Transplantation of human tissues and organs is an important lifesaving medical procedure. You’ll hear personal stories from both donors and recipients as well as facts from international medical authorities and learn about organ and tissue donation registries around the world. Make a commitment to become a donor, and learn how you can inspire others in your club and community to do the same. Attendees will also enjoy a short performance from opera singer and transplant recipient Hae-Chul Lim and a small group of guest vocalists.

1. Organ Donation
–The Gift of Life
Professor Philip O’Connell

2. 1904

3. 1952
Madame Renard Marius Renard
Damaged a
single kidney in
a fall

5. Peter Bent Brigham Hospital 23 Dec 1954

6. Andrew Ritteris
John Ritteris

7. 99
40
50
60
70
80
90
100
5 6 7 8 9 10 11 12 13 14 15
%survival
1970-74 (440)
1975-84 (1266)
1985-89 (1231)
1990-94 (1415)
4.8% per
year
5-year censored survival unchanged
Early improvement but long term
attrition
%survival
T. Mathew et al, 2001
ANZDATA
30
40
50
60
70
80
90
100
757677787980818283848586878889909192939495969798
Australia CD1. One year survival 1975-99
patient
graft
Year of transplantation Years after transplantation
OKT3 IL2-
RAATG
CSA
MM
F
TAC
CSA-ME
AZA
GCV VGV

9. 9
KI 1.9 Kidney transplant
waiting list activity among adult patients

10. Data source: Global Observatory on Donation and Transplantation (www.transplant-observatory.org), slide courtesy of S White
112,631 organs were transplanted
worldwide in 2011 (76,118 kidneys)
2% pancreas
4% lung
5% heart
21% liver
68% kidney33% of all
transplants
from living
donors
Provided by Sarah White, George Institute

11. = 10,000 treated cases of kidney failure
76,118 kidney transplants
performed in 2011
2.16 million Patients living
on dialysis at 31st December
2011
Data sources: Global Observatory on Donation and Transplantation (www.transplant-observatory.org)
ESRD Patients in 2011: A Global Perspective. Fresenius Medical Care. Bad Homburg, Germany.
On a waiting list for kidney transplantation in 2011
Provided by Sarah White

12. Territory size is distorted in proportion to the number of organ transplants reported for each country in 2010
<6
6 to <20
20 to <40
Transplantation rate (pmp)
40 to <70
>70
Global distribution of transplantation activity
2010
Data source: Global Observatory on Donation and Transplantation (www.transplant-observatory.org), slide courtesy of S White
Provided by Sarah White, George Institute

13. WHO CAN BE AN ORGAN
DONOR?

14. Potential solid organ donors
How to
maximise
every
opportunity?

15. Donor procedure
• Needs to be done by an
experienced team
• On call at short notice

16. Donor procedure
• Minimal ischaemic time. Urgent isolation procedure.

18. What can people donate?
ORGANS TISSUE
KIDNEYS CORNEAS
LIVER HEART VALVES
HEART PANCREAS ISLETS
LUNGS SKIN
PANCREAS BONE
TENDONS
LIGAMENTS

19. Determination of Death
• Brain Death – Irreversible loss of Brian
Function
• Circulatory Death – Irreversible loss of
Circulatory Function
In most jurisdictions the criteria for diagnosing death is
not proscribed in law but rather is left to the medical
profession to determine

20. The Steps in a Clinical Examination to Assess
Brain Death.
Wijdicks EF. N Engl J Med 2001;344:1215-1221.
No Response to
Painful Stimulae
Clinical
Assessment of
Brain Stem
Reflexes
Apnea Test
Temp >
BP > 90 mmHg
pO2 200mmHg
pCO2 > 40mmHg

21. Determination of Circulatory Death
• Immobility
• Apnea
• Absent skin perfusion
• absence of circulation as evidenced by absent
arterial pulsatility for a minimum of two minutes, as
measured by feeling the pulse or, preferably, by
monitoring the intra-arterial pressure.
When all of these criteria have been met, the
patient is determined to be dead and organ
removal may proceed.
Australian and New Zealand Intensive Care Society – The ANZICS statement
On Death and Organ Donation 2008

24. Road deaths in NSW 1970 - 1996

26. Family
Supported to make
an informed decision
Professionals
Skilled to communicate
with families about
donation
So is it making a difference?

27. Reasons why family declined donation
Some families gave more than one reason for declining donation. This is why the total
number of reasons why families declined donation (150) is higher than the actual number of
non-consent to donation (97)
Source: DonateLife Audit Data 2013

28. Donation consent rates

29. Raising community awareness –
the challenge
Critical fact:
In Australia the family will always be asked to confirm the
donation wishes of the deceased before donation for
transplantation can proceed.
Challenge:
For all family members to know each other’s donation
wishes so if the situation arises they will uphold them.

30. Raising community awareness
– national media campaign
Phase 1
DonateLife, discuss it today. OK?
Phase 2
DonateLife, know their wishes. OK

31. Raising community awareness
– national media campaign
 10% increase to 58% - people who have had a family
discussion in the last 12 months
 5% increase to 56% - people who know family
members’ wishes
 6% increase to 70% - awareness that family consent
is sought

32. DEVELOPMENT OF AN ETHICAL
ORGAN DONOR POLICY
Legality of Organ Donation underpinned by Legislation
Development of Regulations based on Legislation
Oversight of Organ Donation and Transplantation by
Health Dept. To ensure Transparency and Safety.
Development of Agency to oversee Organ Donation
Institution of Transplant and Organ Donor Registries
Auditing of agencies
Interaction with Transplant Units and Development of
Policies to Ensure Use of Organs is Maximised and used
by appropriately credentialed Centres
PUBLICEDUCATION,AWARENESS&
INVOLVEMENT
DEVELOPMENT OF JUST & TRANSPARENT
ALLOCATION SYSTEM

34. www.donatelife.gov.au34
Australian Organ Donor Register
http://www.humanservices.gov.au/cus
tomer/services/medicare/australian-
organ-donor-register

35. What can you do?