Organ Transplant Organ Transplantation A procedure done to

Organ Transplant • Organ Transplantation: A procedure done to treat patients with end-stage organ disease who are facing organ failure • http: //www. youtube. com/watch? v=Sy. Pjh. H n 7 Qo&feature=related&safety_mode=true&pe rsist_safety_mode=1&safe=active

Organ Transplant • Began over 25 years ago • Success rates are increasing – Better patient selection – Improved clinical skills &operative management – Improved immunosuppressant drugs • Increased success = increased need

National Organ Procurement Act • Enacted in 1984 – Illegal to buy or sell organs • Section 1138 Title XI of Omnibus Budget Reconciliation Act – Requires hospitals to establish organ procurement protocols

Organ Donation • Organs & Tissues must be removed immediately after death – Need agreement & arrangements in place before death

Who Lives? Who Dies? Who Decides? • The decision makers, even with guidelines to follow, often become the judge and jury and often find that the answers to who lives and dies are not always easy to make

Uniform Anatomical Gift Act • Statute has been enacted by all 50 states • Provisions to issues – Donation, accepting and use of anatomical gifts • People can make decisions to donate organs

Uniform Anatomical Gift Act System for allocation of cadaver organs Document of gift Health care power of attorney can authorize ID’s who can decide make a gift when person has not documented a gift • If organ not specified to someone goes to a transplant organization • •

Uniform Anatomical Gift Act • Document of refusal do not want organs donated • 113, 027 people are waiting for an organ • 18 people die each day while waiting • 1 organ donor can save up to 8 lives

Who can Donate • Sound of mind • 18 years or older • Remaining body is transferred to next of kin • Donation by Will: donation becomes effective immediately after death

Failure to Obtain Consent • Nicoletta V. Rochester Eye & Human Parts Bank – Sons eyes were donated – Hospital was immune “good-faith” provisions

Live Organ Donation • Beneficence: Promote the well being of others • Non-Maleficence: First, do no harm

Known Direct Donation • Donation of an organ to loved one or friend – Intense pressure placed on family or friends to donate – Compelled to donate regardless of consequences

Nondirect donation • Donor gives an organ to the general pool to be transplanted – Radical altruism – Psychologically suspect motivations need to be ruled out

Stranger Direct Donation • Direct donation to a stranger – Patient advertises – Organ is a “gift of life” not a commodity to be bought or sold

Patient advertisement • • Most compelling stories Highest means to advertise True need is overlooked Isn’t it better for transplant teams to be involved?

Stranger Direct Donation • Patient was racist • Family insisted that the recipient must be white • Jewish man donated to a Jewish child

Stranger Direct Donation • Is this a violation of fairness? • Will this lead to the buying and selling of organs? • http: //matchingdonors. com/life/index. cfm