Organ Donation Flashcards
What are the different types of living donations available?
• Blood relative • Relative by marriage • Friend • Human Tissue Act 2004/6 - Paired - Altruistic
What do blood relative have to go through before donating a kidney?
6 month surgical work up. Donor given opportunity to decline/change mind - medical/surgical staff will give them a reason they are unable to donate so they don’t have to explain reasons to family membe
What do non-blood relative/friends need to go through before donating a kidney?
Need to go through ULTRA - Unrelated Regulatory Authority - Human organ Transplants Act (1989) currently forbids organs transplanted between living persons who are not genetically related unless permission has been sought by ULTRA
What is altruistic donation?
Donation of kidney from a stranger
What is paired donation?
family members swap kidney donation as donator is not a match for their family member
What is the criteria to determine bran stem death to allow donation after Brain death?
- Irreversible brain damage
- Exclude reversible causes
- Exclude depressant drugs
- Core temperature >34°C
- Exclude metabolic, circulatory and endocrine disorders
- Exclude reversible causes of apnoea
What are two types of donation after death?
Donation after brain death and donation after circulatory death
What are the categories of donation after circulatory death which are important for retrieval and outcome of transplantation?
Non-heart beating
1: Dead on arrival- need to have witnessed sudden death
2: Unsuccessful resus
3: Awaiting cardiac arrest - death is inevitable but they do not fulfil brainstem dead criteria.
4: cardiac arrest in a brainstem dead cadaver
5: unexpected cardiac arrest in Pt in ITU
Name different types of solid organ donation
Kidney Liver Heart Lung Pancreas Small bowel Multi-visceral
Name different types of tissue donation
Eyes Bone Heart valve Tendons Skin Islets Hepatocytes
Describe the steps in the process of transplantation
- Donor identification
- Approach to relative/families
- Screening
- Core donor data
- Electronic offering
- Donor management
- Follow up
What is the process of donor identification?
• Brainstem death criteria/planned withdrawal
Contra-indications:
• Known HIV - have transplanted in past
• Known or suspected Image result for Variant Creutzfeldt-Jakob disease (vCJD
• Everyone else assessed on an individual basis
- Current/Past Medical History
- Procurator Fiscal/Coroner
How do you know if a person is on the Organ Donor Register Access?
• Check the Organ Donor Register • Check if carried a Donor Card • Check if verbalised wishes • Check if noted in a will In unknown family approached for authorisation
What family members can give permission for a Pt to donate organs?
- Adults spouse or civil partner
- Living with as husband and wife/civil partnership > 6 months
- Adults child
- Parent
- Brother/sister
- Grandparent
If none available, authorisation cannot be given
What screening tests are done to assess if a person can donate?
- Blood: cross match, FBC, blotting
- Tissue typing
- U+Es, LFTs, amylase + phosphate
Virology:
• HIV, Hep B, Hep C, Syphillis
• EBV - paediatrics specifically
• cCJD tissues only
