Non-Traditional Living Donation…Non-Traditional Living Donation…Policing the ProcessPolicing the Process

Christina Bryant, RN, PTC

Alabama Organ Center

My journey began nineteen My journey began nineteen years ago…years ago…

KayLynn JensenKayLynn JensenDecember 24, 1958 – August 1, 1989December 24, 1958 – August 1, 1989

Facing the obstacles…Facing the obstacles…

Overcoming protocols…Overcoming protocols…

Establishing the relationship…Establishing the relationship…

Transplant success…Transplant success…January 15January 15thth, 2007, 2007

Waiting List Registrations 1998-2007Waiting List Registrations 1998-2007U.S.U.S.

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007Year of Snapshot

Kidney Liver

Kidney - Active Liver - Active

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Solutions???Solutions???

DialysisDialysis

Deceased DonorsDeceased Donors

Traditional DonorsTraditional Donors

Non-traditional DonorsNon-traditional Donors

Dangers Dangers ofof

Dialysis… Dialysis…

Oxidative Stress & Oxidative Stress & Chronic inflammationChronic inflammationAnemiaAnemiaHypertensionHypertensionFluid Volume OverloadFluid Volume OverloadHyperlipidemiaHyperlipidemiaNeuropathyNeuropathyInfectionInfectionPericarditisPericarditisHEART FAILUREHEART FAILURE

From: Johnnie Sent: Wed 6/25/2008 4:58 PMTo: Christina BryantSubject: Re:

Jody had a heart attack last Wednesday night. It's been called an episode, an event, and even a lethal arrhythmia...but I just call it a heart attack.  He coded in the ER after walking in with slight chest pains.  They used the paddles three times to revive him and told him if it had happened at home he wouldn't be with us.  On Friday morning he received two new stints.  Yesterday, he got a new defibrillator pace maker and today we came home.  I guess I'm still in shock or just have angels assigned to round the clock duty for Jody but we weathered the storm.  And my ever-positive guy is just excited that the shocks delivered put his heart rate back in normal rhythm.  Glass half full!  God is good.  You can call him and he'll tell you his story.  I'm just glad he can.  Dr. said his heart is just weak from all the dialysis and there's not much we can do but hope we've covered our bases now.  Say a prayer and I promise to take the best care of him that I can.

Love,Johnnie

HAPPILY EVER AFTER???HAPPILY EVER AFTER???

Deceased Donors…Deceased Donors…

There were 8,087 deceased There were 8,087 deceased donors in 2007. (approximately donors in 2007. (approximately 16,174 potential kidneys for 16,174 potential kidneys for transplant)transplant)

Of the 16,174 potential kidneys, Of the 16,174 potential kidneys, 10,587 were utilized for transplant. 10,587 were utilized for transplant. (65%) (65%)

Deceased Donor Transplants Deceased Donor Transplants 2005 - 20072005 - 2007

4691466

6227

862

10587

197

2210

300

2000

4000

6000

8000

10000

12000

HL HR IN KI KP LI LU PA

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2005 2006 2007

10,587

Traditional Donor Programs…Traditional Donor Programs…

Living relatedLiving related

Living non-biological Living non-biological relatedrelated

Close FriendsClose Friends

Living Donor TransplantsLiving Donor Transplants1998 - 20071998 - 2007

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

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spla

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Kidney Liver Lung

Pancreas Kidney-Pancreas Intestine

6,039

Non-Traditional Donor ProgramsNon-Traditional Donor Programs

Non-directed donorsNon-directed donors

Paired donorsPaired donors

UNOS’ voluntary generic UNOS’ voluntary generic allocation to intended allocation to intended candidatescandidates

Waiting List Additions 1998-2007Waiting List Additions 1998-2007U.S.U.S.

0

10,000

20,000

30,000

40,000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Year

Kidney Liver

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32,453

Doing the math…Doing the math…

There were 10,587 deceased donor kidney transplants in 2007.There were 10,587 deceased donor kidney transplants in 2007.

There were 6,039 live donor kidney transplants.There were 6,039 live donor kidney transplants.

In 2007, there were 32,453 recipients added to the waiting list.In 2007, there were 32,453 recipients added to the waiting list.

We transplanted 51% (16,626) of the We transplanted 51% (16,626) of the NUMBER ADDEDNUMBER ADDED to the list in to the list in 2007, this percentage excludes more than 70,000 patients already 2007, this percentage excludes more than 70,000 patients already registered to the list at the end of 2006.registered to the list at the end of 2006.

The dogmas of the quiet past are The dogmas of the quiet past are inadequate to the stormy present. The inadequate to the stormy present. The

occasion is piled high with difficulty, and we occasion is piled high with difficulty, and we must rise with the occasion. As our case is must rise with the occasion. As our case is new, so we must think anew and act anew.new, so we must think anew and act anew.

~ Abraham Lincoln ~ Abraham Lincoln

OPEN THE DOOR…OPEN THE DOOR…

EMBRACE THE POSSIBILITIESEMBRACE THE POSSIBILITIES……