Chapter 5 - Organ Donation

RN role in terms or organ donors?

Refer a potential organ donor to Organ Procurement Organization (ex. LifeGift)

Living Donor

• healthy donor after medical evaluation

• > 18yrs

• BMI < 35

• no drugs/alc problems

Brain Dead Donor

• pt must have consented or family

Standard Criteria Donor

• < 50yrs of age

• Brain dead

Altruistic Living Donor

Donates to a stranger

Increased Risk Donor

When the recipient risk is greater of not transplanting greater

Expanded Criteria Donor

• > 60 yrs

• > 50 yrs with 2 comorbidities

Hep C Antibody (+) Donor

Donor may have been successfully treated for HepC in the past

Brain Dead Donor

Complete cessation of function of the brain & brainstem

What must be done before declaring brain death?

Ruling out

Absent Brainstem Reflexes

• fixed pupils

• no dolls eye reflex

• irrigation of ear produces no arm movement

• absent tracheal/pharyngeal reflexes

Donation After Circulatory Death

Pt does not qualify for brain death but is not expected to recover without life-sustaining interventions

Brain Death Physiology

• Vasoconstriction → Vasodilation (Catecholamine release + depletion)

• HTN → Hypotension (Catecholamine release + depletion)

• Hypothermia (Loss of hypothalamus temp regulation)

• Diabetes Insipidus + Hypothyroidism (Loss of pituitary function)

• Decreased insulin

• Hypovolemia

• Inflammatory State

Paired Exchange Program

Living donor is matched to another potential donor whose living donor also does not match