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

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1995

1996

1997

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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