Top 10 things every healthcare professional should know
How many people are in need of organ, eye or tissue transplantation?
Approximately 110,000 men, women and children await lifesaving organ transplants. Sadly, more than 8,000 people die each year because the organs they need are not donated in time.
A cornea donor can restore the sight of two individuals among the more than 40,000 Americans who suffer with corneal blindness. A tissue donor can heal more than 75 individuals in need.
What can be transplanted?
Organs that can be donated include the heart, lungs, kidneys, liver, intestines and pancreas. Tissues include corneas, islet cells, connective tissue (bones, tendons, cartilage, ligaments) bone marrow, blood vessels and blood.
Organ preservation times:
- Heart 4-6 hours
- Liver 12-18 hours
- Kidney 24-48 hours
- Heart-lung 2-4 hours
- Lung 2-4 hours
- Pancreas 12-18 hours
How does the donation process work?
A person who has died that has consented to donation prior to their death is referred to an organ procurement organization (OPO). If the patient has not previously consented (registered) to be a donor, the family will be asked to authorize donation. An extensive evaluation and testing performed by the OPO matches available organs with patients on the national waiting list.
Transplant centers are notified of the results of the match. The transplant team considers the organ offered for their patient that has been evaluated and listed at their center. The organ is accepted or declined. If declined, the organ donated will be offered to the next patient on the national waiting list.
How are organs allocated?
National rules have been established to determine priority for receiving an organ. Characteristics of both the donor and transplant candidate are considered to ensure that allocation proceeds efficiently and effectively. A combination of factors working together determines who receives which organ.
These factors can include: length of time spent on the waiting list, whether the potential organ candidate is a child, patient urgency, body size of both donor and candidate, tissue match between donor and candidate, blood type and blood antibody levels.
What are the criteria for donors and recipients?
The recipient must first undergo an evaluation by a transplant center to determine if they are healthy enough to go through a major surgery and that the transplant has the greatest chance of success.
The evaluation can take weeks, months or longer to complete, depending on the health of the recipient and how quickly the tests can be scheduled. To make sure there is a match, the medical team compares the blood type of the donor and recipient.
Information is collected about the donor from the donor’s medical record and next of kin.
Describe the medical definition of death.
Cardiac death is the irreversible cessation of circulatory and respiratory function. Death on a neurological basis is the irreversible cessation of all brain function, including the brain stem.
Most organ donors are people who suffer from head injuries that result in brain death. These are people who may have had a stroke, traumatic head injury due to a car accident or fall, or a brain tumor that has not metastasized (spread to another part of the body).
There are two legal ways to pronounce death. Death may be pronounced when a person’s heart stops beating (cardiac death) or when the person’s brain stops functioning (brain death). Brain death occurs when blood and the oxygen it carries cannot flow to the brain. The person’s heart is still beating and providing blood and oxygen to the rest of the body because he or she is on a ventilator (breathing machine). In brain death, the organs and tissues remain viable (healthy) and can be removed for transplantation. The organs and tissues are only removed after brain death has been declared by a physician. This physician is never part of the transplant team.
In certain situations, organs can be recovered for transplantation after the person’s breathing and heartbeat have stopped. This is called donation after cardiac death.
Where are the transplant programs in Virginia?
Transplant centers must apply and meet regulatory criteria to perform transplants. Centers are designated by the age (adult or pediatric) and organ they are authorized to transplant. Several people are designated to support patients prior to, during and after transplantation. Every transplant center must identify a social worker, financial coordinator, pharmacist and dietitian, in addition to the surgeon, transplant physician and transplant coordinator.
Other disciplines which support patients and families during the transplant experience include chaplains, child life, physical therapists and occupational therapists.
Where can data be accessed?
National, regional, state and center data can be found by visiting:
Organ Procurement and Transplantation Network (OPTN)
Scientific Registry of Transplant Recipients (SRTR)
How is authorization for donation determined?
There are two ways authorization for donation may be given:
Adult individuals can give authorization by designating themselves as a donor at any time prior to their death. This is commonly known as “first-person authorization” or “donor designation.” When an individual designates themselves as a donor, they are documenting that they want to make an anatomical gift after their death. This document of gift is legal authorization for donation and cannot be revoked by anyone other than the individual.
In the absence of first-person authorization, the individual’s legal next-of-kin makes the decision about donation after the individual’s death.
There are several ways an individual can document their intent to be a donor. The most common way is through their local Department of Motor Vehicles when they obtain or renew their driver’s license. Individuals can also document their intent to be a donor through the Donate Life Virginia online registry.
32.1-297.1. The Virginia Transplant Council
The Virginia Transplant Council (d/b/a Donate Life Virginia) is hereby established to create, compile, maintain, and modify as necessary the Virginia Donor Registry in accordance with the regulations of the Board of Health and the administration of the Department of Health. [source]
32.1-291.14. Rights and duties of procurement organization and others.
When a hospital refers an individual who is dead or whose death is imminent to a procurement organization, the organization shall make a reasonable search of the records of the Virginia Department of Motor Vehicles and any donor registry that it knows exists for the geographical area in which the individual resides to ascertain whether the individual has made an anatomical gift. [source]
Virginia Department of Motor Vehicles
Virginia DMV registers more than 90% of Virginians registered on the Virginia Donor Registry.
Donate Life America
Donate Life America (DLA) is a nonprofit national organization devoted to inspiring people to save and enhance lives through organ, eye and tissue donation. DLA manages and promotes the national brand for donation, Donate Life, and assists Donate Life State Teams and national partners in facilitating high-performing donor registries.
The Lions Medical Eye Bank (LMEB) and Old Dominion Eye Foundation (ODEF) provide human eye tissue for transplant, research and education in the Commonwealth of Virginia and work to register organ, eye and tissue donors.
Organ Procurement Organizations (OPO)
An organ procurement organization (OPO) is a federally-designated agency responsible for facilitating the organ, eye and tissue donation process of deceased individuals. OPOs work collaboratively with their local hospital partners, medical professionals, donor families and community members to build programs, systems and processes needed to make donation possible. There are 58 OPOs nationwide. LifeNet Health, Washington Regional Transplant Community (WRTC) and Tennessee Donor Services serve Virginia.
A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education and allograft transplantation. LifeNet Health and WRTC serve Virginia.
United Network for Organ Sharing (UNOS) is a private organization that manages the nation’s organ transplant system under contract with the federal government. UNOS maintains the national organ waiting list.
Contact Your Nearest Transplant Center
University of Virginia Transplant Center
1215 Lee Street, Charlottesville, 22903
Adult: heart, kidney, lung, pancreas, kidney/pancreas, liver
Pediatric: heart, liver, kidney
Sentara Norfolk General Hospital
600 Gresham Drive, Norfolk, 23507
Adult: heart, kidney, pancreas
Children’s Hospital of The King’s Daughters
601 Children’s Lane, Norfolk, 23507
Inova Fairfax Hospital
8110 Gatehouse Road, Falls Church, 22042
Adult: heart, kidney, lung, pancreas, kidney/pancreas
Virginia Transplant Center, Henrico Doctors’ Hospital
1602 Skipwith Road, Richmond, 23229
Hunter Holmes McGuire VA Medical Center
1201 Broad Rock Boulevard, Richmond, 23249
VCU Health Hume-Lee Transplant Center
1250 East Marshall Street, Richmond 23298
Adult: kidney, liver, pancreas, heart