Organ Donation Notes

Organ Donation Overview

• Exists to give life to those dying without healthy organs.
• Huge shortage of donated organs; regulated, strict, and ethical process.

Types of Organ Donation

Living Donation

• Donor is alive: can donate one kidney, lobe of liver, lung, bone marrow, blood.
• Safe due to:
  • Humans can live with one kidney.
  • Liver can regenerate.
  • Lung lobes removable without loss of function.
• Donor must be:
  • Free from family pressure.
  • Physically and mentally clear.
  • Informed of risks.
  • Aware they can stop at any time.

Deceased Donation

Donation After Brain Death (DBD)

• Gold standard for organ donation.
• Vital organs remain warm/oxygenated on ventilator.
• Definition: complete, irreversible death of brain (legal death).
• Criteria for brain death:
  • Coma, unresponsive to voice/pain.
  • No purposeful movement, brainstem reflexes absent.
  • Apnea test confirms lack of breathing efforts.
• Declared by two independent physicians.

Donation After Circulatory Death (DCD)

• For patients with severe injury not meeting brain death criteria.
• Family withdraws life support; death declared after the heart stops.
• Organs must be recovered quickly; viable organs include kidneys, liver, pancreas, sometimes lungs/heart.

Evaluation of a Potential Donor

• Process steps:
  1. OPO notified for potential organ referrals (Glasgow Coma Scale ≤ 5, withdrawal consideration).
  2. Detailed medical/social history screening to protect recipients.
  3. Physical assessment of organ viability.
  4. Diagnostic testing (CBC, CMP, function tests, imaging, viral screening).
  5. Matching donor to recipient based on blood type, tissue type, size, urgency, distance (managed by UNOS).