met: the attending physician must have declared a patient deceased, and consent for donation must have been obtained.

What can be done about the problems I've cited?

We are working closely with the movie and TV industry to promote greater understanding and prevent further inaccurate portrayal of the donation process. And we are urging employers to encourage their workers to give their consent to organ donation by having pink dots put on their driver licenses the next time they come up for renewal. This effort has gained momentum during the past year, and now more than a million licensed motorists in California have signed up as donors.

But that's just one of every 24 licensed drivers in the state, so we have a lot of work left to do. Success in this effort will save thousands of lives, keep families whole and strengthen communities.

Thomas Mone is chief executive of OneLegacy, a non-profit based in Los Angeles, and is serving a one-year term as president of the Association of Organ Procurement Organizations.