Donate Life: An Overview of Organ, Tissue and Eye Donation UW Health Organ Procurement Organization
Dec 27, 2015
Donate Life: An Overview of Organ, Tissue and Eye
Donation
UW Health
Organ Procurement Organization
Why is Organ Donation So Important?
There are nearly 102,000 people currently waiting for a transplant in the United States, more than 2,500 are children
Every 13 minutes – another name is added to the waiting list
Despite record numbers of transplants - the list is growing at the rate of more than 300 patients each month
Why is Organ Donation So Important? (cont.)
6,500 adults and children died awaiting an organ transplant last year.
18 people a day die on the waiting list.
More than 90% of Americans approve of organ donation, yet less than half say “yes” when asked to make their decision legal
US Transplant Waiting List
Type of Transplant # of Patients Waiting
Kidney 79,642Liver 15,821Lung 1,935Heart 2,778Heart-lung 84Kidney-pancreas 2,235Pancreas 1,504Intestines 212
Total patients 101,949
Source: Organ Procurement and Transplant NetworkUpdated 5/3/2009
Wisconsin Waiting List
Type of Transplant # of Patients WaitingKidney 1,079Liver 214Lung 66Heart 77Heart-lung 0Kidney-pancreas 55Pancreas 11Intestine 2
Total patients 1,466
Source: Organ Procurement and Transplant NetworkUpdated 5/3/2009
Challenges: Donors, Transplants & Waiting Patients
* Data based on snapshot of the waiting list on the last day of * Data based on snapshot of the waiting list on the last day of each yeareach year
5,000
15,000
25,000
35,000
45,000
55,000
65,000
75,000
85,000
95,000
105,000
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Patients WaitingTransplants PerformedOrgan Donors
What Can Be Donated?
Kidneys
End Stage Renal Disease
Diabetes with Renal Disease
High Blood Pressure
Polycystic Kidney Disease
Heart
CardiomyopathCardiomyopathyy
Coronary Artery Coronary Artery DiseaseDisease
Congenital Congenital Heart DiseaseHeart Disease
Valvular Heart Valvular Heart DiseasesDiseases
Lungs
Emphysema/COPDEmphysema/COPD Cystic FibrosisCystic Fibrosis Pulmonary FibrosisPulmonary Fibrosis Primary Pulmonary Primary Pulmonary
HypertensionHypertension Congenital DefectsCongenital Defects
Liver
HepatitisHepatitis A,B,CA,B,C
CirrhosisCirrhosis AlcoholAlcohol MedicationsMedications
Biliary DiseaseBiliary Disease MetabolicMetabolic NeoplasmsNeoplasms
Isolated Pancreas
Diabetes Type I Diabetes Type I without Renal without Renal DiseaseDisease
Hypoglycemic Hypoglycemic UnawarenessUnawareness
Pancreas after Pancreas after Kidney Transplant Kidney Transplant
Simultaneous Kidney-Pancreas
Diabetes Type I Diabetes Type I with End Stage with End Stage Renal DiseaseRenal Disease
Small Intestines
Short Gut Short Gut SyndromeSyndrome
Severe Vascular Severe Vascular DiseaseDisease
Frequently in Frequently in ChildrenChildren
What Can Be Donated? (cont.)
Skin for burn victims Bone Connective Tissue
Ligaments Tendons
Heart for valves/pericardium
Arteries and Veins Eyes (corneas)
Tissues and Eyes
What Can Be Donated? (cont.)
The Differences….
Organ Donation
•The patient must be maintained by a mechanical ventilator•Organs must be properly preserved and transplanted quickly•Life-saving procedure
Tissue/Eye Donation
•Occurs in the first 24 hours after the heart has stopped beating•The tissues can be preserved and used at a later date•Life-enhancing procedure
Current Criteria for Organ Donation
Patients who have been declared brain deadOR
Patients with severe neurological injury and family and MD are discussing withdrawing ventilator support
Up to age 75 – flexible – there was a 96 y.o. donor this summer
HIV – (at this time) No active malignancy
Exception: Primary CNS tumors
Note: Only the OPO can determine donor suitability
Organ Preservation Time
Heart: 4 to 6 hours Lungs: 4 to 6 hours Liver: 12 hours Pancreas: 12 to 18 hours
Kidneys: 72 hrs. Small Intestines: 4 to 6 hrs.
Common Questions in Regards to Donation
?
“ Will the doctors do everything they can to try and save me if they know my
wishes to be a donor?”
Absolutely
OPO is separate from the medical team treating the patient to ensure there is not conflict of interest
Donation is only considered after all efforts to save a patient’s life have been pursued by the medical team
“How does religion relate to organ donation?”
The majority of religions support organ donation
Most religions view organ and tissue donation as a charitable act
Talk to your religious leader about donation
“Will donation disfigure the body?”
No
Organs are removed through surgical incisions
Areas for tissue donation are reconstructed and concealed by clothing
A family is able to have an open casket funeral
“Does donation cost a family money?”
No
Each recovering agency pays for all expenses associated with the recovery
Those costs are passed on to the recipients and their insurance companies
The family is responsible for the normal funeral expenses
“Will donation cause any delays with funeral arrangements?”
No
The recovering agency will make certain the body is released to the funeral home on time
No extra planning is required by families of organ and tissue donors
“Can you pay to get an organ?”
No
Allocation Criteria Blood type
Medical urgency Tissue match Waiting time Organ size
Immune status Geographic distance
“Will the organs be transplanted locally?”
Yes, If…. There are local recipients for the organ There are no status one patients in our
region (livers only) There are no perfect tissue typing
matched recipients in the U.S. (kidneys only)
Approximately 85-90% of all organs donated here are used for transplants here
“Can the Donor Family and Recipients meet each other?”
Yes
Initial contact is coordinated by the OPO because of federal privacy regulations
All recipients are encouraged to write to their donor families
Meetings can be arranged if both parties sign a consent and release of information form
The Two D’s
1. DecideGet a Donor Dot on and sign your Driver’s License or State ID card
2. DiscussTalk to your family about your wishes
In Wisconsin – until you turn 18 years old we must have the consent of your family!
Legal Next of Kin
1. Healthcare Agent 2. Spouse3. Adult Children4. Parents5. Adult Siblings6. Adult Grandchildren7. Grandparents8. An adult who
exhibited special care & concern
9. Legal Guardian10. Coroner or Medical
Examiner
Through donation ...
...lives are changed ...lives are changed foreverforever