Organ donation Flashcards
What is organ donation?
Refers to giving an organ to help someone who needs a transplant.
It is done with care and respect. Incisions are carefully closed and covered.
Types of organ donation?
Kidneys
Heart
Liver
Lungs
Pancreas
Small bowel
Types of tissue donation?
Tissue
Cornea
Bone
Heart valves
How many types of organ donor are there?
Three
Types of organ donor?
- Brain stem death
- Circulatory death
- Living donation
What makes a person eligible and not eligible for donation?
At the time of the death, the responsible Dr and team will decide whether some or all organs or tissue are suitable for transplant.
Not eligible:
- under age 18 (16 in Scotland)
- people who lack capacity to decide whether to opt out
- visitors to England, and anyone living in England for less than 12 months
What does the opt out system mean?
Opt out system was introduced in England during May 2020.
Once you are 18, you are automatically on the organ donation register. You can choose to opt out before you die and have that decision recorded. You won’t be considered in the organ donation register if you are under the excluded group.
What conditions will exclude you from donating organs and tissues?
HIV
Creutzfeldt-Jakob disease (CJD)
Active cancer (cancer that has spread in the last 12 months)
Ebola virus disease
Blood is taken from all potential donors and tested to rule out transmissible diseases and viruses such as HIV and hepatitis.
Factors to consider during patient selection and organ allocation?
Allocation = when an organ becomes available.
Equity: equal probability of receiving a graft.
Utility: greatest no. of life-years following the transplant.
Benefit: the greatest increase in life-years gained.
Family
Factors to consider for kidney acceptance?
Pt would be expected to be alive in 5 years and to be either on dialysis or starting dialysis within 6 months of joining the waiting list.
Factors that affect the decision:
- age for the donor
- donor factors (e.g. hx of cancer, other transmittable conditions)
- recipient has unusual tissue type or highly sensitised
What details are recorded when an organ donor is notified to NHS Blood and Transplant (NHSBT)?
Renal function
Blood group
Tissue type
This info is added to the national database.
How is kidney offered/matched to recipient?
Compatibility of blood group
Length of time on the waiting list (1point for every day of waiting)
Similarity of donor and recipient’s tissue types
If recipient has unusual tissue type, then more points/priority given as you don’t want to miss the rare chance of a transplant.
Recipient has developed antibodies that reduce the likelihood of a match.
Potential offers may be declined due to:
- kidney has a higher risk of failure than average
- recipient had a recent infection -unsuitable to undergo transplantation at the time.
Who is eligible for a liver transplant?
Pt lifespan will be shortened and quality of life will be poor.
Receiving a transplant allows the person to have >50% chance of living another 5 years with an acceptable quality of life.
How do we prioritise who gets a liver transplant?
Clinical urgency
- who needs it the most?
- who will die first without it?
Best match
- similar tissue type
Length of time on waiting list
UKELD (UK model for end stage liver disease)
- predicts prognosis in chronic liver disease
How do you assess quality of life?
Symptoms considered poor QOL:
- persistent tiredness, weakness, immobility, SOB
- ascites resistant to tx
- hepatic encephalopathy
