life alliance organ recovery agency 1-800-255-4483
TRANSCRIPT
![Page 1: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/1.jpg)
Life Alliance Organ Recovery Agency
1-800-255-4483
![Page 2: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/2.jpg)
Teaching Ethics in a Multicultural Environment: An Organ Donation
Perspective
Life Alliance
Organ Recovery AgencyUniversity of Miami
![Page 3: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/3.jpg)
Why is Organ Donation important?
-There are more than 87,000 patients listed awaiting an organ transplant.
-Organ transplants come from Cadaveric donors and by Living donors.
However, the issue that exists is a Supply & Demand Problem.
![Page 4: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/4.jpg)
Newsroom Facts - UNOS
On average, 115 people are added to the nation’s organ transplant waiting list each day – ONE EVERY 13 MINUTES
On average, 66 people receive transplants every day from either a living or deceased donor.
More than 2,200 children under the age of 18 are on the transplant waiting list.
![Page 5: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/5.jpg)
State of Donation/Transplantation
0
5000
10000
15000
20000
25000
30000
1988 1992 1995 1999 2001 2002 2003
donorsorgans transplanted
![Page 6: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/6.jpg)
New Federal Requirements
Hospitals must have working relationships with their area’s OPO, Tissue and Eye Bank.
Hospitals must report ALL deaths and imminent deaths to the OPO.Reporting is required for hospital accreditation and Medicare reimbursement.All OPO’s must audit all deaths in their catchment area.
![Page 7: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/7.jpg)
Morality
The “rightness” or “wrongness” of an act or thought
Widely shared beliefs in a particular culture or subculture
![Page 8: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/8.jpg)
Ethics
The “why” or the actual underpinning for the act or thought.
Perspectives that allows one to examine or understand something
![Page 9: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/9.jpg)
Major Legislation1968 Uniform Anatomical Gift Act
Revised 1987
Authorizes the gift of all or part of the after death for transplants, research, education, or other therapies.
Describes who may donate, how to execute the donation, and who may receive the gift.
![Page 10: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/10.jpg)
There is no national registry of organ donors. Even if you have indicated your wishes on your driver’s license or a donor card, be sure you have told your family as they will be consulted before donation takes place.
![Page 11: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/11.jpg)
How does one express voluntary donation wishes?
Registries: DMV
Donor cards
Advance directives aka, Living Wills
Sharing your thoughts and decisions with your family
![Page 12: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/12.jpg)
Major Legislation1984 National Organ Transplant Act
Established a national Organ Procurement and Transplantation Network (OPTN)
Prohibited sale of human organs
Established the Scientific Registry of Organ transplantation
![Page 13: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/13.jpg)
1987Florida Brain Death Law
Brain death is the irreversible cessation of the entire brain, including brain stem
Determination of death must be made by two board eligible or certified physicians
![Page 14: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/14.jpg)
OPO Responsibilities
Evaluation of all potential donorsObtaining family consentMaintain the donor after Brain Death has been declaredAllocation of the organsRecovery of the organsAftercare of the donor family
![Page 15: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/15.jpg)
Medical Staff Ethical Dilemmas
Admitting failure: A patient has died
Stepping aside
Supporting or Obstructing Patient Management
![Page 16: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/16.jpg)
South Florida Communities
Haitian
African American
Hispanic
![Page 17: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/17.jpg)
Informed Decision to Informed Consent
Does a family need to know what organs and tissues can be donated?Do they need to know the size of the incision?Do they need to know how the body will look after donation? Do they need to know about the various donor suitability tests?
![Page 18: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/18.jpg)
Pediatric Ethical Considerations
What about children who want to be organ donors?
What about adolescents between 16 and almost 18 years old?
Can people younger than 18 give consent?
![Page 19: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/19.jpg)
Acceptable Donors
Severe Head Injuries
Cerebral Insults (SAH,SDH,CVA)
Primary Brain Tumors
Cerebral Anoxia (Near-drowning, Drug ODs,MIs,)
Homicides/Suicides
Metabolic Disorders (DKA)
![Page 20: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/20.jpg)
![Page 21: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/21.jpg)
Brain death vs. Coma?
![Page 22: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/22.jpg)
Brain Death CriteriaHarvard Medical School
Absence of spontaneous movement and response to stimulusAbsence of spontaneous respirationAbsence of brain stem reflexesReversible etiology must be considered and excluded prior to the diagnosing of Brain Death
![Page 23: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/23.jpg)
Brain Death
Patient maintained on ventilator, Heart beatingOrgans are removed in the operating room while the patient is maintained on a ventilator.Tissue recovery follows organ donation
![Page 24: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/24.jpg)
Cardiac Death
Patient has no cardiac or respiratory activityAcceptable donations: Tissue & EyesBody must be kept cool before tissues are removedRemoval within12 to 24 hours
![Page 25: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/25.jpg)
What’s the difference from a coma?
Coma entails some lower level of brain electrical activity, however absence of any cortical activity
Coma does NOT equal Brain Death
![Page 26: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/26.jpg)
Categories Of Donation
Brain Dead DonorCan donate organs, eyes, bone, & tissueHas beating heart, on ventilator
Cardiac Arrest DonorEye, bone, & tissue only: NO organs can be donated
Donation After Cardiac Death:Immediate rescue of organs after cardiac death
(OPO on Site) Asystole occurs within 30 min of extubation
![Page 27: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/27.jpg)
Donation after Cardiac Death
Informing ICU and OR staff that after disconnecting the patient from the respirator will result in Cardiac Death.
Donation follows pronouncement of patient by the attending physician.
![Page 28: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/28.jpg)
How Does It Work?
OrganProcurement
Agency
Donors
TransplantCenter
Recipients
UNOS Organ Center
![Page 29: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/29.jpg)
![Page 30: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/30.jpg)
Organ Matching
![Page 31: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/31.jpg)
Ethical Issues of Transplant Recipients
Retransplantation: How many times can a person be transplanted when others are also waiting?Prisoners: Before and now with today’s DNA evidence?Non-resident aliens?Multiple Listing: Being registered at more than one transplant center?
![Page 32: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/32.jpg)
Does being a celebrity or being rich influence listing?
UNOS allows for multiple listing for certain organs, i.e. Liver, however having available money to travel at a moments notice would help an individual but not change their place on the waiting list.
![Page 33: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/33.jpg)
Nurses’ Role in Donation
Early identificationReferral of potential donors to OPOSupport the families’ right to donateAssist in donor managementComfort grieving families
![Page 34: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/34.jpg)
Goals of Donor Care
Maintain cardiac output
Maintain tissue perfusion
Maintain fluid and electrolyte balance
Ensure adequate ventilation and pulmonary stability
Prevent infection
Control diabetes Insipidus
Regulate body temperature
![Page 35: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/35.jpg)
The Medical Examiner
The Medical examiner has legal jurisdiction over the body, in the county where the injury occurred. Being a Medical Examiner’s Case does not prevent a patient from being an organ donor.
![Page 36: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/36.jpg)
Errors to Avoid With Families
Giving false hope
Using highly technical medical terms
Approaching too early, not allowing the death to be accepted
Being stone cold, uncaring, abrupt or pompous
![Page 37: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/37.jpg)
Errors to avoid with families
Showing an unwillingness to spend time to answer questionsGiving the option of organ donation before knowing if the patient is a candidate
![Page 38: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/38.jpg)
Jackson
Liver Transplant Recipient
![Page 39: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/39.jpg)
Liver, stomach, pancreas,small bowel and piece of colon recipient
![Page 40: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/40.jpg)
Liver and small bowelrecipient
![Page 41: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/41.jpg)
![Page 42: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/42.jpg)
heart recipient
![Page 43: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/43.jpg)
TrineLiver Recipient
![Page 44: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/44.jpg)
Oneisha and Missick
Liver Transplant Recipients
![Page 45: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/45.jpg)
Erik, heart transplant
![Page 46: Life Alliance Organ Recovery Agency 1-800-255-4483](https://reader030.vdocuments.us/reader030/viewer/2022012406/56649d8e5503460f94a778f8/html5/thumbnails/46.jpg)
Life Alliance Organ Recovery Agency
1-800-255-4483