Organ Donation 101

A very special day is just around the corner: the one day a year when you can give your heart to someone new… or your liver, or a kidney. That’s right – February 14th isn’t just Valentine’s Day, it’s also National Organ Donor Day! Today on the blog, we’re celebrating by exploring how organ donation works, so that you can make an informed decision about your preference to donate!

There are currently 119,000 men, women, and children on the national transplant waiting list, and 22 people die every day waiting for a transplant. The good news is that more that 130 million people in the U.S. are registered as organ donors, and one donor can save up to 8 lives. However, only 3 in 1,000 people die in such a way that allows for organ donation.

Image copyright Catherine Lane 2015

Image copyright Catherine Lane 2015

What is organ donation?

Organ donation is when a person allows healthy transplantable organs and tissues to be removed, either after death or while the donor is alive, and transplanted into another person. While most organ and tissue donations occur after the donor has died, some organs and tissues can be donated while the donor is alive.  The most common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas.

How does living organ donation work?

Nearly 6,000 living donations take place in the U.S. each year; that’s about 4 out of every 10 donations. Living donors can potentially donate one of their two kidneys, one of the two lobes of their liver, a lung or part of a lung, part of the pancreas, part of the intestines, skin, bone (typically after joint replacements), or bone marrow.

Potential living donors are evaluated by the transplant center where they intend to make the donation to determine whether they are suitable to be a donor. The evaluation is performed to make sure that no adverse physical, psychological, or emotional outcome will occur before, during, or following the donation. Generally, living donors should be physically fit, in good health, between the ages of 18 and 60, and should not have (or have had) diabetes, cancer, high blood pressure, kidney disease, or heart disease.

What are the long-term effects of being a living donor?

The National Institutes of Health (NIH) is conducting a study to collect information on the outcomes of living donors over time. At present, follow-up reviews of living donors by some transplant centers show that living donors, on average, have done very well over the long term. However, there is some question about the effects of stress on the remaining organ. There could be subtle medical problems that do not develop until decades after the living donation. The effects are not completely known at this time.

How does deceased organ donation work?

For someone to become a deceased donor, he or she has to die in very specific circumstances. Most often, a patient comes to a hospital because of illness or accident, such as a severe head trauma, a brain aneurysm, or stroke. The patient is put on artificial support, which keeps blood with oxygen flowing to the organs. If the patient passes while the medical team is trying to save their life, physicians will perform a series of tests to determine if brain death has occurred. A patient who is brain dead has no brain activity and cannot breathe on his or her own. Brain death is irreversible – someone who is brain dead cannot recover. Only after brain death has been confirmed and the time of death noted, can organ donation become a possibility.

The hospital notifies the local Organ Procurement Organization (OPO) of every patient that has died or is nearing death. The hospital gives the OPO information about the deceased patient to confirm whether he or she has the potential to be a donor. If the person could be a candidate for donation, a representative from the OPO travels immediately to the hospital. The OPO representative searches to see if the deceased is registered as a donor on their state registry. If so, that will serve as legal consent for donation. If the deceased has not registered, and there was no other legal consent for donation, such as a notation on the driver’s license, the OPO will ask the next of kin for authorization. After authorization, a medical evaluation takes place, including obtaining the deceased’s complete medical and social history from the family. If the deceased person’s evaluation allows donation, the OPO contacts the Organ Procurement and Transplantation Network (OPTN), which operates the national database of all patients in the U.S. waiting for a transplant. The OPTN enters information about the deceased donor into the computer system and the search begins.

How do patients get matched with their donations?

Patients on the waiting list for organ donations are registered in a national computer network operated by the Organ Procurement and Transplantation Network (OPTN). Whenever donor organs are identified, the OPTN generates a list of potential recipients who match the donor. Each available organ is offered to the transplant team of the best-matched patient. The transplant surgeon determines whether the organ is medically suitable for that patient or may refuse the organ—for example, if the patient is too sick to be transplanted or cannot be reached in time.

How do you become an organ donor?

The decision to be a living donor is very personal one. The potential donor must consider the possibility of adverse health effects after donation, as well as the potential to save the life of the recipient, who may be a loved one. If you decide to become an organ donor, you can register online in your state or sign up when you visit your state motor vehicle office.

When you register as an organ donor in your state, you’re authorizing donation of your organs if you die in circumstances that make donation possible. Most states give you the option to choose which organs and tissues you donate, or to donate everything that can be used. You can also change your donation status at any time if you change your mind about being a donor, or about which organs you wish to have donated.

 

Resources and further information:

https://organdonor.gov/index.html

https://medlineplus.gov/organdonation.html

 

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