Lecture 12 Flashcards
(24 cards)
What are the 3 potential donor pools?
- Organ donation (heart, lungs, liver, etc.)
- Tissue donation (skin, heart valves, bone)
- Eye donation (corneas, sclera)
What are the pathways to tissue/organ donation?
- Brain death (heart, lung, liver, kidney, pancreas)
- Circulatory death (lung, liver, kidneys, eye, bone)
What are the legal requirements of tissue/organ donation?
- Human Tissue and Transplant Act 1982
- Certificate of death
- AODR - donor consent (no objection recorded)
- Coroner’s consent
- Next of kin consent
- Designated/delegated officer authority
What are the 2 definitions of death?
- Irreversible cessation of circulation of blood in the body of the person
- Irreversible cessation of all brain function of the person
What are the causes of death in DBO donors?
- 53% stroke
- 25% hypoxia
- 14% trauma
- 7% other
What are the causes of death in DCD donors?
- 42% hypoxia
- 37% stroke
- 18% trauma
- 5% other
Causes of brain death in donors (5)
- Spontaneous Intracranial Haemorrhage
- Cerebral Oedema
- Trauma
- Hypoxic Injuries
- Tumours
Spontaneous intracranial hemorrhage
–> subarachnoid or intercerebral haemorrhage
Cerebral Oedema
Meningitis, acute hyperthermia/hypothermia
Trauma
Motor vehicle accidents, gun shot wounds, falls
Hypoxic Injuries
Cardiac arrest, drowning, hanging, asthma
Tumours
Primary brain tumours, astrocytomas
How to determine brain death?
- Clinical testing
- Radiological Imaging
o 4 vessel angiography
o Radionuclide scanning
–> to demonstrate that irreversible injury is not localised to brainstem
–> declared by 2 medical practitioners
What must designated officers demonstrate
That:
- Death has been diagnosed, including correct documentation
- donor has consented to, or not objected to, donation prior
- senior NOK has made decision on deceased behalf
- coroner has been informed and consent obtained
Serology & Tissue Typing of donation
Serology
- Viruses (HIV, Hep B/C, EBV, HTLV, CMV)
- syphillis
- toxoplasmosis
Tissue Typing & Cross-matching
- immunology at FSH
Nucleic Acid Testing
- HIV & Hepatitis B, C
Organ referral & allocation
- urgent listing
- donor info discussed & forwaded to transplant units
- potential recipients have tissue typing & immunology
- organ offers:
o Compatible blood type
o Size match
o Whoever is sickest
Tissue donation post OR
Corneas = 5-100 yrs
Bone Tissue = 15-65 yrs
Skin Tissue = <70 yrs
Heart Valves = <60 yrs
What % of organ donations come from hospital deaths?
1-2%
Organ age suitability;
Heart
< 60yrs CIT 4 hrs
Organ age suitability;
Liver
< 80yrs CIT 12hrs
Organ age suitability;
Lungs
5yrs < 70yrs CIT 6hrs
Organ age suitability;
Intestines
< 50yrs 6-10 hrs
Organ age suitability;
Kidneys
< 80yrsup to 24hrs
Organ age suitability;
Pancreas/ Islet cells
Pancreas 3yrs < 50yrs Islet cells 10yrs < 70yrs 12 hrs
