{"id":2508,"date":"2022-10-21T10:49:35","date_gmt":"2022-10-21T17:49:35","guid":{"rendered":"https:\/\/wildirismedicaleducation.com\/blog\/?p=2508"},"modified":"2022-10-21T10:53:38","modified_gmt":"2022-10-21T17:53:38","slug":"organ-and-tissue-donation","status":"publish","type":"post","link":"https:\/\/wildirismedicaleducation.com\/blog\/organ-and-tissue-donation","title":{"rendered":"Organ and Tissue Donation and Recovery"},"content":{"rendered":"\n<p><strong><a href=\"..\/blog\/author\/ruben-rucoba-and-adrianne-avillion\">By Ruben J. Rucoba, MD, and Adrianne E. Avillion, DEd, MSN, RN<\/a><\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">INTRODUCTION<\/h2>\n\n\n\n<p>As of 2021,&nbsp;169 million&nbsp;people in the United States have registered as donors. Not everyone who registers as a donor is able to donate. In fact, only 3 in 1,000 people die in a way that allows for deceased organ and tissue donation.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What Can Be Transplanted?<\/h3>\n\n\n\n<p>Most organ donations come from deceased donors, but a living donor can donate as well. Tissues can also be transplanted. The following table shows what organs and tissues can be donated from deceased and living donors.&nbsp;<\/p>\n\n\n\n<p class=\"has-ast-global-color-4-background-color has-background has-medium-font-size\"><strong>ORGANS, TISSUES, AND BODY PARTS THAT CAN BE TRANSPLANTED<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><tbody><tr><td><\/td><td><strong>From Deceased Donors<\/strong><\/td><td><strong>From Living Donors<\/strong><\/td><\/tr><tr><td><strong>Organs<\/strong><\/td><td>Heart<br>2 lungs<br>Liver<br>Intestines<br>2 kidneys<br>Pancreas<\/td><td>1 kidney<br>1 lung<br>Portion of the liver, pancreas, or intestine<\/td><\/tr><tr><td><strong>Tissues<\/strong><\/td><td>Heart valves<br>Bone<br>Cornea*<br>Skin<br>Ligaments<br>Tendons<br>Cartilage<br>Veins<br>Middle ear<\/td><td>Blood<br>Platelets<br>Blood stem cells from bone marrow, the bloodstream, or a baby\u2019s umbilical cord<\/td><\/tr><tr><td><strong>Body Parts<\/strong><\/td><td>Hands<br>Face<br>Skull<br>Scalp<br>Penis (first total penis and scrotum transplant performed in 2018)<br>Uterus (trials have begun in U.S.)<\/td><td>Uterus<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"has-ast-global-color-4-background-color has-background has-small-font-size\">Corneal donors are universal, i.e., do not have to \u201cmatch\u201d recipients like organ donors must. Many people can donate corneas, except for people with infections or highly communicable diseases such as HIV or hepatitis. Corneas can be recovered several hours after death and can be stored; a corneal transplant can be performed within 3\u20135 days after donation.<br>(Horsager-Boehrer, 2019; HRSA, n.d.-a)<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Supply and Demand<\/h3>\n\n\n\n<p>The need for organ and tissue donation is critical. It is estimated that someone is added to the national transplant waiting list every 10 minutes and that about 20 people die every day while waiting for a transplant. One donor can save the lives of up to eight people (DMV.org., 2019; UNOS, 2019a).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Legislative Efforts<\/h3>\n\n\n\n<p>To address the issue of supply and demand in the United States, the National Organ Transplant Act (NOTA) was passed by Congress in 1984. This act established the&nbsp;<strong>Organ Procurement and Transplant Network<\/strong>&nbsp;(OPTN) to guarantee the fair distribution of donated organs. A contract with the federal government to oversee the OPTN was granted to the United Network for Organ Sharing. The goals were to:<\/p>\n\n\n\n<ul><li>Increase the number of transplants<\/li><li>Provide equity in access to transplants<\/li><li>Promote efficiency in donation and transplant<\/li><li>Promote living donor and transplant recipient safety<\/li><li>Improve waitlisted patient, living donor, and transplant recipient outcomes (USDHHS, n.d.)&nbsp;<\/li><\/ul>\n\n\n\n<p>In 1998 the Centers for Medicare and Medicaid Services issued its Hospital Condition of Participation, requiring participating hospitals to refer all deaths and imminent deaths to the local&nbsp;<strong>organ procurement organization (OPO)<\/strong>&nbsp;so that families could be approached to be given the opportunity to donate tissues and organs (CMS, 2003).<\/p>\n\n\n\n<p>Individual <a href=\"..\/state-mandated\">states<\/a>\u2019 efforts to increase the supply of donor organs have also been undertaken. In 1968 the first OPO was established in Massachusetts. Today, there are 58 state OPOs that arrange for the recovery of all organs and tissues that become available for transplant. These organizations are members of the OPTN, federally designated, nonprofit, and state-licensed.\u00a0<\/p>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">DONATION AND RECOVERY PROCESS<\/h2>\n\n\n\n<p>The donation process begins by making the decision to be an organ donor and then registering. Registration can be completed in various ways:<\/p>\n\n\n\n<ul><li>Online at <a href=\"http:\/\/registerme.org\" target=\"_blank\" rel=\"noreferrer noopener\">registerme.org<\/a><\/li><li>In person when applying for or renewing a driver\u2019s license or state ID card<\/li><li>By completing and signing a donor card, available through the state\u2019s OPO\u00a0<br><\/li><\/ul>\n\n\n\n<p>There are other ways to register online, such as using health apps on mobile devices (NJ Gift of Life Program, 2016; NJSN, n.d.-a).<\/p>\n\n\n\n<p>Once an individual decides to become a donor, family members should be informed so that they can cooperate with the hospital staff regarding the donor\u2019s wishes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Determining Brain Death<\/h3>\n\n\n\n<p>Brain death statutes in the United States differ by state and institution. The Uniform Determination of Death Act of 1981 provides states with whole-brain criteria of death (Find Law, 2019; ULC, 2014).&nbsp;<em>(See \u201cResources\u201d at the end of this course.)<\/em><\/p>\n\n\n\n<p>The&nbsp;<strong>three essential findings<\/strong>&nbsp;in death that are declared by neurological criteria are:<\/p>\n\n\n\n<ul><li>Irreversible coma<\/li><li>Absence of brain stem reflexes&nbsp;<\/li><li>Apnea (suspension of breathing) (NJSN, 2014; Wijdicks et al., 2010)<\/li><\/ul>\n\n\n\n<p>When brain death has been confirmed, the hospital notifies the local organ procurement organization (OPO). If the patient is a potential donor, an OPO representative immediately goes to the hospital and searches the state\u2019s donor registry for legal consent. If the patient is not registered and there is no other legal consent, consent from the family will be required. When this is obtained, medical evaluation continues.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Donation after Cardiac Death&nbsp;<\/h3>\n\n\n\n<p>Anyone who has brain function that has been deemed incompatible with life but who does not meet all criteria for brain death is a potential candidate for donation after cardiac death (DCD). DCD may be discussed as an option with families when they have accepted that their loved one cannot survive and have made the decision to remove that person from life support support (CORE, 2018).&nbsp;There is a 90-minute time frame in which organs can be recovered after extubation to the pronouncement of death. If the patient does not progress to cardiac death within this time, organ donation cannot occur. Tissue donation may still be an option after death (NJSN, n.d.-b).<\/p>\n\n\n\n<p>If the family agrees to DCD, the patient is removed from the ventilator in an operating room. When the heart stops beating, a physician declares death and organs are recovered. Note that DCD is the original method of managing organ donation, and it has increased donations by as much as 25% in some geographic locations in the United States (CORE, 2018).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Completing a Medical Evaluation<\/h3>\n\n\n\n<p>Screening of a potential donor is essential to determine whether the donor has an infection that could be transmitted to recipients through transplanted organs and\/or tissues. The Organ Procurement and Transplantation Network&nbsp;policies (for OPOs) and&nbsp;FDA regulations and guidance&nbsp;(for tissue and eye banks) require a medical and social history interview to be conducted with the deceased donor\u2019s next of kin or another knowledgeable person (CDC, 2019).<\/p>\n\n\n\n<p><strong>Interviews<\/strong>&nbsp;are designed to assess the donor for:<\/p>\n\n\n\n<ul><li>Risk behaviors that may have exposed the donor to certain diseases<\/li><li>The donor\u2019s past medical history<\/li><li>Relevant travel history (which can be important for exposure to certain pathogens)<\/li><\/ul>\n\n\n\n<p>OPTN policy requires OPOs and living donor recovery centers to perform the following&nbsp;<strong>tests<\/strong>&nbsp;to determine if the donor has certain infections:<\/p>\n\n\n\n<ul><li>Human immunodeficiency virus (HIV)<\/li><li>Hepatitis B virus (HBV)<\/li><li>Hepatitis C virus (HCV)<\/li><li>Syphilis<\/li><li>Cytomegalovirus (CMV)<\/li><li>Epstein Barr virus (EBV)<\/li><li>Toxoplasmosis<\/li><\/ul>\n\n\n\n<p>Living potential kidney donors who are at increased risk for tuberculosis are also tested for this infection (CDC, 2019).<\/p>\n\n\n\n<p>Historically, transplant centers were prevented from accepting and transplanting organs from donors infected with&nbsp;HIV. However, in 2013 the federal HIV Organ Policy Equity Act was passed. This act allows transplantation of solid organs from HIV-positive donors to HIV-positive recipients when following specified research protocols established by the National Institutes of Health (CDC, 2019).<\/p>\n\n\n\n<p>FDA regulations require that tissue and eye banks test donor specimens for risk associated with HIV, HBV, HCV, and syphilis. Living tissue donors must also be tested for West Nile virus. Donor tissues that may contain live white blood cells, such as semen and hematopoietic stem\/progenitor cells, are also screened for human T-lymphotropic virus (HTLV) and CMV. A donor who tests positive for any of these pathogens, but not necessarily CMV, is not eligible to donate (CDC, 2019).<\/p>\n\n\n\n<p>Once a potential donor has been evaluated and accepted, additional assessments are done for the donation of specific organs.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Matching Process<\/h3>\n\n\n\n<p>Following medical evaluation for contraindications, the OPTN is contacted by the OPO in order to begin a search for matching recipients. The OPTN matching process includes:<\/p>\n\n\n\n<ul><li>Blood type<\/li><li>Body size<\/li><li>Severity of patient\u2019s medical condition<\/li><li>Distance between the donor\u2019s hospital and the patient\u2019s hospital<\/li><li>Patient\u2019s waiting time<\/li><li>Whether the patient is available<\/li><li>Tissue type (HRSA, n.d.-d)<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Organ Recovery<\/h3>\n\n\n\n<p>During the above process, the donor is maintained on artificial support. The condition of every organ is monitored by hospital medical and nursing staff along with the OPO coordinator, who also arranges arrival and departure times of both surgical teams. When the surgical team arrives, the donor is taken to the OR, and under sterile technique, organs and tissues are recovered and all incisions closed.&nbsp;<\/p>\n\n\n\n<p>The tissue and organs are then transported rapidly by commercial or contracted airplanes, helicopters, and\/or ambulances to the hospital where the transplant recipient is waiting and may be prepped and ready in the OR (HRSA, n.d.-d).<\/p>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">BARRIERS TO DONOR RECRUITMENT&nbsp;<\/h2>\n\n\n\n<p>Although a very high percentage of Americans say they support organ and tissue donation, the percentage of those who have taken steps to become a donor is quite low. According to Donate Life America (2019), 95% of Americans are in favor of being a donor but only 58% are registered as donors.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Common Reasons Individuals Decide Not to Donate<\/h3>\n\n\n\n<p>There are many reasons given by individuals for not becoming a donor. Multiple surveys have been done to uncover those reasons and have found the following:&nbsp;<\/p>\n\n\n\n<p><strong>Religious belief systems<\/strong>.<strong>&nbsp;<\/strong>Many people feel their religion encourages donations as an altruistic act, but many nondonors cite religious beliefs as the basis for not registering to be organ donors. Although the donation or receipt of organs from living or deceased donors is not forbidden by most major religions, it can be a barrier when people are simply unaware of their religion\u2019s stance regarding organ donation and believe their religion does not allow it.<\/p>\n\n\n\n<p>Some people believe that donating organs is interfering with God\u2019s plans\u2014that if a person is dying it is \u201cmeant to be\u201d and should not be interfered with. Others believe that the body must remain whole after death in order to enter the next life. Still others believe that God is the rightful owner of their body and that they do not have the right to give away parts of it.<\/p>\n\n\n\n<p><strong>Cultural beliefs<\/strong>.<strong>&nbsp;<\/strong>Cultural beliefs are not connected to any particular stance on religion but involve broader concerns regarding healthcare, death, and dying. Often these beliefs are based on superstition. Such superstitions may be that talking about death or signing a donor card can lead to one\u2019s own demise (the \u201cjinx\u201d factor). Others believe that the spirit will transfer from the donor to the recipient.&nbsp;<\/p>\n\n\n\n<p><strong>Family influences<\/strong>.<strong>&nbsp;<\/strong>Family members can strongly influence the decision to be an organ donor, and some people feel the need to ask permission from family members before making a choice. Many others believe that organ donation will significantly impair the family\u2019s grieving process.<\/p>\n\n\n\n<p><strong>Body integrity<\/strong>.<strong>&nbsp;<\/strong>Unconnected to religion, many people see removing organs, even after death, as a violation of physical integrity. Some are concerned that family members would be traumatically affected by the thought of an organ removal process that involves \u201cbeing cut up\u201d (the \u201cick\u201d factor). And still others mistakenly believe that donating organs necessarily precludes an open coffin wake, especially if the eyes are removed for donation of the corneas.&nbsp;<\/p>\n\n\n\n<p><strong>Mistrust of the healthcare system and professionals<\/strong>.<strong>&nbsp;<\/strong>Because some people have had negative experiences with the medical system (e.g., discrimination, racism), they have negative views concerning organ donation. The most commonly expressed concern is that being a registered donor will negatively affect the treatment one receives in the hospital (e.g., that healthcare personnel will declare death prematurely for the sole purpose of harvesting the patient\u2019s organs).&nbsp;<\/p>\n\n\n\n<p>Another often-mentioned concern involves fear about the validity of brain death determination and suspicion of the providers who make that decision. There are others who do not believe that brain death, a requirement for organ donation, can be considered true death, while others believe that a brain-dead person can recover.&nbsp;<\/p>\n\n\n\n<p>Another fear is that one\u2019s organs might go to an \u201cundeserving\u201d recipient or be used for research instead of saving lives. These beliefs are most often expressed among minority populations, who have a greater sense of being marginalized from the healthcare system.<\/p>\n\n\n\n<p><strong>Misconceptions about the organ donation process<\/strong>.<strong>&nbsp;<\/strong>Although in the United States it is illegal to buy or sell organs, people fear a black market that is eager to harvest organs or that their organs may be sold without their receiving compensation.<\/p>\n\n\n\n<p>Lack of knowledge is apparent when individuals state that their age, illness, or physical or mental defects can prevent them from being an organ donor, or that people who are rich or are celebrities move up the waiting list more quickly. Others may mistakenly think their families will incur the cost of donating (Mayo Clinic, 2019; Harrison &amp; Sanders, 2016; HRSA, n.d.-e; Quick et al., 2016).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Lack of Clarity about Decision-Making Authority&nbsp;<\/h3>\n\n\n\n<p>An important barrier to donation involves the ultimate responsibility for making the decision to donate. In the United States, the system of deceased-donor organ donation is based on \u201cexplicit consent.\u201d That means an individual is assumed&nbsp;<strong>not&nbsp;<\/strong>to be a donor unless they have indicated their wishes by registering to donate (i.e., \u201copt in\u201d). Some countries have a system whereby all individuals are assumed to be donors unless they have \u201copted out,\u201d however research does not indicate a clear consensus on whether an opt-out system results in increased donations over an opt-in system.<\/p>\n\n\n\n<p>The Uniform Anatomical Gift Act (UAGA) of 2006 provides the legal framework for determining consent for organ donation. Most states have enacted some form of this act, which specifically prevents any family member or otherwise responsible party from revoking an individual\u2019s first-person consent (State of NJ, 2017; USLegal, 2019).&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Process Breakdowns among Healthcare Professionals<\/h3>\n\n\n\n<p>When best practices are not followed, a deviation from the organ donation protocol may jeopardize organ recovery. These deviations are known as&nbsp;<em>process breakdowns<\/em>&nbsp;and include:<\/p>\n\n\n\n<ul><li><strong>Missed referrals<\/strong>&nbsp;due to the failure to notify the OPO about the deceased<\/li><li><strong>Untimely referrals<\/strong>, when the OPO is not notified about an imminent death within one hour of such determination or within one hour of a patient\u2019s death<\/li><li><strong>Suboptimal request<\/strong>&nbsp;for donation due to a poorly timed request or because a requester is untrained<\/li><li><strong>Hemodynamic stability not maintained<\/strong>&nbsp;and life-saving measures discontinued despite a timely referral&nbsp;<\/li><li><strong>Patient withdrawn from a ventilator<\/strong>&nbsp;and extubated before the family is offered the opportunity to donate&nbsp;(Razdan et al., 2015)&nbsp;<\/li><\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\">THE JOINT COMMISSION STANDARDS<\/h4>\n\n\n\n<p>The Joint Commission has specific standards for compliance with written policies, protocols, and procedures for donating and procuring organs and tissue. Quality assurance and performance play an important role in compliance. Data to be collected include the answers to the following questions and statements (TJC, 2014):<\/p>\n\n\n\n<ul><li>Are the organ, tissue, and eye donation programs integrated with the hospital\u2019s Quality Assurance Performance Improvement (QAPI) program?<\/li><li>Is the effectiveness of record reviews monitored as part of the hospital\u2019s QAPI program?<\/li><li>Does the hospital have QAPI mechanisms in place to ensure that the families of all potential donors are informed of their options to donate?<\/li><\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">Healthcare Professional Attitudes and Perceptions<\/h3>\n\n\n\n<p>While there is little research or consensus, limited studies indicate certain ethical concerns and conflicts among both physicians and nurses that interfere with the organ donation process. Such concerns and conflicts include the following:<\/p>\n\n\n\n<ul><li>Lack of knowledge about the organ donation process, causing a negative impact on attitudes that can lead to failure to identify potential donors<\/li><li>Difficulty accepting brain death as death (i.e., belief that as long as a patient\u2019s heart is beating, the patient is still alive and should continue to receive care)<\/li><li>Difficulty removing a ventilator for a donation after cardiac death when there is still minimal brain activity (i.e., belief in the possibility that the person may recover)<\/li><li>Difficulties among the multidisciplinary team during the organ donation process related to:<ul><li>Lack of commitment on behalf of healthcare professionals to the process<\/li><\/ul><ul><li>Lack of knowledge regarding how to carry out the brain death protocol and doubt about when to begin the process<\/li><\/ul><ul><li>Resistance to starting the brain death protocol due to personal difficulties dealing with death (Araujo &amp; Massarollo, 2014; Umana et al., 2018)<\/li><\/ul><\/li><\/ul>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">ROLE OF THE NURSE IN ORGAN RECOVERY AND TRANSPLANT&nbsp;<\/h2>\n\n\n\n<p>Nurses are critical members of the interdisciplinary team involved in organ recovery and transplantation. Nurses skilled in caring for transplant donors and recipients include the following:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Critical Care and Emergency\/Trauma Nurses<\/h3>\n\n\n\n<p>The nurses in critical care or emergency\/trauma settings are essential in the collaborative process of organ donation and recovery. These nurses are often the first professionals to identify a potential donor and make a referral to the local OPO. They are also involved in:<\/p>\n\n\n\n<ul><li>Partnering with the local OPO by introducing themselves to the coordinator, asking for information and resources, and working collaboratively to implement changes<\/li><li>Participating in activities to increase awareness of organ donation among colleagues and in the community<\/li><li>Advocating for patients and their families and honoring the patient\u2019s last wishes<\/li><li>Upholding the family\u2019s right to be offered the option of organ donation<\/li><li>Promoting compassionate communication between the healthcare team and families<\/li><li>Being knowledgeable about the relevant issues surrounding organ donation (Jawoniyi &amp; Gormley, 2015; O\u2019Leary, 2018)&nbsp;<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Designated Requestors<\/h3>\n\n\n\n<p>It is a federal regulation that a specially trained, designated hospital staff member, known as a&nbsp;<em>designated requestor,<\/em> approach the family to discuss the option of organ donation. Many requestors are registered nurses who have completed a course offered or approved by the OPO. The requestor lets the family know the patient is registered to be an organ donor and that those wishes will be carried out after death is pronounced. The family is also given clarification of the definition of brain death and informed that the patient will remain on life support after death is pronounced (CFR, 1998).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical Transplant Nurses<\/h3>\n\n\n\n<p>Clinical transplant nurses provide patient care primarily at the bedside, in inpatient units, and in operating rooms.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Transplant Nurse Coordinators<\/h3>\n\n\n\n<p>Transplant nurse coordinators provide direct as well as indirect patient care and are responsible for synchronization of all aspects of transplant care across all settings to ensure high-quality, effective, and safe care. These nurses focus on the provision of care for recipients or donors. They are responsible for evaluating a patient\u2019s condition, developing a treatment plan for the patients, and following up with their care (GMU, 2019).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Procurement Nurse Coordinators<\/h3>\n\n\n\n<p>Procurement nurse coordinators may practice in intensive care, emergency and trauma, or operating room settings. They may also travel to outlying centers to provide patient and staff education and to assist in organ procurement. They have a major role in the provision of follow-up support and advocacy for donor families.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Living-Donor Nurse Coordinators<\/h3>\n\n\n\n<p>The living-donor nurse coordinator practices primarily in clinics or outpatient settings, preparing and educating potential donors about organ donation. Following donation, the nurse follows patients for varying lengths of time to help promote full recovery both physically and mentally.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Advanced Practice Transplant Professionals<\/h3>\n\n\n\n<p>The advanced practice nurse works in multiple settings, including inpatient units, outpatient clinics, and the community. These nurses are generally the most experienced and deliver an advanced level of patient care within the specialty of transplantation (NATCO, 2019).<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\">NURSES BREAKING DOWN THE BARRIERS<\/h4>\n\n\n\n<p>All nurses can play an active, integral part in breaking down barriers and increasing the donation rate by:<\/p>\n\n\n\n<ul><li>Increasing awareness about the need for organ and tissue donation among colleagues, friends, and family<\/li><li>Advocating for or organizing a unit- or hospital-wide formal education plan about the organ donation process and nurses\u2019 roles in the process<\/li><li>Learning about criteria for organ donation<\/li><li>Being familiar with the local protocols for in-hospital deaths (i.e., calling the OPO for every death)<\/li><li>Understanding issues surrounding brain death<\/li><li>Understanding ethical concerns regarding organ donation (particularly withdrawal of life support)<\/li><li>Dealing with their own personal feelings about death and mortality<\/li><li>Registering to be an organ donor<\/li><\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">CONCLUSION<\/h2>\n\n\n\n<p>Organ transplants have offered the gift of life to many people over the years. But without cooperation and collaboration among healthcare professionals, federal and state governments, and society, the benefits of transplantation would not be possible.&nbsp;<\/p>\n\n\n\n<p>The issue of supply and demand is quite complex. It is dependent upon understanding and providing education to dispel individual attitudes, myths, and other barriers that stand in the way of organ and tissue donation.<\/p>\n\n\n\n<p>Nurses and other healthcare professionals must increase their knowledge about becoming a donor, the process of organ and tissue donation and recovery, and in particular the concept of brain death. These individuals must learn to become advocates for their patients and families; they can also demonstrate their advocacy for the donation process by registering themselves to be organ donors.&nbsp;<\/p>\n\n\n\n<p>Nurses are an integral part of and have significant roles in the process of organ procurement and transplantation, requiring specialized skills and training. They are effective collaborators within the transplantation team, and transplant nurses often have the most one-on-one contact with transplant patients.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">RESOURCES<\/h3>\n\n\n\n<p><a href=\"https:\/\/www.uniformlaws.org\/committees\/community-home?CommunityKey=015e18ad-4806-4dff-b011-8e1ebc0d1d0f\" target=\"_blank\" rel=\"noreferrer noopener\">Anatomical Gift Act (Uniform Law Commiss<\/a><a href=\"https:\/\/www.uniformlaws.org\/committees\/community-home?CommunityKey=015e18ad-4806-4dff-b011-8e1ebc0d1d0f\">ion)<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.donatelife.net\/\" target=\"_blank\" rel=\"noreferrer noopener\">Donate Life America<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/optn.transplant.hrsa.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">Organ Procurement and Transplantation Network&nbsp;<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/what-is-the-uniform-declaration-of-death-act-or-udda.html\" target=\"_blank\" rel=\"noreferrer noopener\">Uniform Declaration of Death Act<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.organdonor.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">U.S. Government information on organ donation and transplantation (USDHHS)<\/a><\/p>\n\n\n\n<p>REFERENCES<\/p>\n\n\n\n<p>Araujo M &amp; Massarollo M. (2014). Ethical conflicts experienced by nurses during the organ donation process.<em>&nbsp;Acta paul. enferm.<\/em><em>, 27<\/em>(3), 215\u201320.&nbsp;<\/p>\n\n\n\n<p>Center for Organ Recovery &amp; Education (CORE). (2018). Donation process. Retrieved from https:\/\/www.core.org\/understanding-donation\/donation-process\/<\/p>\n\n\n\n<p>Centers for Disease Control and Prevention (CDC). (2019). Transplant safety: donor screening and testing. Retrieved from https:\/\/www.cdc.gov\/transplantsafety\/protecting-patient\/screening-testing.html<\/p>\n\n\n\n<p>Centers for Medicare &amp; Medicaid Services (CMS). (2003). Conditions of participation, conditions for coverage: identification of potential organ, tissue, and eye donors, questions and answers. Retrieved from https:\/\/www.njsharingnetwork.org\/document.doc?id=268<\/p>\n\n\n\n<p>Code of Federal Regulations (CFR). (1998). 42 CFR 482.45, condition of participation: organ, tissue, and eye procurement. Retrieved from https:\/\/www.law.cornell.edu\/cfr\/text\/42\/482.45<\/p>\n\n\n\n<p>DMV.org. (2019). Organ donation in New Jersey. Retrieved from https:\/\/www.dmv.org\/nj-new-jersey\/organ-donor.php<\/p>\n\n\n\n<p>Donate Life America. (2019). 113,000 people are waiting for a lifesaving transplant. Retrieved from https:\/\/www.donatelife.net<\/p>\n\n\n\n<p>Find Law. (2019). What is the Uniform Declaration of Death Act (UDDA)? Retrieved from https:\/\/healthcare.findlaw.com\/patient-rights\/what-is-the-uniform-declaration-of-death-act-or-udda.html<\/p>\n\n\n\n<p>Finger E. (2016). Organ procurement considerations in trauma. Retrieved from http:\/\/emedicine.medscape.com\/article\/434643-overview#a3<\/p>\n\n\n\n<p>Gwynedd Mercy University (GMU). (2019). Transplantation nursing career guide. Retrieved from https:\/\/www.gmercyu.edu\/academics\/learn\/become-transplant-nurse<\/p>\n\n\n\n<p>Harrison M &amp; Sanders T (Eds.). (2016).&nbsp;<em>Social policies and social control<\/em>. Chicago: Policy Press.<\/p>\n\n\n\n<p>Health Resources &amp; Services Administration (HRSA). (2019). Organ donation statistics. Retrieved from https:\/\/www.organdonor.gov\/statistics-stories\/statistics.html<\/p>\n\n\n\n<p>Health Resources &amp; Services Administration (HRSA). (n.d.-a). Organdonor.gov: what can be donated. Retrieved from https:\/\/www.organdonor.gov\/about\/what.html<\/p>\n\n\n\n<p>Health Resources &amp; Services Administration (HRSA). (n.d.-b). History &amp; NOTA. Retrieved from https:\/\/optn.transplant.hrsa.gov\/governance\/about-the-optn\/history-nota<\/p>\n\n\n\n<p>Health Resources &amp; Services Administration (HRSA). (n.d.-d). The deceased donation process. Retrieved from https:\/\/www.organdonor.gov\/about\/process\/matching.html<\/p>\n\n\n\n<p>Health Resources &amp; Services Administration (HRSA). (n.d.-e). Religion and organ donation. Retrieved from https:\/\/www.organdonor.gov\/about\/donors\/religion.html<\/p>\n\n\n\n<p>Horsager-Boehrer R. (2019). Uterine transplant: this prospect for pregnancy is not worth the risks. Retrieved from https:\/\/utswmed.org\/medblog\/uterine-transplant-motherhood\/<\/p>\n\n\n\n<p>Jawoniyi O &amp; Gormley K. (2015). How critical care nurses\u2019 roles and education affect organ donation.&nbsp;<em>British Journal of Nursing, 24<\/em>(13), 698.&nbsp;<\/p>\n\n\n\n<p>Mayo Clinic. (2019). Organ donation: don\u2019t let these myths confuse you. Retrieved from https:\/\/www.mayoclinic.org\/healthy-lifestyle\/consumer-health\/in-depth\/organ-donation\/art-20047529<\/p>\n\n\n\n<p>NJ Gift of Life Program. (2016). Register me. Retrieved from https:\/\/registerme.org\/<\/p>\n\n\n\n<p>NJ Sharing Network (NJSN). (2014). Guidelines for determining death based on neurological criteria. Retrieved from https:\/\/www.njsharingnetwork.org\/file\/Brain-Death-Guidelines-July-27-2014sq-2.pdf<\/p>\n\n\n\n<p>NJ Sharing Network (NJSN). (n.d.-a). Take action: make your next minute matter. Retrieved from https:\/\/www.njsharingnetwork.org\/register-today<\/p>\n\n\n\n<p>NJ Sharing Network (NJSN). (n.d.-b). Donation after cardiac death (DCD) overview. Retrieved from https:\/\/www.njsharingnetwork.org\/document.doc?id=175<\/p>\n\n\n\n<p>NATCO: The Organization for Transplant Professionals. (2019). Transplant nursing: scope and standards of practice, 2014 July version. Retrieved from http:\/\/www.natco1.org\/Professional-Development\/competencies.asp<\/p>\n\n\n\n<p>O\u2019Leary GM. (2018). Deceased donor organ donation: the critical care nurse\u2019s role.&nbsp;<em>Nursing Critical Care, 13<\/em>(4), 27\u201332. doi:10.1097\/01.CCN.0000534920.55430.ba<\/p>\n\n\n\n<p>Organ Procurement and Transplantation Network (OPTN). (2018). Strategic plan. Retrieved from https:\/\/optn.transplant.hrsa.gov\/governance\/strategic-plan\/<\/p>\n\n\n\n<p>Quick BL, Reynolds-Tylus T, Fico AE, &amp; Feeley TH. (2016). An investigation into mature adults\u2019 attitudinal reluctance to register as organ donors.&nbsp;<em>Clinical Transplantation, 30<\/em>(10), 1250\u20137. doi:10.1111\/ctr.12815<\/p>\n\n\n\n<p>Razdan M, Degenholtz HB, Kahn JM, &amp; Driessen J. (2015). Breakdown in the organ donation process and its effect on organ availability.&nbsp;<em>Journal of Transplantation, 2015,<\/em>&nbsp;article ID 831501, 8 pages. Retrieved from http:\/\/dx.doi.org\/10.1155\/2015\/831501<\/p>\n\n\n\n<p>Shepherd L, O\u2019Carroll RE, &amp; Ferguson E. (2014). An international comparison of deceased and living organ donation\/transplant rates in opt-in and opt-out systems: a panel study.&nbsp;<em>BMC Medicine,&nbsp;12,&nbsp;<\/em>131. doi:10.1186\/s12916-014-0131-4<\/p>\n\n\n\n<p>State of New Jersey. (2017). Senate, no. 3282, State of New Jersey, 217th legislature. Retrieved from ftp:\/\/www.njleg.state.nj.us\/20162017\/S3500\/3282_I1.HTM<\/p>\n\n\n\n<p>The Joint Commission (TJC). (2014). Compliance guide for hospital Joint Commission, CMS, or Department of Health surveys. Retrieved from http:\/\/www.life-source.org\/wp-content\/uploads\/2012\/10\/Compliance_Guide_LS1412-108.pdf<\/p>\n\n\n\n<p>Uniform Law Commission (ULC). (2014). Determination of death act summary. Retrieved from http:\/\/www.thaddeuspope.com\/images\/Determination_of_Death_Act_Summary.pdf<\/p>\n\n\n\n<p>United Network for Organ Sharing (UNOS). (2019a). History. Retrieved from https:\/\/unos.org\/transplant\/history\/<\/p>\n\n\n\n<p>United Network for Organ Sharing (UNOS). (2019b). Organ transplants in the United States set sixth consecutive record in 2018. Retrieved from https:\/\/unos.org\/news\/organ-transplants-in-united-states-set-sixth-consecutive-record-in-2018\/<\/p>\n\n\n\n<p>U. S. Department of Health and Human Services (USDHHS). (n.d.). OPTN vision and goals. Retrieved from https:\/\/optn.transplant.hrsa.gov\/governance\/about-the-optn\/vision-goals\/<\/p>\n\n\n\n<p>USLegal. (2019). New Jersey Anatomical Gift Act Law. Retrieved from https:\/\/uniformacts.uslegal.com\/anatomical-gifts-act\/new-jersey-anatomical-gift-act-law\/<\/p>\n\n\n\n<p>Umana E, Grant O, Curran E, Mohamed A, &amp; O\u2019Donnell J. (2018). Attitudes and knowledge of healthcare professionals regarding organ donation: a survey of the Saolta University Health Care Group.&nbsp;<em>Ir Med,&nbsp;<\/em><em>111<\/em>(10), 838. Retrieved from https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30560634<\/p>\n\n\n\n<p>Wijdicks EFM, Varelas PN, Gronseth GS, &amp; Greer DM. (2010). Evidence-based guideline update: determining brain death in adults.&nbsp;<em>Neurology, 74<\/em>(23), 1911\u20138.&nbsp;&nbsp;doi:10.1212\/WNL.0b013e3181e242a8<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As of 2021,\u00a0169 million\u00a0people in the United States have registered as donors. Not everyone who registers as a donor is able to donate. In fact, only 3 in 1,000 people die in a way that allows for deceased organ and tissue donation&#8230;<\/p>\n","protected":false},"author":18,"featured_media":2550,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[22],"tags":[32,80],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Organ and Tissue Donation | Wild Iris Medical Education<\/title>\n<meta name=\"description\" content=\"Learn about the organ and tissue donation process. 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