Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. Transplantable organs and tissues are removed in a surgical procedure following a determination, based on the donor’s medical and social history, of which are suitable for transplantation. Such procedures are termed allotransplantations, to distinguish them from xenotransplantation, the transfer of animal organs into human bodies.The demand for viable organs outweighs the supply. Statistics indicate that approximately every 18 minutes, someone is added to the national waiting list for organ transplant.In 1954, Dr. Joseph E. Murray performed the first successful kidney transplant in Boston. Since then, medical science has concentrated on organ donation as a way of replacing a recipient’s dysfunctional organ with that of a healthy donor organ. TYPES OF ORGAN DONATION
The organs that can be donated include:
Patients with severe heart failure who cannot be helped any longer with medication and/or surgery may benefit from a heart transplant. Liver
Patients with liver failure may benefit from a liver transplant. Pancreas
Patients with severe diabetes or renal failure may benefit from a pancreas transplant. Kidney
Patients with kidney failure on dialysis may benefit from a kidney transplant. Most kidney donations are from donors considered brain dead however a small percentage of kidney donations come from living donors. Usually from a family member.
Patients whose lungs cannot function properly with medication and/or surgery may benefit from a lung transplant. Small Bowel (Intestine)
Patients who suffer small bowel damage, either from infection or trauma, may benefit from a small bowel transplant. Damage to the small bowel will hinder a patient from absorbing enough food to survive. ORGAN DONOR ORGANIZATIONS
Organ Procurement Organizations (OPOs) are the liaisons between the potential organ donor, the transplant center, and the recipient. Organ Procurement Organizations are the federally designated agencies throughout the United States that facilitate the organ recovery process. All OPOs are non-profit organizations. OPO directives include:
* Receiving potential donor referrals
* Evaluating the potential donor
* Discussing the option of donation with the family members * Coordinating the process of removal of the donated organs * Preservation of donated organ(s) for the recipient surgery staff * Distribution to recipient destination
In the U.S. and Puerto Rico, there are 58 Organ Procurement Organizations. ORGAN DONATION PROCESS
1. The physician pronounces brain death after evaluation, testing, and documentation of patient’s condition. Each state has its own criteria for determining brain death. 2. Hospital staff refers the potential donor to the Organ Procurement Organization for the initial evaluation. 3. The OPO will then perform chart evaluation and key information gathering. This includes a thorough examination of the patient’s past medical and current condition. The social history will be assessed after the family has expressed interest in the potential donation. OBTAINING CONSENT
After the OPO determines a patient meets criteria for donation, the consent process proceeds as follows: 1. Death is explained to the family. The physician or nursing staff usually informs the family of the death initially. The OPO staff ensures that the family understands the brain death situation. (The potential donor must be maintained on a ventilator so the family may believe the patient is still alive, even though brain death has been determined) 2. The options for donation are carefully explained to the family. At this point all potential donations are discussed (Tissue, Eye, Skin, etc) so the family is not approached multiple times for each donation option.) 3. If informed consent is obtained from the legal next of kin or legal power of attorney, consent forms are read, signed, and witnessed. 4. A thorough questionnaire regarding the potential donor’s medical and social history is presented to the family. 5. Consent is obtained from the Medical Examiner/Coroner in the event that a donation may hinder a death investigation. EVALUTION AND MAINTENANCE OF POTENTIAL DONOR
After the proper consent process is complete and the patient is considered a donor, the evaluation and maintenance process proceeds as follows: 1. Tests are performed to determine blood type (ABO) and DNA (HLA Typing). 2. Tests are performed to rule out any transmissible diseases. 3. Transplantable organs are evaluated for suitability and stability. 4. Hemodynamic (Circulation of oxygen-rich blood) functions are stabilized. 5. Organ recipients are identified.
6. Transplant teams are mobilized. In organ donation, the surgery team responsible for the transplant is the team mobilized for the recovery. The OPO does not perform the organ recovery. ORGAN RECOVERY
1. The procedures for organ donor recovery begins in an operating room of the hospital by the surgery team responsible for the transplant. 2. The donated organs are than preserved in sterile solutions and immediately transported with the transplant team to the awaiting recipients. 3. The donor is then released for autopsy and/or funeral arrangements. BENEFITS OF ORGAN DONATION
Perhaps you are considering becoming an organ donor, but are not completely sure why you should. There are many benefits of organ donation, for all parties involved. You Can Help Save Lives and Make a Difference
* Here in New York. there are nearly 10,000 people waiting for an organ transplant. By signing up today, you can help save lives! Did you know that just ONE organ donor can save up to EIGHT lives? For Transplant Recipients
* A second chance. For organ donor recipients, a transplant often means a second chance at life. * Improved quality of life. For some, an organ transplant means no longer having to be dependent on costly routine treatments to survive. It allows many recipients to return to a normal lifestyle. For others, an eye or tissue transplant means the ability to see again or the recovery of mobility and freedom from pain.
For Donors and Their Families
* The ability to comfort grieving families. It is always difficult to lose a loved one. Many grieving families of organ donors can take comfort in the fact that their loss may help to save or improve the lives of others. * The power to save lives. Registering to be an organ donor is a charitable act that costs nothing. It allows a donor to save up to eight lives through organ donation, and to save or improve the lives of up to 50 recipients through tissue and eye donation. DISADVANTAGES OF ORGAN DONATION
* At one time, certain religions objected to organ donation. Now, most support these procedures, so in most cases that disadvantage has been removed. A disadvantage to organ donation is the donor or his family has no say in who receives the donated organs. Organs may be donated to recipients who have very different religious or political views or to people the donor may not have considered deserving. For this reason, donors have to believe all life is sacred and one recipient isn’t more valuable than another. CONCLUSION
The demand for organ transplantation has rapidly increased all over the world during the past decade due to the increased incidence of vital organ failure, the rising success and greater improvement in posttransplant outcome. However, the unavailability of adequate organs for transplantation to meet the existing demand has resulted in major organ shortage crises. As a result there has been a major increase in the number of patients on transplant waiting lists as well as in the number of patients dying while on the waiting list. In the United States, for example, the number of patients on the waiting list in the year 2006 had risen to over 95,000, while the number of patient deaths was over 6,300. This organ shortage crisis has deprived thousands of patients of a new and better quality of life and has caused a substantial increase in the cost of alternative medical care such as dialysis. There are several procedures and pathways which have been shown to provide practical and effective solutions to this crisis.
These include implementation of appropriate educational programs for the public and hospital staff regarding the need and benefits of organ donation, the appropriate utilization of marginal (extended criteria donors), acceptance of paired organ donation, the acceptance of the concept of “presumed consent,” implementation of a system of “rewarded gifting” for the family of the diseased donor and also for the living donor, developing an altruistic system of donation from a living donor to an unknown recipient, and accepting the concept of a controlled system of financial payment for the donor. As is outlined in this presentation, we strongly believe that the implementation of these pathways for obtaining organs from the living and the dead donors, with appropriate consideration of the ethical, religious and social criteria of the society, the organ donation and transplantation.organ shortage crisis will be eliminated and many lives will be saved through the process of organ donation and transplantation.
1.http://www.gavelife.org – Organization established to advocate for organ donations from prisoners. 2. http://www.organdonor.gov/. “Organ Donation.” First-Gov.com, 2002.Dying & Death in Law & Medicine: a Forensic Primer for Health and Legal Professionals. Berger, Arthur S., Praeger, Arthur S., 1993. 3.The Ethics of Organ Transplants: The Current Debate Caplan, Arthur L., and Daniel H. Coelho, eds., Prometheus Books, 1999. 4. Dying & Death in Law & Medicine: a Forensic Primer for Health and Legal Professionals. Berger, Arthur S., Praeger, Arthur S., 1993.