As an occupational health nurse practitioner at Crawford Long Hospital, Sandy Winzeler was a touchstone to all who met her.

"Sandy was not just a colleague, she was a friend and mentor," said Connie Wilbanks, COHN-S, who worked with Winzeler in employee health for 15 years. "She was the whole package of what the term "nurse" means to the general public — she was caring, compassionate, extremely intelligent.

"She was always busy caring for others — whether it be her family, her neighborhood, her community and, certainly, her patients. And she gave of herself, and so generously."

When Winzeler died last fall of ovarian cancer, she continued that generosity. She became a tissue and eye donor.

A gifted clinician in life, Winzeler's tissue and bone, donated for research, will help scientists studying ways to cure and treat people with musculoskeletal and skin diseases, including studies on arteriosclerosis and other research projects.

Her eyes, which were donated to the Georgia Eye Bank, went to help others see. "It does not surprise me that she would have made this great donation," said Wilbanks, tearfully recalling her friend.

For Pat Higgins, RN, MS, who knew Winzeler when they both were Army Reserve nurses, the sorrow of losing a respected friend was lessened somewhat because Higgins knows intimately what tissue donation can mean to others.

"I get to see the bigger picture," she said.

As executive director of the Southeast office of the nonprofit Regeneration Technologies Inc. donor services, Higgins and her staff help educate medical staff, families, funeral home directors and coroners about tissue donation. She's also responsible for directing the recovery teams that go to hospitals, funeral homes and morgues to help retrieve the tissue.

"When a loved one dies, it is tough on the family to both learn about tissue donation and make a decision to donate at the same time," Higgins said.

Unlike organ donation, which must be done soon after brain death, tissue retrieval can be done within a 24-hour window, and the tissue can be frozen and saved for later use.

A tissue donation can include bone, skin, heart valves, connective tissues and veins, and is used in research and in more than 750,000 surgeries each year in the United States, Higgins said. Donated veins for example, can help restore blood circulation, and skin donations may speed the healing process for burn victims.

"One donor can help 40 to 50 people," she said.

Tissue donations are immediately frozen and can stay on wet ice up to 72 hours, Higgins said. The bone and tissue is sent to a tissue bank laboratory where it is cleaned and repacked, and sent to hospitals across the country.

Like organ donations, the need for tissue donors is continuous. Members of the RTI team work around the clock and will be called to either a hospital morgue or funeral home for retrieval, Higgins said.

Under the direction of a medical director, a retrieval team usually consists of a surgical technician and a nurse, but there are more people behind the scenes who work with the families of tissue donors, hospital staff and funeral directors. Letting funeral directors understand how tissue donation works is important, said Higgins, since 60 percent of all deaths occur somewhere other than a hospital.

The removal of bone and tissue doesn't mean the body will be left hollow; prostheses can replace tissue and bone, leaving no evidence that they have been removed, except for some hidden stitches.

Working to teach hospital staffs more about tissue donation and getting the word out to the public is Colie Estes, who is a pastor.

Because tissue donation can be done within 24 hours after a death, a donation can be carefully considered by the family of the deceased, allowing them to go home and think about it, Estes said. RTI also offers bereavement care and support.

Hospital personnel don't approach the family about a donation, but do alert RTI about a probable donor.

Sometimes the deceased already will have indicated to their family or friends that they want to be a tissue and organ donor. The decision to donate should not interfere with funeral arrangements, nor should it incur any cost to the family, Estes added.

"I am so impressed that someone is able to help somebody else in the midst of their grief," she said.

A medical consent form must be signed, either by a family member or the person who knew the deceased best, like a friend or roommate.

Like blood donation, there are some health factors that prevent a donation, such as being infected with HIV/AIDS. Concerns about contaminated tissue led the Food and Drug Administration to mandate that tracking codes be put on all donations so the donor source can be traced, Higgins said.

While organ donation has been more publicized, tissue donation is gradually receiving some recognition. This year's Rose Bowl Parade featured a tissue donation float with 22 riders who either benefited from donor tissue or whose loved ones were donors. There is also a memory quilt of donors, and a "celebrate life" event held at the Houston Mill House in Atlanta every April.

For information about tissue donation or RTI, contact the donor referral line at 1-888-252-3510 or call 678-279-4002.

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