Organ Donation and Transplatation – Types, Process, Protocols

Organ donation and transplantation is removing an organ from one person (the donor) and surgically placing it on another person (the recipient) whose organ has stopped working. Organs that can be donated consists of the liver, kidney, pancreas and heart.

What is organ donation and transplantation?

Organ donation is the process of surgically removing an organ or tissue from one person (the organ donor) and placing it into another person (the recipient). Transplantation is important because the recipient’s organ has stopped working or has been damaged by disease or injury.

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Organ transplantation is one of the great achievements in modern medicine. Unfortunately, the need for organ donors is much greater than the number of people who really donate. Every day in the United States, 21 people die waiting for an organ and more than 107,380 men, women and children await life-saving organ transplants.

What organs and tissues can be transplanted?

Organs and tissues that can be transplanted consists of the following:

• Liver.
• Kidney.
• Pancreas.
• Heart.
• Lung.
• Intestine.
• Corneas.
• Middle ear.
• Skin.
• Bone.
• Bone marrow.
• Heart valves.
• Connective tissue.
• Vascularized composite allografts (transplant of several structures that may include skin, uterus, bone, muscles, blood vessels, nerves and connective tissue).

Who can be an organ donor?

People of all ages should regard themselves potential donors. When a person dies, they are assessed for donor suitability based on their medical history and age. The organ procurement organization decides medical suitability for donation.

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How do I become an organ donor?

Individuals who are interested to be organ donors should fulfill the following steps:

• You might join a donor registry. A registry is more than just an expression of interest in becoming a donor. It’s a way to legally give consent for the anatomical gift of organs, tissue and eyes. Each time you go to your local Bureau of Motor Vehicles (BMV), you will be asked, “do you want to make an anatomical gift?” All you have to do is say “Yes.” You can also join the registry at any time by filling out a “Document of Gift” form from the BMV. For more information, go to www.lifebanc.org and click on donor registry. Donor registry information for any state might be obtained from www.donatelife.net.
• Sign and carry an organ donor card. This card can be downloaded at: www.organdonor.gov.
• Let your family members and loved ones know you’d like to be a donor.
• You might also want to tell your family healthcare provider, lawyer and religious leader that you’d like to be a donor.

By becoming an organ donor, does this mean that I wouldn’t be eligible to receive the best medical care possible?

Not at all. Your decision to donate does not affect the quality of the medical care you will receive.

Costs to the organ donor’s family for donation

There is no cost to the donor’s family for the donation of organs, tissue or eyes. Funeral costs will be the responsibility of the family.

Will organ donation disfigure the body?

The recovery of organs, tissue and eyes is a surgical procedure performed by trained medical professionals. Generally, the family may still have a traditional funeral service.

If I need an organ or tissue transplant, what do I need to do?

If you need a transplant, you need to get on the national waiting list. To get on the list, you need to visit a transplant hospital. To find a transplant hospital near you, visit the Scientific Registry of Transplant Recipients (SRTR) and use the search function on the top of the page.

The transplant hospital’s multi-disciplinary team will evaluate you and decide if you are a suitable transplant candidate. In addition to criteria developed for some organ types by United Network of Organ Sharing (UNOS), each transplant hospital has its own criteria for accepting candidates for transplant.

If the hospital’s transplant team determines that you are a good transplant candidate, they will add you to the national waiting list. You can get on the waiting list at more than one transplant hospital, and UNOS policies do permit “multiple listing.” However, be sure to check each transplant hospital’s guidelines about who will be the primary care provider.

Next, you wait. There’s no way to know how long you’ll wait to receive a donor organ. Your name will be added to the pool of names. When an organ becomes available, all the patients in the pool are assessed to determine compatibility.

What organization actually manages the distribution of organs? What is the process to receive an organ or tissue?

UNOS maintains the national Organ Procurement and Transplantation Network (OPTN). Through the UNOS Organ Center, organ donors are matched to waiting recipients 24 hours a day, 365 days a year.

When an organ becomes available, the local organ procurement organization sends medical, social and genetic information to UNOS. UNOS then generates a list of potential recipients, based on such factors as:

• Blood type.
• Tissue type.
• Organ size.
• Medical urgency of the patient’s illness.
• Time already spent on the waiting list.
• Geographical distance between the donor and the recipient.

The organ is offered first to the transplant center with the candidate who is the best match. The transplant team decides if it will accept or refuse the organ based on established medical criteria and other factors.

If the transplant center refuses the organ, the transplant center of the next patient on the list is contacted and the process continues until the organ is placed.

Types of Donation

Living donation

Living donation provides another option for transplant candidates, and it saves two lives: the recipient and the next one on the dead organ waiting list. Even better, kidney and liver patients who are able to receive a living donor transplant can receive the best quality organ much earlier, usually in less than one year.

A living donor is a choice for patients who otherwise may face a lengthy wait for an organ from a dead donor. To spare a person a long and uncertain wait, relatives, loved ones, friends, and even individuals who wish to stay anonymous may serve as living donors.

Kidney and liver transplant candidates who are able to receive a living donor transplant can receive the best quality organ much earlier, usually in less than a year.

• More than 100,000 people are on the national transplant waiting list.
• More than 85% of patients waiting are in need of a kidney.
• 11% of patients waiting are in need of a liver.
• In 2020, 5,700 more lives were saved through the kindness of living donors.

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Facts about Living Donation

Want to know more about living donation? Here are some important facts:

• Living donation is an option to save a life while you are still alive.
• Living organ donation and transplantation was formulated as a direct result of the critical shortage of dead donors.
• Living donors don’t have to be in relation to their recipients. On average, 1 in 4 living donors are not biologically related to the recipient.
• Patients who obtain a living donor transplant are eliminated from the national transplant waiting list, making the gift of a dead donor kidney or liver available for someone else in need.

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Deceased donation

Deceased organ, eye or tissue donation is the process of giving an organ (or a part of an organ), eye, or tissue at the time of the donor’s death, for the need of transplantation to another person. At the end of your life, you can give life to others.

Deceased donation consists of organ, cornea and tissue donation.
Deceased organ donation is the process of giving an organ or a part of an organ, at the time of the donor’s death, for the need of transplantation to another person. Cornea donation replaces sight and tissue donation helps save and cure lives.

In order for a person to become an organ donor, blood and oxygen must flow through the organs until the time of replacement to confirm viability. This requires that a person die under circumstances that have caused by a fatal brain injury, often from massive trauma resulting in bleeding, swelling or lack of oxygen to the brain.

Only after all efforts to protect the patient’s life have been exhausted, tests have been conducted to ensure the absence of brain or brainstem activity, and brain death has been confirmed, is donation a possibility.

The state and national Donate Life Registries are searched securely online to determine if the patient has personally authorized donation. If the potential donor is not found in the Registry, his or her next of kin or legally authorized representative (usually a spouse, relative or close friend) is offered the opportunity to authorize the donation. Once the donation decision is established, the family is asked to provide a medical and social history. Donation and transplantation professionals determine which organs can be transplanted and to which patients on the national transplant waiting list the organs are to be allocated.

Vascularized Composite Allografts (VCA)

Vascularized Composite Allografts (VCAs) involve the transplantation of multiple structures that may include skin, bone, muscles, blood vessels, nerves and connective tissue. The most commonly known type of VCAs are for hand and face transplants.

Vascularized Composite Allografts (VCAs) involve the transplantation of multiple structures that may include skin, bone, muscles, blood vessels, nerves and connective tissue. The most commonly known type of VCAs are for hand and face transplants. Federal regulations for VCAs became effective in July 2014. This groundbreaking form of therapy returns vital function and identity to people who have suffered a devastating injury or illness.

VCA requires a specific authorization, separate from a standard donor registration. Authorization for VCA is never assumed as part of a registration to be an organ, eye and tissue donor. VCA authorization must be specifically stated by an individual on his/her donor registration or by the legal next-of-kin if authorizing the donation at the time of death.

Pediatric donation

Pediatric transplants differ slightly from other organ donations — as organ size is critical to a successful transplant, children often respond better to child-sized organs. There are currently 2,000 children under the age of 18 waiting for a variety of organs, and nearly 25% of them are under 5 years old.