April 30, 2012
Organ and tissue donation can help to save the lives of so many others during this time where it is greatly needed. There are many people on the waiting list to receive an organ due to illness or complications with their own organs and those that receive the miracle of an organ that is donated that actually matches them as well, can live a better, longer quality of life. Health care and technology have grown so far to be able to transplant a human organ from someone who has passes away into another person who is in great need of it to live. Unfortunately there are more patients on the waiting list than there are organ donors and the need keeps rising. There are many ethical and legal issues that surround this gift of life but what is most important is that patients and their families understand what this all entails so that health organizations can act quickly in utilizing their wishes.
Organ transplantation became known in the late 1980’s and with the improved guidelines and structure and the immuno-suppressant drugs to decrease tissue rejection has been a nation-wide success in helping those that are in need of an organ. There are federal regulations that hospitals are to adhere to when they are dealing with organ procurement responsibilities that include the staff duties and notification along with how to deal with the family concerns of the deceased. “Organ transplantation is done to treat patients with end-stage organ disease who face organ failure” (Pozgar, 2010).
The table below represents a seven year study done to see if the Certified Requestors would help in increasing donors. “Certified Requestors are individuals trained and certified by the UWHC-OPO to discuss with patient families the DCD (donation after cardiac death) donation process and they are ultimately responsible for making the organ donation request. In this regard, increasing the support and motivation of Certified Requestors is seen as a key to achieving increased support from families” (D'Alessandro, Peltier, & Phelps, 2008).
(D'Alessandro, Peltier, & Phelps, 2008).
Legally there has to be a cardiac death before consideration of donating is brought up to the families. Another view of this is that some feel that brain death could constitute as death and then after the medical equipment to keep the person alive is taken away, donating could be an option. Unfortunately, when the medical equipment is removed there could be a lesser chance of them to donate because of how long it will take the heart to stop before they can clinically pronounce death. There are donors that have not been able to donate organs because of the small window of opportunity has been superseded due to their heart still going and the organs and tissue lacking the oxygen and blood flow needed to keep them for a recipient. This is not a new or untested approach. DCD (donation after cardiac death) is an extremely well-established medical practice, and has been a standard for decades in countries around the world. In fact, DCD donations account for anywhere between 20% and 50% of donations in the world's top performing countries. “It is unlikely that the DCD donor satisfies the criteria for brain death at the time of organ procurement as it takes longer than five minutes for the entire brain to be irreversibly damaged from lack of oxygen. The speed with which a diagnosis of death is made in the DCD context is done solely to facilitate organ procurement. The closer the donor is to life, the more useful the organs will be to the recipient” (Harrington, 2009 p 98). When a patient is brain dead, they are not able to live without machines because the body functions are all part of the brain so if they have wishes to be a donor, their body is kept alive by the machines until a team can come to remove the organs. The blood is still circulating through the organs and tissue to keep them...
References: Childress, J. F. (2008). Organ Donation after Circulatory Determination of Death: Lessons and Unresolved Controversies. Journal of Law, Medicine & Ethics, 36(4), 766-771. Doi:10.1111/j.1748-720X.2008.00336.x. Retrieved from EBSCOhost: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=5cd246a4-61a1-4aff-adbc-6f1ce38f1039%40sessionmgr115&vid=5&hid=105
Clark. (2011). The Organ Donor’s Bill of Rights. Retrieved from: http://livingdonorsonline.org/ldosmf/index.php?topic=616.0
D 'Alessandro, A. M., Peltier, J. W., & Phelps, J. E. (2008). Increasing Organ Donations After Cardiac Death by Increasing DCD Support Among Health Care Professionals: A Case Report. American Journal of Transplantation, 8(4), 897-904. doi:10.1111/j.1600-6143.2008.02155.x Retreieved from EBSCOhost: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=4&hid=105&sid=4e788749-8249-4e3a-a7f1-bcd05228015e%40sessionmgr111
Gift of a Lifetime. (2004). Retrieved from: http://www.organtransplants.org/understanding/religion/
Harrington, M. M. (2009). The Thin Flat Line: Redefining Who is Legally Dead in Organ Donation After Cardiac Death. Issues In Law & Medicine, 25(2), 95-143. Retrieved from EBSCOhost: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=53631154-34ac-4434-9293-d09bbd916453%40sessionmgr113&vid=16&hid=105
Pozgar, George D. (2010). Legal and Ethical Issues for Health Professionals (2nd Edition). Sudbury, MA: Jones and Bartlett Publishers, LLC. ISBN: 9780763764739
Steinbrook, R. (2007). Organ Donation after Cardiac Death. New England Journal of Medicine. 357:209-213. Retrieved from: http://www.nejm.org/doi/full/10.1056/nejmp078066
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