Organ Donation Flashcards
What are some OFTF recommendations?
- UK wide organ donation organisation (ODO) should be established, which is responsible for NHSBT
- Each trust should have an identified clinical donation lead and an NHS board donation committee to help achieve this
- BSD testing should be carried out in all patients where BSD is a likely diagnosis
- Donation activity must be monitored by potential donor audit
- Electronic on-line donor registration and offering systems
- UK wide network of dedicated organ retrieval teams for timely high quality organ removal
What does ODTF stand for?
Organ donation task force
What does ODO stand for?
Organ donation organisation
Living donors can be who?
- Blood relative
- Relative by marriage
- Friend
- Human tissue act 2004/06
- Paired
- Altruistic
What are the different donor criterias?
- Donation after brain death
- Patient confirmed brain stem dead
- Criteria for determining brain stem death
- Irreversible brain damage
- Exclude reversible causes
- Exclude depressant drugs
- Core temperature >34
- Exclude metabolic, circulatory and endocrine disorders
- Exclude reversible causes of apnoea
- Donation after circulatory death
- Significant brain injury, not able to meet brain stem death testing criteria
- Planned withdrawal of care
- Offered the option of organ donation to the family
What is the criteria for brainstem death?
- Irreversible brain damage
- Exclude reversible causes
- Exclude depressant drugs
- Core temperature >34
- Exclude metabolic, circulatory and endocrine disorders
- Exclude reversible causes of apnoea
What does ODR stand for?
Organ donor register
What must be check prior to approaching relatives for authorisation to harvest organs?
Prior to approaching relatives ODR must be checked
If no entry on ODR approach nearest relative for authorisation removal of organs
Who dictates the ethics of organ donation?
GMC
Solid organ donation can be done with?
- Kidney
- Liver
- Heart
- Lung
- Pancreas
- Small bowel
- Multi-visceral
Tissue organ donation can be done with?
- Eyes
- Cornea and sclera
- Bone
- Heart valves
- Tendons
- Skin
- Islets
- Hepatocytes
How does the waiting list compare to the amount of organ donors?
Massive gap
Roughly, what percentage of population are on organ donor list?
33%
Describe the process of organ donation?
- Donor identification
- Brainstem death/planned withdrawal
- Contra-indications
- HIV, known or suspected vCJD
- Organ donor register access
- Check the organ donor register
- Check if carried donor card
- Check if verbalised wishes
- Check if noted in will
- If unknown approach family for authorisation
- Approach to relatives
- Patients wishes paramount
- Family hierarchy
- Adult spouse or civil partner -> living with as husband and wife for not less than 6 months -> adults child -> parent -> brother/sister -> grandparent -> adults grandchild -> uncle/aunt -> cousin -> niece/nephew -> friend of longstanding
- If none available then authorisation cannot be given
- Screening
- Haematology
- Cross match, FBC, clotting
- Tissue typing
- U&Es/LFTs, amylase and phosphate
- Virology
- HIV, HTLV, Hep B, Hep C, CMV, Toxoplasmosis, Syphillis
- EBV
- vCJD
- Haematology
- Core donor data
- Blood gases
- All drugs on and given
- Fluid status/haemodilution
- Evidence of brain stem death on clinical records
- Haemodynamic status
- Physical examination
- Electronic offering
- Super urgent offering or national offering
- Donor management
- Follow-up
- Phone call following day family
- Meet with them for visit to mortuary
- Phone retrieval centres over next few days for recipient uptakes
- Letter to donor family
- Letter to all who participated in retrieval
Explain the family hierarchy for authorising organ donation?
- Adult spouse or civil partner -> living with as husband and wife for not less than 6 months -> adults child -> parent -> brother/sister -> grandparent -> adults grandchild -> uncle/aunt -> cousin -> niece/nephew -> friend of longstanding
What are haemodynamic goals for organ donation?
