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The Need: What’s Being Transplanted?. Organs: in adults & children with end-stage organ failure Heart Heart-Lung Lung single or double Liver Kidney Kidney-Pancreas Pancreas only Intestine. Organ Donor Demographics. AGE.

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The Need:What’s Being Transplanted?

  • Organs:

    • in adults & children with end-stage organ failure

    • Heart

    • Heart-Lung

    • Lung

      • single or double

    • Liver

    • Kidney

    • Kidney-Pancreas

    • Pancreas only

    • Intestine


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Organ Donor Demographics

AGE

NOTE: Data subject to change due to future data submission or correction.


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Transplant waiting list as of February 24, 2003…

The Problem:

  • Nearly 2,000 Virginians are waiting for an

  • organ transplant

  • Every week three Virginians die waiting for

  • an organ transplant

  • As of October 8, 2003, 82,808 were waiting for

  • an organ transplant in the United States.

80,432 patients are currently waiting nationwide for a live-saving organ transplant.

Over 2,000 patients are waiting here in Virginia.

Three Virginians die each week waiting.


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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


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Death by Neurological Criteria

  • An individual with irreversible cessation of all functions of the entire brain, including the brainstem, is dead.

JAMA 246:2184-2186, 1981


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Organ Donor Demographics

COD

NOTE: Data subject to change due to future data submission or correction.


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Organ Donor Case Overview

Donor Management with LifeNet

Transplant

Arrival at Hospital

Authorization

Organ Recovery

in OR

Brain

Death

Organ Placement

Recognition as

Potential Donor

Serology

Lab results

OR time

Coordinate

teams

Organ

Resuscitation

(Enhance organ

oxygenation

& perfusion)

EMS

Referral to LifeNet

for Initial Evaluation


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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


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The Need: What’s Being Transplanted

  • Heart valves

  • Pericardium

  • Skin

  • Bone -Whole or processed grafts

  • Veins

  • Fascia

  • Ligaments/Tendons


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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.


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The Need:What’s Being Transplanted?

  • Eyes:

    • Cornea, Sclera

    • Whole Eyes for Research


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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…


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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


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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!”


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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?


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Some Donation Controversies

  • How should organ donation be increased?

    • Financial Incentives

    • More Public Education?

    • Presumed Consent?