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How Does the Donor Process Work?
Gift of Life coordinates the recovery of organs and tissues for transplant. The process is complex and involves medical professionals at many different levels.
Partnerships with regional hospitals enable the process to work smoothly 24 hours a day, seven days a week, 365 days a year. In addition, support from a network of professionals at area tissue and eye banks, tissue and blood typing labs, courier services, air charter firms, among others provide services that ensure the success of donation and transplantation.
At the center of donation is the generosity of those individuals who say "yes" to donation.
Cause of Death
- A person's cause of death determines what organs and tissues can be donated. Most organ donors suffer fatal head injuries such as those from car accidents, stroke or a brain aneurysm.
- Until death has been declared, however, donation is not even part of the equation. For the hospital and the medics who respond to an incident, their sole efforts are to save the lives of the victim. The doctors will do everything in their power to save the lives of the individual. Only after all life-saving measures have been explored is donation considered.
- The declaration of death is contigent upon whether the patient died of cardiac death or brain death, and that then determines how donation can proceed.
- You can learn more about these two types of death in greater detail HERE.
Donor Referral from the Hospital
- A physician, nurse supervisor, emergency room or intensive care unit nurse or health care professional is required to call their local organ procurement organization with any death or imminent death of a patient. In eastern PA, Southern NJ and DE, hospital staff would notify Gift of Life. We review the potential donor's medical condition and history to determine what gifts he or she would be able to donate.
- After a series of tests, a physician declares the patient brain dead. This is done in accordance with accepted medical practice, usually by a neurosurgeon or neurologist. An individual who is brain dead has no brain activity.
- If the patient is a candidate for donation, a transplant coordinator from Gift of Life immediately travels to the hospital to review the patient's chart and meet with the medical team.
Gift of Life Evaluates Potential Donor
- At a sensitive and appropriate time, a Gift of Life transplant coordinator meets with the family. After offering condolences, the conversation begins with whether their loved one has made the decision to donate. In cases where the potential donor has made the designation decision, the coordinator counsels the family on the process as the recovery proceeds. If there has been no decision made prior, the transplant coordinator speaks to the family and help them understand the amazing life-saving opportunity that organ and tissue donation possesses. Once the family consents to donate, the coordinator begins the rigorous work of making the donation happen.
- If the patient's medical history does not rule out donation, Gift of Life then begins the process of identifying potential recipients. A Gift of Life transplant professional will consult the national list of patients awaiting transplants maintained by the United Network for Organ Sharing (UNOS) located in Richmond, VA. The registry includes medical information about the patient, the length of the time the patient has been waiting, the transplant center(s) where the patient is waiting, etc. The waiting list is constantly changing as new patients are added to the list, and as others are taken off of the list due to death, a transplant or a change in medical status.
- A Gift of Life transplant specialist enters the donor's basic medical information into a computer system at the Gift of Life office, which is then shared with the transplant centers. The transplant surgeons review their list of patients (by organ type) who match the donor, starting at the top of the waiting list. If the surgeon declines, the next highest patient on the list is considered for the transplant. Gift of Life works to ensure that all available organs are allocated to waiting recipients.
- Each organ is allocated based on different criteria. However, the list will be sorted by the patient's medical urgency, degree of match to the donor and the time on the waiting list. Most organs that are donated locally (about 75 percent) are given to local patients. The remainder is shared with patients in other regions of the country. The list does not reference race, gender, age, income or social status.
- Meanwhile at the hospital, the donor's vital signs are carefully monitored by the hospital medical staff with the support of the Gift of Life transplant coordinator. Adequate heart rate, blood pressure, respiration and urine output are critical to maintaining the viability of the donor's organs for transplant.
- The Gift of Life transplant coordinator arranges the arrival and departure times of the surgical recovery transplant teams. The procurement team consists of a surgeon(s), a nurse or other clinician and a Gift of Life organ preservationist. Due to increased preservation times, up to 72 hours for kidneys and 24 hours for livers, the transplant team will normally drive to the hospital. Heart or lung transplant teams often fly because these organs can be preserved outside of the body for only about four hours.
Surgical Recovery of Organs and Tissues
- After the surgical teams arrive, the donor is taken to the operating room.
- Organs and tissues are recovered from the donor. Tissue recoveries such as bone, cornea and skin occur following the organ recoveries. The appearance of the donor is not affected, and open-casket funerals are still possible.
- As the organs are recovered from the body, they are infused with a cooled solution, which flushes all blood out of the organ - the key to preserving the organ. The organ is measured and evaluated closely and placed in a sterile container that is then packed in a sterile solution and ice for transportation to the hospital where the transplant will take place.
- Kidneys require additional testing to determine which recipient is the best match for the donated organ. A Gift of Life preservationist takes tissue and blood samples from the donor to a lab for further testing. Tissue typing such as this can take up to eight to 12 hours. For hearts and livers, the recipients have already been identified by the time the organ recovery takes place.
- Once recipients are identified, they are asked to arrive at the hospital and prepare for transplantation.
Organs Are Transplanted
- Transplants are performed.
- Gift of Life provides follow-up services which include writing letters to the donor family informing them of very general information about the individuals whose received their loved ones donated organs. (The names of recipients are not released.) Letters are also written to the physicians and nurses who helped to care for the donor at the area hospital.
- All costs incurred during procurement are billed to Gift of Life. The transplant recipient's transplant hospital will then reimburse Gift of Life for procurement costs. In turn, the hospital is reimbursed by the recipient's insurance company or through Medicare.
- Family Support Services, a free program provided by Gift of Life, will contact each donor family about one month after the donation. These services are provided by clinical social workers who specialize in helping individuals and families deal with illness, disability and death of loved ones.
- FSS staff will continue to provide information, program and services to the family, including grief resources, counseling and opportunities with other donor families and recipients for at least one year following donation.