By Gweneth O’Shaughnessy
The role of the physician is essential to the organ and tissue donation process. Routinely, Gift of Life is notified of a potential organ donor scenario from a hospital’s Emergency Department or ICU. When the clinical triggers to initiate a referral are satisfied, a member of the healthcare team calls Gift of Life at 1-800-KIDNEY-1.
THOSE CLINICAL TRIGGERS ARE:
1. At the first indication that a ventdependent patient with a non-recoverable neurologic
Injury or illness (when the patient begins to lose neuro reflexes); OR
2. Prior to the first formal brain death examination; OR
3. Prior to family discussion about withdrawal of life-sustaining therapies/ DNR.
Notifying Gift of Life at this time is the first step toward ensuring that a family’s donation opportunity is preserved. A Gift of Life Transplant Coordinator will then travel to the hospital and partner with the physician and healthcare team to begin the evaluation process. Once a determination has been made that the patient is a medically suitable donor candidate, a plan will be mobilized for hemodynamically supporting the patient through brain death examinations, meeting the emotional and spiritual needs of the family, and determining an appropriate time to speak with them about their donation opportunity.
Discussing organ donation with families requires sensitivity and compassionate care, as well as the expertise of both the medical team, and Gift of Life. The optimal process unfolds when a physician or Other member of the healthcare team, along with a Gift of Life Transplant Coordinator conduct the organ donation consent conversation. When this occurs, consent rates can reach 72%.
In this region last year, 392 patients donated organs and 1,114 patients received the gift of a lifesaving organ transplant. One organ and tissue donor can save or enhance the lives of more than 50 individuals, and as a result, hundreds of thousands of individuals benefited from vital bone grafts to repair fractures and to prevent amputations, skin for burn patients, heart valves to prevent defects, tendons to repair knee injuries and corneas to end blindness. A record number of musculoskeletal donors were also coordinated in this region, reaching 1,035, and more than 2,330 donors gave the gift of sight. This is one of the most generous regions in the U.S. “We are grateful to those individuals in 2010 who made the generous decision to be organ and tissue donors, and to the families who gave others the precious gift of a second chance at life,” Gift of Life President and CEO Howard M. Nathan said. “In 2011, we will continue to focus on increasing donor designations on state driver’s licenses and on working with the community to support families awaiting these critical transplants.”
The number of patients waiting in this region for an organ transplant now exceeds 6,500. The largest impediment to increasing the available supply of transplantable organs is failure to obtain consent. An additional compounding factor is that the potential organ donor pool is extremely small. In fact, only 1-2% of all patient deaths are declared upon neurological criteria. Even one missed Opportunity to speak with a family has a detrimental impact on those patients awaiting the gift of a lifesaving organ transplant.
BELOW FOLLOWS A SET OF RECOMMENDATIONS FOR HOW PHYSICIANS CAN SUPPORT THE ORGAN AND TISSUE DONATION PROCESS:
1. If you are caring for a patient in the Emergency Department that meets that above clinical triggers, ensure that the patient is referred to Gift of Life in a timely manner (1-800-KIDNEY-1).
2. Partner with the Gift of Life Transplant Coordinator to evaluate the patient’s donation opportunities.
3. Provide the family of your patient with information about the grave prognosis or brain death where applicable. Support them by answering questions.
4. Refrain from discussing organ donation until:
a. A Gift of Life Transplant Coordinator is present for the discussion
b. It has been determined that the patient is a medically suitable donor candidate
5. Collaborate with the Gift of Life Transplant Coordinator and plan the timing and content regarding the donation discussion.
6. Preserve the donation opportunity by ensuring the patient is hemodynamically supported and once consent has been obtained, optimize end organ function.
From identifying and referring potential donors, to working with The Gift of Life Transplant Coordinators in support of families and their end of life decision-making, physicians are critical to the success of the donation process. Gift of Life’s Hospital Services Department’s close collaboration with physicians and healthcare professionals at the 138 hospitals throughout our region ensures that vital ongoing communication and an optimal organ donation process is hardwired into a hospital’s practice. The Hospital Services Department also offers a variety of educational programs and seminars for medical professionals to learn about the organ and tissue donation process. To learn more about these opportunities, please contact Gweneth O’Shaughnessy, Director, Hospital Services at goshaughnessy@ donors1.org.
During its more than 36 years, Gift of Life Donor Program has coordinated more than 30,000 organ transplants, along with more than 300,000 tissue transplants. Gift of Life Donor Program’s service region includes the eastern half of Pennsylvania, southern New Jersey and Delaware. One of 58 non-profit organ procurement organizations, Gift of Life Donor Program is part of the nationwide organ and tissue sharing network run by the United Network for Organ Sharing (UNOS).
Individuals are encouraged to make the commitment to donate by registering online at www.donors1.org. For more information on organ and tissue donation, please call Gift of Life at 1-800-DONORS-1 (1-800-366-6771) or visit www.donors1.org.
Gweneth O’Shaughnessy is Director, Hospital Services for the Gift of Life Donor Program.
Your story about Organ and Tissue Donation highlighted the tragic shortage of human organs for transplant operations.
There are now over 110,000 people on the National Transplant Waiting List, with over 50% of these people dying before they get a transplant. Most of these deaths are needless. Americans bury or cremate 20,000 transplantable organs every year.
There is a simple way to put a big dent in the organ shortage – give donated organs first to people who have agreed to donate their own organs when they die.
Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. Everyone who is willing to receive should be willing to give.
Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. LifeSharers has over 14,500 members as of this writing.