Organ donation and transplantation

Question 1

Lawful use of tissue and organs under the Human Tissue Act

Answer 1

Storage or use of the body parts of any living or dead person can be done for the purposes of:

Anatomical examination
Determining the cause of death
Public display
Transplantation
Research in connection with disorders or functioning of the human body

Question 2

Types of tissue that can be used for transplantation

Answer 2

Organs and parts of organs

Gametes

Other tissue - blood, bone marrow

Tissue can be replaceable or irreplaceable.

Question 3

Appropriate consent for donation

Answer 3

Living adult:
Consent must be explicit and given by a competent adult over 18. Must have valid consent.

Deceased adult:
For anatomical examination or public display, explicit consent must be given in writing and be witnessed before their death. Only consent acceptable.
For other purposes consent can be given by the deceased before their death, nominated representatives or someone in a ‘qualifying relationship’ before they died

Question 4

Appropriate consent for donation in children

Answer 4

Consent is appropriate if the child has given a valid consent. It not, consent should be given by someone with parental responsibility for the child

Dead child:
Removal, storage or use of body parts for public display or anatomical examination, consent must be given by the child, witnessed and in writing when alive.
For other purposes, consent can be given by the child prior to death, from someone with parental responsibility or someone in a qualifying relationship

Question 5

Types of living organ donation

Answer 5

Directed (specified person, paired or pooled)

Altruistic

Question 6

Qualifying relationships for giving consent

Answer 6

Heirarchy of relationshiops:

1. Spouse or partner
2. Parent or child
3. Sister or brother
4. Grandparent or grandchild
5. Niece or nephew
6. Step-parent
7. Half-sister or brother
8. Friend of long standing

Question 7

Advantages and disadvantages of Opt in systems

Answer 7

Values autonomy: as long as family cannot override decision

Allows for religious and other objections

Inadequate supply for present needs

Need to check record of donation intention

Question 8

Advantages and disadvantages of an opt out system

Answer 8

May increase supply

Still allows for autonomy if not overridden by family

Raises worries about state of ownership of bodies, trust between doctors and patients and the definition of death

Question 9

Sources of organ transplantation

Answer 9

Xenotransplantation

Living donation

Cavaveric donation - Circulatory or brainstem death

Question 10

Criteria for confirmation of cardiac death

Answer 10

5 minutes of asystole