Organ Donation & Transplant — Brodie's Good Vibe Tribe

Organ donation

Organ donation is when a person allows healthy transplantable organs and tissues to be removed, either after death or while the donor is alive, and transplanted into another person.

Organ donors may be living, brain dead, or dead via circulatory death. Tissue may be recovered from donors who die of circulatory death, as well as of brain death – up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be "banked".

organ transplantation

Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the person's own body, to replace the recipient's damaged or absent organ. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, nerves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart. Cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold.

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How it first started

The first successful living organ transplant was performed between 23-year-old identical twins in 1954. Dr. Joseph E. Murray at Peter Bent Brigham Hospital in Boston transplanted a healthy kidney from Ronald Herrick into his twin brother, Richard, who had chronic kidney failure.

Richard Herrick went on to live an active, normal life, dying eight years later from causes unrelated to the transplant. Since that time, thousands of patients have received successful transplants from living donors.

Becoming a Living Donor

The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor's decision and reasons are kept confidential. Registering in the Ohio Donor Registry does not mean you will be called for living donation. Anyone considering becoming a hero as a living donor should contact one of the state's eight transplant programs below or visit the United Network of Organ Sharing's website at www.UNOS.org.

Organs Used in Living Donation

Living donor transplants are a viable alternative for patients in need of new organs. Many different types of organs can be provided by living donors, including:

Kidney
This is the most frequent type of living organ donation. For the donor, there is little risk in living with one kidney because the remaining kidney compensates to do the work of both kidneys

Liver
Individuals can donate segments of the liver, which has the ability to regenerate the segment that was donated and regain full function.

Lung
Although lung lobes do not regenerate, individuals can donate a lobe of one lung.

Pancreas
Individuals can also donate a portion of the pancreas. Like the lung, the pancreas does not regenerate, but donors usually have no problems with reduced function.

Intestine
Although very rare, it is possible to donate a portion of the intestine.

Heart
While extremely rare, a domino transplant makes some heart-lung recipients living heart donors. When a patient receives both a heart and lung transplant from a deceased donor, his or her healthy heart may be given to an individual waiting for a heart transplant. This procedure is used when physicians determine that the deceased donor lungs will function best if they are used in conjunction with the deceased donor heart.

Qualifying as a Living Donor

In order to qualify as a living donor, an individual must be physically fit, in good general health, and free from high blood pressure, diabetes, cancer, kidney disease and heart disease. Individuals considered for living donation are usually between 18 and 60 years of age. Gender and race are not factors in determining a successful match. The living donor must first undergo a blood test to determine blood type compatibility with the recipient. If the donor and recipient have compatible blood types, the donor undergoes a medical history review and a complete physical examination. The following tests may be performed:

Tissue Typing
The donor's blood is drawn for tissue typing of the white blood cells.

Cross-matching
A blood test is done before the transplant to see if the potential recipient will react to the donor organ. If the cross-match is "positive," then the donor and patient are incompatible. If the cross- match is "negative," then the transplant may proceed. Cross- matching is routinely performed for kidney and pancreas transplants.

Antibody Screen
An antibody is a protein substance made by the body's immune system in response to an antigen (a foreign substance; for example, a transplanted organ, blood transfusion, virus or pregnancy). Because the antibodies attack the transplanted organ, the antibody screen tests for panel reactive antibody (PRA). The white blood cells of the donor and the serum of the recipient are mixed to see if there are antibodies in the recipient that react with the antigens of the donor.

Urine Tests
In the case of a kidney donation, urine samples are collected for 24 hours to assess the donor's kidney function.

X-rays
A chest X-ray and an electrocardiogram (EKG) are performed to screen the donor for heart and lung disease.

Arteriogram
This final set of tests involves injecting a liquid that is visible under X-ray into the blood vessels to view the organ to be donated. This procedure is usually done on an outpatient basis, but in some cases it may require an overnight hospital stay.

Psychiatric and/or Psychological Evaluation
The donor and the recipient may undergo a psychiatric and/or psychological evaluation.

· Cleveland Clinic, Cleveland, Ohio, (216) 445-3150

· Nationwide Children’s Hospital, Columbus, Ohio, (614) 722-2000

· Children’s Hospital Medical Center, Cincinnati, Ohio, (800) 344-2462

· University of Toledo Medical Center, Toledo, Ohio, (419) 383-4000

· The Ohio State University Medical Center, Columbus, Ohio, (614) 293-4103

· Christ Hospital, Cincinnati, Ohio, (513) 585-2000

· University of Cincinnati/University Hospital, Cincinnati, Ohio, (513) 584-1000

· University Hospitals Case Medical Center of Cleveland, Cleveland, Ohio, (216) 844-1000