The Need:What’s Being Transplanted? Organs:

– in adults & children with end-stage organ failure

– Heart – Heart-Lung– Lung

single or double

– Liver– Kidney– Kidney-Pancreas– Pancreas only– Intestine

Organ Donor Demographics

AGE

NOTE: Data subject to change due to future data submission or correction.

January 2000 through December 2000

0 - 54%

6 - 104%

11 - 154%

16 - 2018%

21 - 309%

31 - 4013%

41 - 5021%

51 - 5511%

56 - 606%

61 - 656%

66 - 704%

82 recovered donors

Transplant waiting list as of February 24, 2003…

80,432 patients are currently waiting nationwide for a live-saving organ transplant.

Over 2,000 patients are waiting here in Virginia.

Three Virginians die each week waiting.

The Problem:•Nearly 2,000 Virginians are waiting for an organ transplant•Every week three Virginians die waiting for an organ transplant•As of October 8, 2003, 82,808 were waiting foran organ transplant in the United States.

THE NEED: ORGAN DONORS AND PATIENTS WAITING1988 through 2000

0

10000

20000

30000

40000

50000

60000

70000

80000

90000

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Organ Donors Patients Waiting

Organ Donor Criteria Age is generally less than

80, but is based on patient’s current medical history

Dead by Neurologic Criteria– “Brain Dead”

Medical history is examined at the time of death

Free of HIV – all serologies are examined at

time of death

Death by Neurological Criteria

An individual with irreversible cessation of all functions of the entire brain, including the brainstem, is dead.

JAMA 246:2184-2186, 1981

Organ Donor Demographics

COD

NOTE: Data subject to change due to future data submission or correction.

January 2000 through December 2000

11

15

45

6

3

2

0 5 10 15 20 25 30 35 40 45 50

GSW

MVC

CVA

Head Trauma

Anoxia

Other

Number of Donors

82 recovered donors

Arrival at

Hospital

EMS

Recognition asPotential Donor

Brain Death

Referral to LifeNetfor Initial Evaluation

Authorization

Donor Management with LifeNetDonor Management with LifeNet

Organ Resuscitation(Enhance organ

oxygenation& perfusion)

Organ PlacementSerology

Lab resultsOR time

Coordinateteams

Organ Recoveryin OR

Transp

lant

Organ Donor Case Overview

Tissue Donor Criteria Donation occurs after

cardiac death Criteria:

– Age < 70– Recovered within 24 hours

after death if body is cooled in the first 12 hours

– No active, transmissible disease

– No autoimmune disorder

The Need: What’s Being Transplanted Heart valves Pericardium Skin Bone -Whole or processed

grafts Veins Fascia Ligaments/Tendons

Eye Donor Criteria Donation occurs after cardiac

death Criteria:

– No upper age limit– 1 year to 68 years

cornea transplant

– Less than 1 year or greater than 68 years

research

– History of cancer is acceptable– Other research for patients with

history of glaucoma, diabetes, etc.

The Need:What’s Being Transplanted?

Eyes:– Cornea, Sclera– Whole Eyes for Research

The Donor Card A donor card is now recognized as a legally binding document and

cannot be overturned by the family.– Amendment is possible

Donation by Donor Designation…

The way to succeed:save7lives.org

•A new way for Virginians to record their donation decisions A Website where Virginians can learn more about organ donation and make an informed decision•An on-line process that is simple and convenient

Common Concerns About Donation Disfigurement Funeral Arrangements Financial Responsibility Religious Beliefs “I cannot be a donor

because of my medical history.”

“If I want to be a donor, they won’t try and save me!”

Some Donation Controversies Who should be

transplanted? – U.S. Citizens only? – Smokers? Alcoholics? – The very young or old?– The rich or the poor? – Those in prison? – Only those who have agreed

to be donors themselves?

Some Donation Controversies

How should organ donation be increased?– Financial Incentives– More Public Education? – Presumed Consent?

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