Organ Donation and Transplant - NCLEX Review

Organ Donation and Transplant

Deceased Donor Organs

  • Organs that can be taken from deceased donors:
    • Heart
    • Two lungs
    • Liver
    • Kidneys
    • Pancreas
    • Hands and Faces (more recent, not on NCLEX)

Definition of Deceased

  • Deceased means:
    • Brain death while the heart and lungs are still functioning.
    • The person still has a beating heart and is breathing on their own.
  • The healthcare system will stop the person's heart and breathing to harvest the organs.
  • If they wait until the heart stops, the organs will not be viable.

Tissues from Deceased Donors

  • Tissues that can be taken from deceased donors:
    • Bones
    • Skin
    • Tendons
    • Ligaments
    • Valves
    • Corneas
  • Deceased and dead are defined differently.

Organs from Live Donors

  • Organs that can be taken from live donors:
    • One lung
    • One kidney
    • Parts of organs

Tissues from Live Donors

  • Tissues that can be taken from live donors:
    • Blood and blood products
      • Stem cells
      • Plasma
      • Whole blood
  • Basically, only blood can be taken from live people.

Types of Donation

  • Four types of donation:
    • Organ donation
    • Tissue donation
    • Cornea donation
    • Blood donation

Chart Knowledge for NCLEX

  • Chart categories:
    • Can it come from deceased people?
    • Can it come from live people?
    • Is tissue matching required?
    • Can it be stored?
Organs
  • From deceased people: Yes
  • From live people: Yes (e.g., one kidney)
  • Tissue match: Yes
  • Stored: No
Tissues
  • From deceased people: Yes
  • From live people: No (generally)
  • Tissue match: Yes
  • Stored: Yes
Corneas
  • From deceased people: Yes
  • From live people: No
  • Tissue match: No
  • Stored: Yes
Blood
  • From deceased people: No
  • From live people: Yes
  • Tissue match: Yes (type and cross match)
  • Stored: Yes (blood bank)

Memorization Tip

  • Memorize what cannot be done for each type of donation:
    • Organs: Cannot be stored.
    • Tissues: Not from live people.
    • Corneas: Don't have to be matched and not from live people.
    • Blood: Not from deceased people.

Mnemonic

  • Say "Organs, Tissues, Corneas, Blood" repeatedly to memorize the order.
  • National slogan: "Save lives. Make a donation."
  • Associate first letters:
    • Organs (O) - Save (S) --> OS (Organs are not Stored)
    • Tissues (T) - Lives (L) --> TL (Tissues not from Live people)
    • Corneas (C) - Make (M) --> CM (Corneas are not Matched)
    • Blood (B) - Donation (D) --> BD (Blood not from Dead people)
  • Remember corneas don't come from a live person.

Patient Teaching for Transplant

  • There is no cost to the family for tissue transplant or donation.
  • Patient dignity is essential; organ donation is treated with solemnity.
  • There is no benefit to being rich or famous.
  • All major religions support donating organs.

Transplant Terms

Compatibility
  • Tissue matching involves matching HLA sites on chromosome number six.
  • HLA<br/>sites<br/>on<br/>chromosome<br/>number<br/>6HLA <br />\newline sites <br />\newline on <br />\newline chromosome <br />\newline number <br />\newline 6
Grafts
  • Autograft: From you to you
  • Xenograft: From Animal to you
  • Allograft/Homograft: From another person to you

Post-Transplant Medications

Anti-Rejection Meds
  • Steroids (end in -sone): Betamethasone, Prednisone
  • Azathioprine
  • Drugs ending in -limus: Tacrolimus
  • Summary: Azathioprine, -sone, -limus
Missing a Dose
  • Call the healthcare provider immediately if a dose is missed.
  • Rejection can occur within hours.

Signs and Symptoms of Rejection

  • Two types of signs:
    • Systemic
    • Local (organ-specific)
Systemic Signs
  • Body-wide signs:
    • Fever (Pyrexia) - even a slight elevation
    • Malaise (feeling unwell)
  • If both signs present, seek medical attention.
Local Signs
  • Organ-specific signs:
    • Kidney: Fever, malaise, blood in urine, decreased urine output, edema
    • Liver: Fever, malaise, jaundice, itching, nausea, vomiting
    • Lungs: Crackles, dyspnea, wheezing
    • Heart: Irregular heartbeat, jugular vein distension, high or low blood pressure, tachycardia or bradycardia
Approach for Select All That Apply Questions
  • Select fever and malaise first.
  • Then select any signs or symptoms indicating organ failure.

Legality and the Nurse

  • A nurse can witness the consent for harvesting the patient's organs.
  • The nurse does not obtain consent for the patient to be a donor; organ donation representatives do this.