Organ Donation/Recovery

itsme · Nov 7, 2003

Yes! Hopefully if a person is of driving age, they have looked into it and are using the donor stickers on there license, otherwise, I do think that the next of kin, POA, or guardian should have the right to make that decision. When I die, I hope to donate everything possible, then go to science, hopefully that would make something good from my death, and if it can give someone a chance at life, or if my body can be used for research, then I will die a happy woman!! There are too long of waiting lists for needed organs, and not enough donors!

EastCoast · Nov 7, 2003

I think that a dying persons predisclosed wishes should be 'considered' however in some cases the parents/family can not really consider donation for whatever reason. I think if it is going to cause great psychological trauma for the living survivor it is not appropriate. The point of donation is not to make someone live longer and have a person who is more devestated standing at the grave of the donor. Organ procurment organizations understand this theory as well.

In china ( i believe...may be another country...too early in the AM to think )they take prisioners and shoot them. Then they call the families after the organs have been retreived. THis is barbaric. Other countries have presumed consent. That does not seem like a bad idea as people know long before someone dies they have potential to be an organ donor.

gwenith, BSN, RN · Nov 7, 2003

Unless it was overturned a couple of our states had "opt out" laws - in other words you are considered a donor unless you state otherwise but even in this case or the case of a clear living will we will never retrieve organs from a patient if the relatives do not wish it.

J. B. · Nov 7, 2003

Thanks for the comeback.

During my tinure I learned that even if the wishes were know (donor card or verbal acknowledgement prior to trauma and brain death if the family refused we did not persur recovery if medical eligibility existed. Reason being...family can take you to court the deseased can not.

In areas or countries have presumed consent this doesnt mean that the individual actually reaches medical or legal eligibility. In addition Family consent is sought because the deseased body become the property of the Next-Of-Kin. For example even if there is an autopsy required by a corner a consent is requested..If the hospital wishes to perform an autopsy consent must be obtained... mortisian must get consent to prepare the body for bural.

J. B. · Nov 7, 2003

I probably should post that if you wish to have a question answered and want to seek a more current and authoritative person I would suggest you contact your local Organ and or Tissue Procurement Agancy in your region. SOme are under the same roof and of course Lions Eye Bank may or may not be connected to your local procurement agency.

gwenith, BSN, RN · Nov 8, 2003

John Australia has a totally DIFFERENT set up to the US. A lot of our donations are free. We do not buy blood for example. We have a free hospital system and the "procurment agency" is the retrieval team at the hospital where the transplant will occur.

We also have less litigation and as far as I know there is no consent for autopsy.

EastCoast · Nov 8, 2003

In the US the recipient pays for the transplant (or the insurance company that is). If we have someone with suspicious brain death in our state then the Med. Examiner has jurisdiction of the body and he is the one who can also either collaborate with the organ bank in asking the family or can have full jurisdiction and not allow anything to be done. This to me is ridiculous. Why can't an autopsy be performed simultaneously in these circumstances?

J. B. · Nov 11, 2003

Looks like I have some followup to add just dinner time here will get back as sonn as can

gwenith, BSN, RN · Nov 11, 2003

Warning for any lay persons reading this thread - please stop right here. We will be discussing organ retrieval as a dispassionate subject and at no time will we be meaning any disrespect or diparagement to those who have died. Organ donation is a wonderful thing and a marvelous gift of life, however to discuss the legalities and impacts we have to be dispassionate and clinical.

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. I have seen a case where the autopsy was conducted after retrieval but it was in the case of a patient with a primary and severe head injury (epidural). Each of the attending surgeons had to make a statement about the condition of the tissue/organ that they removed and then the state coroner added his findings and finalised the report. It was an interesting read from a clinical viewpoint as the coroner clearly detailed the initial injury and the subsequent bleed and then the damaged caused as the epidural was not picked up in time. (Patient originally came from a very small remote area hospital that did not have a CT scanner and by the time they flew someone out - well you know the rest - so sad)

J. B. · Nov 11, 2003

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. · Nov 11, 2003

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.