Transplant Tissue Update
Keith Larson, CTBS, CEBT
Lifesharing Recovery Manager
Lifesharing
• Founded in 1984 as a Division of UCSD Medical Center
• One of 58 Regional Federally Designated Non-Profit
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OPO and Tissue Recovery Bank
Affiliated with 26 donor hospitals and 4 local transplant
centers in San Diego/Imperial Counties
1,700 San Diego patients/112,000 patients nationwide
Work closely with 2 Medical Examiners offices, Funeral
homes, Nursing homes, Hospices and local San Diego
Eye Bank
Most of the Tissue recoveries take place here at the
MEO-Lifesharing has a dedicated Recovery Suite.
Lifesharing has approximately 60 employees
RN's/Tissue Recovery Staff are Unionized
What is Tissue Donation and
why the need:
• Over 20,000 deaths annually
• 9.8 registered DMV potential donors
• Lifesharing recovered 420 Tissue Donors last year
• Approx 1,500,000 allografts transplanted worldwide each year for
a variety of life-saving and life-enhancing surgeries:
• 36 million Americans with debilitating musculoskeletal conditions
who could benefit from an allograft.
• Partner with 7 different Tissue Processors (i.e. Allosource, Lifecell,
LifeNet, MTF, etc). Also store/distribute frozen/freeze dried grafts
for some of these tissue processors here in San Diego.
• Partner with UCSD Whole Body Donation – donor can be a tissue
and whole body donor
Referral to Recovery-Non MEO
Imminent Death /
Death Occurs
Recovery takes
place
Lifesharing
is notified
Full Review
Initial review
Authorization is
confirmed /
obtained.
Lifesharing is Notified of Death
Patient Chart is needed
Anyone can Call
888 – 4 A DONOR
888 423-6667
What the Hospital Staff will initially need to provide to
Lifesharing:
•Basic info
•Your Name & Title
•Hospital , Unit & Floor
•Call Back number
•Patient Info
•On a vent? Heartbeat?
•Name of Patient
•Age of Patient / Date of Birth / Race / Gender / Weight
•Date of Death / Time of Death
•Cause of Death
•Medical Record Number
•Admit Date
•Medical Examiner Case
•Location of Body
•Next of Kin Information
•Medical Screening
•HIV Hepatitis B / Hepatitis C / Cancer / Dementia / Sepsis
Provide a Referral Number
Inform you who will be notified and will call you back
Initial Review
DO NOT APPROACH FAMILY ABOUT DONATION!
Lifesharing or SDEB will call back to confirm information
and ask additional questions to determine suitability
• Cancer questions
• When diagnosed?
• Treatments?
• Physicians?
• Sepsis
• Cultures?
• WBC’s
• Chest X-Rays?
• Next of Kin information
• Status
• Phone number to reach them
• Language barriers
Consent is obtained via telephone / in person
Hospital is notified of outcome
• Body will be transported to our recovery suite
• Body will be released to funeral home
Authorization is confirmed / Obtained
Legal Next of Kin is given Option of Donation
or advised of Registration
Support is given whether family decides to
donate or not to donate
High Risk Assessment is obtained
Determination of suitability is established for
next level of review or Donor is “shut down”
If A MEO Case:
• Lifesharing and the San Diego Eye Bank review the
MEO death reports twice a day.
• If a potential donor then NOK is contacted by a
Family Services Coordinator
• If NOK gives authorization, and the case is a
possible Autopsy case, then the MEO investigator is
contacted and a Pre/Post Autopsy request form is
faxed.
• Then once authorization is received either
Lifesharing or the San Diego Eye Bank we evaluate
how to proceed with tissue recovery.
Recovery
Body is transported to Lifesharing recovery
suite
Physical Inspection is done
Authorization/Medical Soc is reviewed
Blood drawn for serologic testing for HIV, HBV,
HCV, RPR
Recovery of donated tissue is conducted by
trained professionals
Tissues Recovered
Corneas
Costal Cartilage
Heart for valves
Mandible
Humerus
Ribs
Vertebrae
Elbow
Radius/Ulna
Ilium
Femur
Fascia
Femoral V/A
Patellar
Tendon
Tibia
Saphenous vein
Fibula
Ankle
Tibialis
tendons
Tissue Uses
Mandible/
Hemi Mandible
Cancellous
Chips
Wedges,
Dowels, Chips
Whole, Proximal,
Chips, DBM
Elbow, Whole Joint
Fascia
Proximal/Distal, Dowels,
Heads, Shafts, Chips, DBM
Shaft, Chips, DBM
BTB, Proximal,
Dowels, Chips,
Shafts, DBM,
Hamstrings
Ankle, Whole Joint
Tissue Uses:
Applications:
Benefits:
Bones: spinal fusions, congenital defects,
reconstruction due to trauma, cancer,
tumors, disease & fractures
 Restores appearance, mobility &
decreases pain, prevent amputation
Tendons: replacement ACL, PCL, Achilles
tendons.
 Restores Mobility
Skin: grafts for burn victims, abdominal
wall repairs, hernia repair, pelvic floor
reconstruction, facial reconstruction, breast
reconstruction following mastectomy.
 Promotes healing, reduces scarring and
restores abdominal wall.
Blood vessels: replaces damaged arteries
and veins.
 Increase circulation, limb salvage
Heart valves: replaces damaged or
defective heart valves
 Improve heart function, allows a child to
grow into graft
Specialty Grafts
• Right 5th Metacarpal and 1st Phalange –to repair
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finger of a 15 yr. old girl who suffered a traumatic
injury playing soccer-recover from a male/female
between the ages of 15-45 yrs-no autopsy
Rt/Lft Elbow En-Bloc-male donors, no autopsy
Shoulder, Clavicle, Humeral Head
Tremendous need for Infant Heart Valves and
Juvenile Cartilage grafts-Full Term Birth to 13th
birthday
With some grafts No autopsy because some grafts
are processed fresh and released +/- 21 days. They
are mixed w/stem cells to expedite bone growth.
Used for sports medicine injuries!
Skin Recovery
Dermatome Recovery
Freehand Graft Recovery
Improved Surgical Repair
Ruptured Omphalocele
Courtesy Dr. Schrupp
Placement of Acellular Dermis
Wound Closure
Co-joined Twins
Acellular Dermis Silos
Top LifeSharing Hospital Tissue Usage:
2009 - 2011
Hospital
Total Grafts
Donors Needed
Scripps
Memorial
Encinitas
942
140**
Scripps
Memorial
LaJolla
1007
43**
Sharp Memorial
663
44
Grossmont
District
1343
62
Kaiser San
Diego
653
17
The Facts
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Donor families incur no expense for donation

Donation is consistent with the life-preserving traditions of most
major religions

Donation is a sterile aseptic procedure. Open casket funeral are
possible-anyone can be a eye donor for Tx or Research
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You do not have to match blood, age or gender to be a tissue
donor

Tissue cannot be bought or sold

Donor families tell Lifesharing donation makes sense out of
tragedy and helps their grieving
Follow -Up
• Follow-up letter is sent to the NOK to inform them if
the donation took place or not.
• We offer twice a year a ‘Day of Remembrance’ at a
local funeral home for the families who donated.
• Sometimes the donor families may want to meet the
recipients of Organs donated.
THINGS TO CONSIDER
Do not rule patient out as donor candidate
before calling the Donor Referral Line
“1-888-4A-DONOR”
A Lifesharing Coordinator will discuss
options when timing is appropriate.
Communication is key – Keep us informed
if a Family Member wishes to donate!
Remember…
One organ and tissue donor can
save the lives of 8 people and
enhance the lives of 60 people
Questions?
What is Tissue Donation and
why the need:
• Surgical recovery of donated tissue for safe and sterile transplant
into a recipient
• Approx 1,500,000 allografts transplanted each year for a variety of
life-saving and life-enhancing surgeries:
• 36 million Americans with debilitating musculoskeletal conditions
who could benefit from an allograft.
• Partner with 7 different Tissue Processors (i.e. Allosource, Lifecell,
LifeNet, MTF, etc).
 Over 20,000 deaths annually
 420 tissue donors last year