The Need:
What’s Being
Transplanted?

Organs:
– in adults & children with endstage organ failure
– Heart
– Heart-Lung
– Lung

–
–
–
–
–
single or double
Liver
Kidney
Kidney-Pancreas
Pancreas only
Intestine
Organ Donor
Demographics
AGE
January 2000 through December 2000
0 -5
4%
6 - 10
4%
11 - 15
4%
16 - 20
18%
82 recovered donors
66 - 70
4%
21 - 30
9%
61 - 65
6%
56 - 60
6%
31 - 40
13%
51 - 55
11%
41 - 50
21%
NOTE: Data subject to change due to future data submission or correction.
Transplant waiting list as
of February 24, 2003…
The Problem:
•Nearly 2,000 Virginians are waiting for an
80,432 patients are currently waiting nationwide for a liveorgan transplant
saving organ transplant.
•Every week three Virginians die waiting for
an organ transplant
Over 2,000 patients are waiting here in Virginia.
•As of October 8, 2003, 82,808 were waiting for
an organThree
transplant
in the United
States.
Virginians
die each
week waiting.
T HE NEED: ORGAN DONORS AND PAT IENT S WAIT ING
1988 through 2000
90000
80000
70000
60000
50000
40000
30000
20000
10000
0
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
Organ Donors
1998
1999
2000
Patients Waiting
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
Death by
Neurological
Criteria

JAMA 246:2184-2186, 1981
An individual with
irreversible cessation
of all functions of the
entire brain, including
the brainstem, is dead.
Organ Donor
Demographics
COD
January 2000 through December 2000
82 recovered donors
2
Other
3
Anoxia
6
Head Trauma
45
CVA
15
MVC
11
GSW
0
5
10
15
20
25
30
35
40
45
50
Number of Donors
NOTE: Data subject to change due to future data submission or correction.
Organ Donor Case Overview
Arrival at
Hospital
Transplant
Donor Management with LifeNet
Authorization
Recognition as
Potential Donor
Brain
Death
Organ Recovery
in OR
Organ Placement
Organ
Resuscitation
EMS
Referral to LifeNet
for Initial Evaluation
(Enhance organ
oxygenation
& perfusion)
Serology
Lab results
OR time
Coordinate
teams
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
The Need: What’s
Being Transplanted







Heart valves
Pericardium
Skin
Bone -Whole or processed
grafts
Veins
Fascia
Ligaments/Tendons
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.
The Need:
What’s Being
Transplanted?

Eyes:
– Cornea, Sclera
– Whole Eyes for Research
The Donor Card

A donor card is now recognized as a legally binding
document and cannot be overturned by the family.
– Amendment is possible

Donation by Donor Designation…
The way to succeed:
save7lives.org
•A new way for Virginians to record their donation
decisions A Website where Virginians can learn more
about organ donation and make an informed decision
•An on-line process that is simple and convenient
Common Concerns
About Donation






Disfigurement
Funeral Arrangements
Financial Responsibility
Religious Beliefs
“I cannot be a donor
because of my medical
history.”
“If I want to be a donor, they
won’t try and save me!”
Some Donation
Controversies

Who should be
transplanted?
–
–
–
–
–
–
U.S. Citizens only?
Smokers? Alcoholics?
The very young or old?
The rich or the poor?
Those in prison?
Only those who have agreed
to be donors themselves?
Some Donation
Controversies

How should organ
donation be increased?
– Financial Incentives
– More Public Education?
– Presumed Consent?
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.