[J. B.]

It has been said that organ recovery and the trasplant are done at the same location. In many cases here in the US that can and does happen. However there are also as many times where the potential organ donation occures in area of the country far away from where the alocation and tranplantation it self happens. The logistics involved, the distance and time relationship to post cross cllamp time are just some of the things that play a role in where organs are actually transplanted.

[J. B.]

My history with coroner relations I have found many and most support organ transplantation. It is critical to have coroner support in any procurement efforts and without it recovery can be literally impossible. Education and good communication and trust are key for it to be a colaborative and functional relationship.
I have know some that are so supportive that without their cooperation any efforts would have failed.
I have also had instances where Legal-medical-social eligibility all existed and recovery could not be pursued because of a coroner rule out for reason that could not be justified.
As for doing the autopsy at the time of organ recovery or in conjunction with, that is happening in some circles in the US and with great success. Howwever it is not manditory and autopsy can certainly be performed after organ recovery. For this to be collaborative the relationship between the recovery surgeons, procurement agency and coroner office must be well established. Usally a understanding and ability for a complete and throughal visual examination and discription of the body is required so that aftet the surgical procedure the coroner can have some evedense preservered ( including Phots ) if needed to assit the coroner in their duties.

[caroladybelle]

Originally posted by gwenith

We don't pay for organs or tissue full stop. Having said that we do have children from overseas (most notably Japanese) who are recipients and of course they have to pay all hospital costs but the tissue/organ is not "paid" for - it is considered a donation.

Most countries have a number of Japanese on their potential recipient lists. As Japan does not recognize "brain death", lung/heart transplants are nearly non existant there, or so is my understanding (d/t the short period of time that a heart is good for outside a physiologically "living" host - recovering a viable organ, with required tests and moving it to the needed locale in the brief time period is not generally possible - other than a "brain death" situation)

[gwenith]

I have also been told that it is a cultural thing - many Japanese just do not donor the way we do. They are put on our lists but NOT ahead of the um "non-paying" customers. If a match comes up - they get it simple as that.

[J. B.]

The fact is donation rates are actually about same for evey ethnic group in the US. to say one donates more than another is a misconseption. When grouped together the overall rates are low to begin with and the differences between are really negligable.
The unknown fact is that more want to donate than actuall become eligible.
As for understanding brain death it is not an easy thing to grasp let alone accept.

[gwenith]

Someone once pointed out to me that one of the difficulties with brain death is that we are attempting to get the family to accept social death before actual death and this is the reverse of the normal cycle of events - no wonder teh families have such a hard time. I always feel that in the case of the brain dead patient it is the only time when needs of the relative outweigh those of the patient.

[J. B.]

The thing is when the family has lost all control and greiving the loos of a loved one it is often theaputic in the lives of the donor family that they be given some decision making power. Especially when the wishes of the deseased are know it is often very heplful for the family to be able to ack on behalf of the loved one ...out of respect as a last gesture in fulilling the wishes of the deseased. They are ofter very offended when someone decides for them without any consultation.
The relatives are acting on behalf of their loved one.