Title of presentationTitle of presentation

Introduction into Organ and Tissue Donation.

Christine Ross DSN CNC.

Introduction to Organ and Tissue Donation

• Organ Donation is a life-saving and life-changing medical process where organs & tissues are removed from a donor & transplanted into someone who is ill or dying from organ failure.

• There are 74 hospitals in Australia that have dedicated donation specialist staff and many more hospitals that contribute to Organ and Tissue donation services. The DonateLife Network includes OTA staff, DonateLife agency staff and DonateLife hospital-based staff who work with a broad range of colleagues in the health system, including eye and tissue banks, to implement the Australian Government’s national reform agenda to increase organ, eye and tissue donation for transplantation.

Who benefits from your gift of life• People need an organ transplant when their own organs are

failing. Organ failure can happen to people of any age, including babies, children and adults.

• One organ and tissue donor can save or enhance the lives of 10 or more people.

• Despite the hundreds of life-saving organ transplant operations performed in Australia each year, Australia meets only one third of its transplant demand.

• Almost anyone can donate organs and tissues. Age, health and lifestyle do not automatically exclude an individual from being a donor. The determining factors are where and how the donor dies and the condition of the organs and tissues.

• There are only a few medical conditions that may prevent someone from being a donor.

The Australian Situation

• Australia is a world leader in successful transplantation outcomes

• Our organ and tissue donation rates have remained relatively static over the past decade

National Reform AgendaInitiated to:

Improve the donation process

Remove barriers to donation through increased clinical capacity and capability in hospitals

Drive and co-ordinate a nationally consistent program

Build a national eye and tissue network

Optimize organ and tissue allocation

Build a National Information System

NSW Organ & Tissue Donation

7

Organ & Tissue Donation Services

• DonateLife NSW

• NSW Tissue Banks

Why think about Organ Donation now?

Fact: In your life time - you are 10 times morelikely to need a transplant than you are to be in the

position to be a donor

In addition….

• 90% Australians support organ & tissue donation

But…• 45% of Australians don’t discuss their

donation wishes with their family

Which results…• Half of families refuse donation when

asked

Our Message

•Discover the facts about organ and tissue donation

Discover

•Make an informed choice and Decide about becoming an organ donor Decide

•Discuss your decision with those close to you and know each other’s wishes

Discuss

• Kidney 1070

• Liver 111• Heart 192

• Lungs 149• Pancreas 39 • Intestine 1• Stomach 1

TOTAL 1563

Australian Waiting List as of 1st August 2012

29

878

88

1292

15

32

Australian Organ Donation Data 2012354 Donors

Australia 2012

1052

People who received a

life changing transplant

1099

103

29

234

105

266

275

55

ACT 32

Solid organs retrieved and transplanted

2012 StatisticsAustralia: 354 Donors 1099 Organs transplanted 73 intended donors 75 of the 354 were Donation after

Cardiac Death (DCD -22%) 15 Donors per million

1983 NSW Human

Tissue Act

History: The Donation ‘Timeline’

Christiaan Barnard – 1st Human Heart

Tx 1967

1966 Pancreas Tx1956 Kidney Tx

1986 Double Lung Tx

1985 Liver, Kidney Tx

1987 Kidney & Pancreas Tx

1990 Single Lung Tx

2007 NSW DCD Guidelines

1979 Netherlands

Australian Transplant Programs

Transplant & Donor Coordinator Appointments

Non-Heart Beating Donation

Donation After Brain Death (DBD)

DBD & Donation After Cardiac Death (DCD)

1983 UK, Sweden, Australia

1981 USA

1984 Heart Tx

1963 Lungs Tx

Pathways to Organ Donation

• Donation after Brain Death (BD)

• Donation after Cardiac Death (DCD ) • Live donation – kidneys and liver

segment • Tissue Donation – heart valves, eyes and

musculoskeletal tissue

What is a legal definition of death?

• Irreversible cessation of all function of the person’s brain,

or• Irreversible cessation of circulation

of blood in the person’s body.

Human Tissue Act 1983

Brain death

Cardiac death

Legislation

• NSW Human Tissue Act - 1983

• The Coroner’s Act - 2009

How does Brain Death occurSevere

cerebral injury

Brain swelling

Intracranial hypertension

Reduced cerebral

blood flow

Cerebral ischemia

As this cycle continues, cerebral

blood flow declines to a

point at which it ceases

altogether and whole brain death

occurs

What can be donated?HEART ( heart valves

only- if Donation after Cardiac Death)

LUNGS

LIVER

KIDNEYS

PANCREAS

EYES

HEART VALVES

BONES & TENDONS

Obtaining Consent

Phased out from Nov 2012

NOK

Coroners

AODR

Common Questions• Will doctors work to save my life if they know I’m a donor?

• Am I too old/too young or not healthy enough to donate?

• Can my family override my decision?

• Will donation disfigure my body?

• Will it cost my family money to donate organs & tissues?

• Will donation delay the funeral arrangements?

What About Religion ??

DONATION PROCESS

Why are Organ Donation rates so low?

• Brain Death only accounts for around 1.5% of hospital

deaths

• ~ 50% decline rate

• Improved Car/Road design

• Improved Health Care Delivery

• Falls prevention programs

• Workplace safety standards

1800 777 203www.medicareaustralia.gov.au

Tell your family! Tell your friends! Australian Organ Donor Register

How do you make your wishes known?

‘Next Step Program’

• Outcome of donation & support by phone• Resources - ‘In Reflection’ booklet• Access to Counseling• Annual Service of Remembrance and reflection• Correspondence from recipients• Cards on the 1st and 2nd Anniversary

Tissue recipients - tendonsThe generosity of her donor and their family have changed Morgan’s outlook on life - “I never really

thought about organ donation before… I may not have received a heart or a lung or something that is totally life-changing, but I have received…(a patella tendon graft)…

something that is helping me achieve my goals”

Tina Morgan, Australian Tae kwon doe athlete, Sydney Morning Herald, Sept 24, 2007

Winning her second Olympic gold medal Alisa Camplin thanked the organ donor whose generosity allowed doctors to repair

her right knee so she could compete -“I am a registered organ donor and I am the lucky recipient of one …thank you, thank

you …”

Alisa Camplin, Australian Aerial ski jumping athlete, The Age, January 27, 2004