Organ and Tissue Donation Emergency Department Orientation. Calgary Health Trust May, 2015

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1 Organ and Tissue Donation Emergency Department Orientation Calgary Health Trust May, 2015

2 Fact Vs. Fiction 2

3 Southern Alberta Organ & Tissue Donation Program Southern Alberta Organ Donation Program HOPE Deceased organ donation Southern Alberta Tissue Donation Program Deceased tissue donation Living bone donation Lions Eye Bank Ocular donation 3

4 Donor Coordinators 6 Registered Nurse Coordinators On call 365 days/year, 24 hours/day Coordinate testing, recovery, processing and distribution of organs and tissues for transplantation, research and teaching Professional and public education 4

5 Benefits to Donation 1 Donors Respect their wishes 2 Families 94% of donor families state the donation process provided them with comfort in their loss of a loved one. 3 Recipients Organ donors can save up to 5 lives Can improve the lives of up to 60 tissue recipients 5

6 Legislation (2009) Human Tissue & Organ Donation Act Mandatory consideration of the potential for organ &/or tissue donation for every death in Alberta SAOTDP must be notified if organs and/or tissues are suitable for donation Consideration must also be documented in the health record 6

7 Legislation (2013) Human Tissue & Organ Donation Act Amended in 2013 On-Line Registry Currently over 110,000 registrants Registry Agents across the Province Creation of a Provincial Agency Two Organ Procurement Organizations in Alberta 7

8 Organ vs. Tissue Donation 8

9 Organ Donation Facts Admitted to Intensive Care Unit Ventilator Dependent Severe insult to the brain resulting in brain death 9

10 Organ Donation Facts Neurologic Death No blood flow to brain Nuclear Perfusion Scan diagnostic of brain death Not reversible Legal time of death 10

11 Neurological Death Severe insult to the Brain Cardiac arrest Overdose Trauma Neurologic death must be confirmed by two Physicians for organ donation Only 1-2% of all deaths result in neurologic death 11

12 Organ Donation - Process Overview ICU admission Coordinator Receives Report Family Meeting (Consent and medical social questionnaire) Organ function assessment Lab work Diagnostic testing Organ allocation OR coordination Organ retrieval 12

13 Contraindications - Organs There are only two absolute contraindications for organ transplant: 1. Metastatic Cancer 2. HIV 13

14 Donor Rates Organ Donors Average 20/year in Calgary Greater change you will need an organ than be an organ donor Tissue Donors Any death (brain death not required) Average more than 1 referral per day 14

15 Tissue Donation Any death in hospital, long-term care, palliative care Neurologic death not required Tissues must be recovered within 8 hours (eyes) to 24 hours (all other tissues) after time of death 15

16 Standard Contraindications - Tissue Exclude the patient from tissue donation Life enhancing we do not take any risks examples include: high risk activities, prostitution, IV drug use Cancer: contraindication for all tissues except eyes 16

17 Absolute Contraindications Age > 80 years HIV positive HTLV 1 or 2 positive Hepatitis B positive Hepatitis C positive Sepsis (bacteremia, fungemia, viremia) Active Tuberculosis Active Endocarditis Active Encephalitis or Meningitis Antibiotic Resistant Organisms: VRE, MRSA infection/colonization Creutzfeld Jacob disease IV drug user (in last 5 years) Insight Our Teams/Departments Southern Alberta Organ and Tissue Donation If any of the above conditions are present, decline for tissue donation. There is no need to contact the Donor Coordinator. 17

18 Absolute Contraindications Age > 80 years HIV positive HTLV 1 or 2 positive Hepatitis B positive Hepatitis C positive Sepsis (bacteremia, fungemia, viremia) Active Tuberculosis Active Endocarditis Active Encephalitis or Meningitis Antibiotic Resistant Organisms: VRE, MRSA infection/colonization Creutzfeld Jacob disease IV drug user (in last 5 years) Insight Our Teams/Departments Southern Alberta Organ and Tissue Donation If any of the above conditions are present, decline for tissue donation. There is no need to contact the Donor Coordinator. 18

19 Corneal Transplant Before and after a viral infection. 19

20 Heart valve transplant Normally are saved for children who need heart valve transplantation. 20

21 Skin grafts 21

22 Skin transplant 22

23 Cancellous Bone Chips 23

24 Tendons 24

25 Post Donation Support Outcome phone call &/or letter Referral to Grief Support Program in Calgary Annual recognition service Confidential Recipient/Donor correspondence 25

26 Calgary Statistics (2014) Local donors saved or enhanced 1,993 lives: 49 organ recipients 130 sclera recipients (white part of the eye) 291 cornea recipients 1523 tissue recipients (bone, skin, tendon, heart valves) 26

27 Opportunities Donation after Cardiac Death (DCD) Potential organ donors that do not meet brain death Available for families in major centres across Canada, including Edmonton An active Calgary committee Compliance with 2009 Legislation Could greatly reduce wait lists for cornea transplants 27

28 Local recipient at the Donor Recognition Service (April, 2015) Thank you for the priceless gift we have been given. A gift that affects not only us recipients but our loved ones, and those around them. Know that your loved ones are honored, their legacy is huge and far reaching! 28

29 Fiction cannot compare to reality vs. 29

30 Your choice is the right choice 30

31 Questions?? Register your wishes at: 31