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Bridging Lives The Process of Tissue Donation. Seung Lee, BS, CTBS Tissue Hospital Services Specialist. Tissue Donation Circumstances. 55,659 total referrals in 2009 Brain Death – 5% Cardiac Death – 95% Tissue donation can occur in both Criteria differs than an organ donor.

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slide1

Bridging Lives

The Process of Tissue Donation

Seung Lee, BS, CTBS

Tissue Hospital Services Specialist

tissue donation circumstances
Tissue Donation Circumstances
  • 55,659 total referrals in 2009
  • Brain Death – 5%
  • Cardiac Death – 95%
  • Tissue donation can occur in both
  • Criteria differs than an organ donor
standards and regulatory agencies
Standards and Regulatory Agencies
  • U.S. Food and Drug Administration (FDA) – 1993
    • Interim Rule
    • Good Tissue Practices
  • State of California (other states and countries)
  • Center for Medicare/Medicaid Services (CMS)
    • Calling in all deaths
    • Hospital Agreements with Tissue/Eye Bank
time limitations
Time Limitations
  • Tissues can become non-viable during the time the family considers the donation option
    • Refrigeration within 12 hours (15 vs. 24 hours)
  • Timely referrals allow the family the maximum time available to consult w/ one-another about the opportunity of donation
    • Domino Effect
tissue distribution
Tissue Distribution
  • Tissue is strictly monitored to maintain temperature requirements ranging from 10 degrees Celsius to -196 degrees Celsius
  • Graft Expiration:
    • Bone FZ = 5 years FD = 2-3 years
    • Skin FZ = 5 years Fresh = 14 days
    • CV FZ = 5 years
    • Corneas Refrigerated = 7 days
tissue donation potential
Tissue Donation Potential

Cornea/Eyes

Heart Valves

Skin

Bone

Tendons

Cartilage

Veins

the gift of sight
The Gift of Sight

A precious gift…

A world of darkness

…transplanted

slide10
Skin
  • Increases burn survival from 17 to 77%
  • Promotes healing
  • Temporary coverage
  • Protects against:
    • fluid loss
    • Infection
  • Decreases pain
ruptured omphalocele
Ruptured Omphalocele

Courtesy Dr. Schrupp

slide16

Tunneling Ulcer

Post Debridement

slide19
Bone
  • Replacement for skeletal defects caused by cancer, trauma, or birth defects
  • Prevents amputation
  • 60% of allografts used in spinal surgeries
  • Allograft provides the matrix for recipient’s bone to grow and resume normal function
demineralized bone with carrier
Demineralized Bone with Carrier
  • Consists of bone matrix and a carrier such as glycerol, collagen, etc.
slide22

Bone for Spinal Fusion

Spinal curvature

After bone grafts…

kacey
Kacey

Kacey in 2005

  • Rode on the Donate Life Float in the 2005 Rose Bowl Parade
  • Fiancée proposed the night before parade.
  • Graduated from Nursing School
  • Got married
  • Became a spokesperson for Tissue Donation
kacey1
Kacey

A Proximal Humerus was correctly matched by size and a medical director approved the graft for a limb-preserving surgical procedure on Kacey.

osteosarcoma
Osteosarcoma

Bone Graft into Defect

Tumor excision

Fixation of Matrix

connective tissue
Connective Tissue
  • Tendons and Ligaments
    • Replace or strengthen damaged tissues in knees and other joints
  • Cartilage
    • Facial reconstruction
  • Fascia
    • Uterine & Bladder slings
    • Hernias
facial suspension
Facial Suspension

Reestablishment of facial symmetrywith a tissue sling

Hemi-facial paralysis

(Courtesy Dr. Frodel)

urological surgeries
Urological Surgeries

Bladder Sling Procedures:

Fascia is used to lift a bladder that doesn’t have the muscle control to keep in suspended.

vascular grafts
Vascular Grafts
  • Coronary bypass surgery
  • Restores blood flow
  • Prevents amputation
heart valves pericardium
Heart Valves/Pericardium
  • Replace defective heart valves
  • Better valve pressure than porcine or mechanical valves
  • No need for anti-coagulation drugs
  • Treatment of choice for pediatrics & women of childbearing age