Donor Alliance
Introduction
Speaker: Kaye Malinski, Oregon Clinical Coordinator with Donor Alliance.
Background: Three years at Donor Alliance, previous experience as an ICU nurse for seven years.
Purpose: Overview of the donation process, potential donors, and differences in donation pathways.
Donor Alliance Overview
Mission: Save lives through organ and tissue donation and transplantation.
Vision: Maximize all donation opportunities with the help of bedside staff.
Core Values: Integrity, leadership, excellence, accountability, and people first.
Organization Type: Nonprofit organization and federally designated organ procurement organization (OPO) serving Colorado and Wyoming.
Coverage: Over 184,000 square miles, third largest donor service area (DSA) in the U.S. with 84 hospitals as potential donor sites.
Becoming a Donor
Two ways to become a donor:
Next of kin authorization for organ donation.
Registering as an organ, tissue, and eye donor.
Donor Registry:
Designation can be done via DMV or the Donate Life website.
Uniform Anatomical Gift Act (UAGA) passed in 2006 allows registrants to leave advance directives regarding donation.
Confidential centralized database applicable across 50 states.
First-person authorization: family cannot override a registered decision.
Donor Designation Rates:
Wyoming: ~60% of population registered.
Colorado: ~65% vs. national average of ~50%.
Importance of Organ Donation
Statistics:
Nearly 104,000 people waiting for transplants; 16 deaths per day on the waiting list.
Most needed organs: kidneys, liver, heart, lungs, and more.
Equivalent of filling Empower Field ~1.5 times with those waiting.
Colorado and Wyoming: ~1,300 on waiting lists.
Donor Alliance may allocate organs nationally.
In 2024, total transplants: 48,149; total transplants since inception: 1 million.
Donation Process Overview
Types of Donors:
Ordinary donors (<1% of deaths): Unexpected events; often require life support in ICU.
Brain death patients identified as potential organ donors.
Tissue donation: occurs in <4% of deaths, possible in all locations.
Impact of Donation:
One organ donor can save 2-9 lives; one tissue donor can help up to 75 lives.
Eligible Organs and Tissues:
Organs: heart, lungs, liver, pancreas, intestines, kidneys (can be split).
Tissues: corneas, heart valves, skin, veins, and lymph nodes.
Referring a Potential Donor
Appropriate Referral Triggers:
GCS of 5 or less; loss of 2 brainstem reflexes; discussing poor prognosis.
Discussions of end-of-life, palliative care, DNR, or donation-related inquiries.
Tissue Referrals: All deaths within 60 minutes.
Steps in the Donation Process
Poor prognosis diagnosis leads to referral.
Donor family support coordinator engages family regarding donation.
Legal next of kin authorization if not registered.
Medical evaluation by clinical coordinator.
Matching organs with recipients.
Recovery surgery scheduled.
Donation Pathways
Brain Death Pathway
Golden standard; organs remain oxygenated until recovery.
Requires specific tests to declare brain death.
Care is managed by Donor Alliance staff; intensive care maintained until recovery.
Donation After Circulatory Death (DCD)
Occurs when life support is withdrawn.
Maintained comfort for the donor; family allowed with donor.
Post-excavation care, potential issues if donor does not pass in specified time.
Perfusion technologies can enhance organ recovery.
Perfusion Technology
Advantages: Enables easier recovery of organs post-circulatory death.
Techniques: Normothermic regional perfusion; pumps to sustain organ viability post-mortem.
Blood can be sourced from either blood bank or the donor directly.
Closing Remarks
Appreciation expressed for care provided to donors and their families.
Encouragement for continued awareness and support of donation processes.