2. Organ Donation
▪ Process of removing organ or tissue from a live, or recently dead, person to be used in
another
▪ The former is the donor and the latter is the recipient
▪ People of all ages
▪ Any healthy willing person
▪ Only expectation – HIV and Active cancer patients
4. Current Scenario - India
http://www.newindianexpress.com/nation/2017/oct/30
5. Organ Shortage - Reasons
▪ Family consent, and negative attitude contribute towards organ shortage.
▪ Religion
▪ Fear, ignorance and misunderstanding
▪ Legal aspects
▪ Media reports on scandals involving organ rackets
▪ Lack of Awareness
6. Common Concerns About Donation
▪ Disfigurement
▪ Funeral Arrangements
▪ Financial Responsibility
▪ Religious Beliefs
▪ Medical History
7. Types of Organ Donors
▪ Person after death
▪ Living person to related patient
▪ Living person unrelated to patient
▪ Brain dead patient (Cadaver Transplant)
9. Deceased Donors (Cadaveric)
DECEASED DONOR (Cadaveric)
DCD (Donation after circulatory
death) NON-HEART BEATING
Donors do not fulfil the brain-stem death criteria
DBD (Donation after
brain-death) HEART-
BEATING
Maastricht Classification (1995; amended
2003)
Category
I. Dead on arrival at hospital
II. Unsuccessful resuscitation
III. Awaiting cardiac arrest
IV. Cardiac arrest after brain-stem death
V. Unexpected cardiac arrest in patient in
an ITU /
CCU (new category 2003)
Period of observation: 10 minutes after
asystole Warm ischaemia time: <40 minutes
10. Organs and Tissues for Donation
https://www.organdonor.gov/about/what.html
11. Organs Donated
Living Donor After Brain Death Cadaver – Naturel Death
Kidney – Entire Kidney Cornea
Liver – Segmented Heart Bone
Lung – Lobe Liver Skin
Intestine – Portion Lungs Blood vessels
Pancreas – Portion Pancreas
Intestine
Heart valves
Connective tissues
www.healthxchange.sg/
12. Reasons for Donation
https://www.organdonor.gov
Heart - Congenital Heart Disease, Coronary Artery Disease, Cardiomyopathy, Valvular Heart
Diseases
Lung - Chronic Obstructive Pulmonary Disease (COPD), Emphysema, Pulmonary Fibrosis,
Hypertension, Congenital Defects
Liver - Hepatitis, Biliary Disease, Tumors, Liver Cancer, Cirrhosis
Kidney - Diabetes, High Blood Pressure, End Stage Renal Disease, Polycystic Kidney Disease
Pancreas - Type 1 Diabetes without Renal Disease, Hypoglycemic Unawareness, Pancreas after
Kidney Transplant
Small Intestines – Short Gut Syndrome, Severe Vascular Disease, Children with Intestinal Failure
who can’t absorb nutrients from foods
13. Reasons for Donation
https://www.organdonor.gov
Corneas – restore loss of vision, cornea infection or injury
Tendons and Ligaments – sports injuries such as replacing an ACL (anterior cruciate ligament);
restore mobility for patients undergoing joint restoration
Heart Valves – replace damaged heart valves
Veins – coronary artery bypass surgery, repair damaged vessels to produce blood flow, create
a hemodialysis fistula
Skin – temporary biological “bandages” for burn victims, diabetic wound repair, mastectomy,
rotator cuff reconstruction, and abdominal wall reinforcement
Bones – replace or reconstruct bones destroyed by cancerous tumors, trauma or infection;
used in dental, spine, and neck surgeries
14. Difference Between Organ Donation and Tissue and Cornea
Donation
• Organs may only be recovered if a patient dies while on a mechanical
ventilator in a hospital and that occurs in fewer than 5% of all deaths
• Organs must be properly preserved and quickly transplanted
• Organ transplantation is a life-saving procedure
Organ Donation
• Tissue recovery occurs within the first 24 hours after the heart stops beating
• Tissues can be preserved for use at a later date so immediate
transplantation is not necessary
• Tissue donation is either a life-saving or life-enhancing procedure, allowing
people to live pain free with increased mobility or gain sight
Tissues and Cornea
Donation
https://www.organdonor.gov
15. Organ Donor Criteria
▪ Age is generally less than 80, but is based on patient’s current medical history
▪ Dead by Neurologic Criteria
▪ “Brain Dead”
▪ Medical history is examined at the time of death
▪ Free of HIV
▪ all serologies are examined at time of death
16. Tissue Donor Criteria
▪ Donation occurs after cardiac death
▪ Criteria:
▪ Age < 70
▪ Recovered within 24 hours after death if body is cooled in the first 12 hours
▪ No active, transmissible disease
▪ No autoimmune disorder
17. Eye Donor Criteria
▪ Donation occurs after cardiac death
▪ Criteria:
▪ No upper age limit
▪ 1 year to 68 years
▪ cornea transplant
▪ Less than 1 year or greater than 68 years
▪ research
▪ History of cancer is acceptable
▪ Other research for patients with history of glaucoma, diabetes, etc.
18. Improving Organ Donation
▪ Create Awareness
▪ Improved patient care to facilitate easier approach for organ donation, in case of
patient death
▪ Trained transplant coordinators and grief counselors
▪ Improved hospital infrastructure
▪ Qualified Intensivists and Surgeons
▪ Increased HLA typing and cross matching facilities
▪ Improved facilities in packing, transport and retrieval of organs
▪ Supporting organization for networking and registry maintenance
www.huffingtonpost.com
19. Types of Transplants
▪ Autograft - A transplant of tissue from one to oneself. (examples skin grafts, vein
extraction for CABG, etc.)
▪ Allograft - A transplanted organ or tissue from a genetically non-identical member of
the same species
▪ Isograft – Organs or tissues transplanted from one to a genetically identical other
(identical twin)
▪ Xenograft - A transplant of organs or tissue from one species to another. Examples
porcine heart valves
20. Outcome of Organ Transplant
As per The Scientific Registry of Transplant Recipients, the national database of
statistics related to transplantation related to US
www.srtr.org
21. Outcome of Organ Transplant
As per The Scientific Registry of Transplant Recipients, the national database of
statistics related to transplantation related to US
www.srtr.org
22. Outcome of Organ Transplant
www.medicalnewstoday.com; 2018
Survival after Liver transplant –
As per National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),
average survival form a deceased donor
▪ 86% still alive 1 year after surgery
▪ 78% still alive 3 years after surgery
▪ 72% still alive 5 years after the surgery
▪ 53% still alive 20 years after the surgery
23. Outcome of Organ Transplant
https://www.inova.org/healthcare-services/lung-transplant
Survival after Lung transplant –
According to the International Society of Heart and Lung Transplantation (ISHLT), 4,218 lung
transplants were performed world wide
Survival for all lung transplant recipients was analysed. Benchmark survival rates were:
▪ 88% at 1 year (in the US)
▪ 72% at 3 years (in the US)
More than 80% of patients had no activity limitations at 1, 3, 5 and 10 years after transplant
24. Outcome of Organ Transplant
www.cedars-sinai.edu
Survival after Heart transplant –
Study conducted at Cedars-Sinai, US and
reports submitted to Scientific Registry of
Transplant Recipients - one-year patient
and graft survival data is presented
25. How are Organs Allocated?
▪ ABO blood type
▪ Medical urgency
▪ Time on the waiting list
▪ Geographic location
26. Organ Donation - Pros
▪ A single donor can save more than one life
▪ A donor can have normal life even after the transplant
▪ People who are certified brain dead are capable of donating many body parts
▪ Organs can be donated after death and can be 'banked‘
▪ Potential donors are easy to find
organdonation.com/organ-donation-pros-and-cons
27. Organ Donation - Cons
▪ Religious reasons
▪ Family beliefs
▪ Misconceptions
▪ Donors are scared of their own health
organdonation.com/organ-donation-pros-and-cons
28. Acts and Laws
▪ Transplantation of Human Organ Act (1994)
▪ Organ selling is legally banned
▪ Brain death
▪ First relative donors
▪ The act of obtaining consent
▪ Unrelated donors
Indian J Urol. 2009 Jul-Sep; 25(3): 348–355
29. Ethical issues
▪ Bioethical issues
▪ Deontological issues (patient autonomy, living wills and guardianships)
▪ Teleological issues (transplant tourism , organ theft, black market, exploitation)
▪ Brain death patients
▪ Political issues
▪ Religious issues
Med Princ Pract. 2003 Jan-Mar;12(1):54-69
30. Awareness
▪ Dispel myths and misconceptions about organ donation
▪ Avoid exploitation and misuse of organ donations
▪ Carry a donor card
31. Facts About Organ Donation
Who can be a donor?
Will doctors try to save me?
Who decides if I become a donor if
I’m not registered?
•Anyone can register
•Age is not a barrier
•Donation professionals review a patient’s medical record and social
history to determine eligibility
•Yes!
•Doctors and medical teams will do all they can to save your
life
•Donation only occurs after a patient is declared dead
•You legally authorize first person consent when you register on your
state’s online registry, the national registry, or at the DMV
•When your decision isn’t documented in a state or national online
registry your next-of-kin decides
32. Facts About Organ Donation
Does donation disfigure the body?
Does donation delay a funeral?
Is there a cost to the donor or their
family?
•Open casket funerals can occur following donation
•Organs are removed during a surgical procedure in an
operating room
•Areas where tissue donation occur are reconstructed and
concealed by clothing
•No
•The act of donation doesn’t cause untimely delays for the
funeral
•The recovering agency ensures that the donor’s body is
released to the funeral home on time
•If you are a donor, your family or your insurance doesn’t pay
any bills or costs related to the donation
•Your family does pay the cost of funeral expenses
33. Facts About Organ Donation
Are organs transplanted locally?
Do the wealthy or celebrities get
priority for a transplant?
How do religions feel about organ
donation?
•Yes, when there are local or regional recipients who
match the organ and no other kidney waitlist patients in
the U.S. who are a perfect match
•Approximately 85 – 90% of all organs donated in
Wisconsin are used for transplant in Wisconsin
•No, the national system ensures that a donor is matched
with the best possible recipient with the most medical
need and who has been waiting the longest
•Race, gender, age, financial or celebrity status aren’t
factors in selecting recipients
•Organ donation is considered a charitable act of widely-
known religions
•Please consult your faith leader if you are unsure about
your religion’s position on organ donation
