The Need:

Whats Being Transplanted?

Organs:
in adults & children with endstage organ failure Heart Heart-Lung Lung

single or double

Liver Kidney Kidney-Pancreas Pancreas only Intestine

AGE
0-5 4% 66 - 70 4% 61 - 65 6%

Organ Donor Demographics

January 2000 through December 2000
11 - 15 4% 16 - 20 18% 82 re cov e re d donors 6 - 10 4%

21 - 30 9%

56 - 60 6% 31 - 40 13% 51 - 55 11%

41 - 50 21%
NOTE: Data subject to change due to future data submission or correction.

Transplant waiting list as of February 24, 2003 The Problem:

Nearly 2,000 Virginians are waiting for an 80,432 organ transplant patients are currently waiting nationwide for a livesaving organ transplant. Every week three Virginians die waiting for an organ transplant As of Over 2,000 patients are waiting here in Virginia. October 8, 2003, 82,808 were waiting for an organThree Virginians die each week waiting. transplant in the United States.

THE NEED: ORGAN DONORS AND PATIENTS WAITING

1988 th rough 2000 90000 80000 70000 60000 50000 40000 30000 20000 10000 0 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 patients 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

COD
Other 2

Organ Donor Demographics

January 2000 through December 2000
82 recover ed donors Anoxia 3

Head Trauma

CVA

45

MVC

15

GSW

11

10

15

20

25

30

35

40

45

50

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

Organ Donor Case Overview

Transplant Donor Management with LifeNet

Arrival at Hospital

Authorization
Brain Death

Recognition as Potential Donor

Organ Recovery in OR Organ Placement

Organ Resuscitation
Serology Lab results OR time Coordinate teams

EMS

Referral to LifeNet for Initial Evaluation

(Enhance organ oxygenation & perfusion)

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: Whats 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:
Whats 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 wont 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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