Non-Heart Beating Organ Donation: A Case Study

2005 ◽  
Vol 15 (11) ◽  
pp. 467-475
Author(s):  
John Stirling
Keyword(s):  
Organ Donation ◽  
Clinical Assessment ◽  
Clinical Management ◽  
Organ Donor ◽  
Potential Donor ◽  
Heart Beating ◽  
Donation Process ◽  
Donor Transplant

The aim of this case study is to discuss the clinical management of a non-heart beating organ donor. This case study will concentrate in particular on the clinical assessment of the potential donor patient undertaken by the donor transplant coordinator (DTC) and the donation process up to the time of transplantation. The author will also describe the differences between heart beating and non-heart beating donors and discuss how transplantation can benefit renal recipient patients.

scholarly journals Experiencing organ donation: feelings of relatives after consent

2015 ◽  
Vol 23 (5) ◽  
pp. 895-901 ◽  
Author(s):  
Marli Elisa Nascimento Fernandes ◽  
Zélia Zilda Lourenço de Camargo Bittencourt ◽  
Ilka de Fátima Santana Ferreira Boin
Keyword(s):  
Organ Donation ◽  
Emotional Support ◽  
Management Practices ◽  
Organ Procurement ◽  
Organ Donor ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Potential Donor ◽  
Donation Process ◽  
The Family

Objective: to identify experiences and feelings on the organ donation process, from the perspective of a relative of an organ donor in a transplant unit.Method: this was exploratory research using a qualitative approach, performed with seven family members of different organ donors, selected by a lottery. Sociodemographic data and the experiences regarding the donation process were collected through semi-structured interviews. The language material was transcribed and submitted to content analysis.Results: poor sensitivity of the medical staff communicating the relative's brain death - the potential donor - and the lack of socio-emotional support prior to the situation experienced by the family was highlighted by participants.Conclusions: the study identified the need to provide social-emotional support for families facing the experience of the organ donation process. From these findings, other care and management practices in health must be discussed to impact the strengthening of the family ties, post-donation, as well as the organ procurement indexes.

Donor organ management

2021 ◽  
pp. 691-705
Author(s):  
Arne P Neyrinck ◽  
Patrick Ferdinande ◽  
Dirk Van Raemdonck ◽  
Marc Van de Velde
Keyword(s):  
Brain Death ◽  
Treatment Strategies ◽  
Organ Donor ◽  
Hormonal Changes ◽  
Physiological Changes ◽  
Donor Pool ◽  
Potential Donor ◽  
Donor Management ◽  
Heart Beating ◽  
Pituitary Thyroid Axis

Organ transplantation is the standard treatment modality for end-stage organ disease in selected cases. Two types of potential organ donors can be identified: the brain-dead 'heart-beating donors', referred to as DBD (donation after brain death), and the warm ischaemic 'non-heart-beating donors', referred to as DCD (donation after circulatory death). Brain death induces several physiological changes in the DBD donor. An autonomic storm is characterized by massive catecholamine release, followed by autonomic depletion during a vasoplegic phase. This is associated with several hormonal changes (suppression of vasopressin, the hypothalamic-pituitary-adrenal axis, and the hypothalamic-pituitary-thyroid axis) and an inflammatory response. These physiological changes form the basis of organ donor management, including cardiovascular stabilization and hormonal therapy (including vasopressin and analogues, thyroid hormone, and cortisol). Donor management is the continuation of critical care, with a shift towards individual organ stabilization. An aggressive approach to maximize organ yield is recommended; however, many treatment strategies need further investigation in large randomized trials. DCD donors have now evolved as a valid alternative to increase the potential donor pool and challenge the clinician with new questions. Optimal donor comfort therapy and end-of-life care are important to minimize the agonal phase. A strict approach towards the determination of death, based on cardiorespiratory criteria, is prerequisite. Novel strategies have been developed, using ex situ organ perfusion as a tool, to evaluate and recondition donor organs. They might become more important in the future to further optimize organ quality.

A Qualitative Study of Turning Points or Aha! Moments in Older Adults’ Discussions About Organ Donation

2018 ◽  
Vol 28 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Kimberly Downing ◽  
Linda L. Jones
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Organ Donation ◽  
Organ Procurement ◽  
Turning Points ◽  
Age Groups ◽  
Organ Donor ◽  
Younger Age ◽  
Donation Process ◽  
Dialogue Process

Introduction: Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. Objective: The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as “Aha!” moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. Setting and Participants: Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or “Aha!” moments of participants’ decision-making about organ donation and organ donor registration. Findings: Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). Discussion: The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.

Chaplain “DOs and DON’Ts” on Organ Donation

2018 ◽  
Vol 43 (7) ◽  
pp. 1-2
Author(s):  
Jozef Zalot ◽  
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Family Members ◽  
Organ Donor ◽  
Organ Donors ◽  
Vital Organ ◽  
Course Of Action ◽  
Donation Process ◽  
Organ Procurement Organizations ◽  
The Relationship

This guide was developed in collaboration with LifeCenter Organ Donor Network (Cincinnati, OH) to offer chaplains a framework for the best possible course of action when they provide spiritual care to family members of patients who are potential vital organ donors. Some organ procurement organizations (OPOs) may want to control the donation process. They are thus hesitant to invite in—let alone collaborate with—any “outsiders” who they believe might undermine the likelihood of procuring vital organs. So how should a chaplain respond when ministering to potential vital organ donors and their families? Should they speak with family members about donation? What should they say? Do OPOs want chaplains to speak with family members? Should there be limits to these conversations? This can be a touchy area, because vital organ donation necessarily entails the death of the patient. This makes the relationship between chaplains and OPOs sometimes strained.

scholarly journals Organ Donation and the Ars Moriendi

2019 ◽  
Vol 86 (4) ◽  
pp. 327-334
Author(s):  
Stephen Doran
Keyword(s):  
Organ Donation ◽  
Human Person ◽  
Organ Donor ◽  
Third Party ◽  
Organ Donors ◽  
Potential Organ Donor ◽  
Ars Moriendi ◽  
Dying Patients ◽  
Donation Process ◽  
The Impact

Organ donation is rightly understood as a gift that is a genuine act of love. Organ donation as an act of love requires it to be an act of freedom that honors the integrity of the human person who is in the process of dying. However, the process of organ donation, by necessity, inserts a third party of interest whose primary aim is to assist someone other than the dying person. Caregivers can become “organ focused” instead of “patient focused.” The procurement of organs potentially results in the commodification of the potential organ donor. Furthermore, death is not a momentary event but rather an ontological change in the person where the union of body and soul becomes divided. This Catholic understanding of death is important to assess the impact of organ donation on the process of dying. Family members of organ donors often have traumatic memories associated with the organ donation process, potentially overshadowing the ars moriendi—the art of dying. Summary: While organ donation is an act of love, the donation process can be distraction from the care of the dying patient, who may be treated differently than other dying patients who are not organ donors. A Catholic understanding of death is helpful in assessing the impact of the organ donation process.

scholarly journals Critical Care Nurses’ Attitudes Towards Organ Donation and its Relationship With Empathy

2020 ◽  
Vol 24 (6) ◽  
pp. 544-555
Author(s):  
Mahnaz Taherkhani ◽  
◽  
Leili Yekefallah ◽  
Leila Dehghankar ◽  
Peyman Namdar ◽  
...  
Keyword(s):  
Critical Care ◽  
Organ Donation ◽  
Organ Donor ◽  
Educational Interventions ◽  
Critical Care Nurses ◽  
Reactivity Index ◽  
Average Score ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Donation Process

Background: Critical care nurses play an important role in the organ donation process, and their attitudes towards it and willingness to register as an organ donor are related to various factors, including empathy. Objective: This study aims to compare the attitudes of nurses in Intensive Care Unit (ICU), Emergency Department (ED), and Dialysis Unit (DU) towards organ donation and its relationship with empathy. Methods: This descriptive study with cross-sectional design that was conducted in 2019 in hospitals affiliated to Qazvin University of Medical Sciences in Qazvin, Iran on 222 nurses from the three critical care units who were selected by stratified random sampling method. Data collection tools were Chakradhar’s Organ Donation Questionnaire (ODQ) and Davis’s Interpersonal Reactivity Index (IRI), completed by nurses were completed. Data were analyzed by descriptive and analytical tests. Findings: The mean ODQ score was higher in DU and ICU nurses than in ED nurses (P=0.23), where the nurses of ICU-General had the highest score (51±6.07) and the nurses of ED-Trauma had the lowest score. The highest and lowest IRI scores were related to DU and ICU-General nurses, respectively. The total IRI score (r=0.13, P=0.04) and its dimensions of perspective taking ( r=0.152, P=0.02) and fantasy (r=0.14, P=0.03) had a positive correlation with the nurses’ attitudes. Conclusion: Critical care nurses have greater than the average score in ODQ. There is a significant relationship between empathy and their attitudes towards organ donation. Their empathy with patients has a significant effect on increasing their attitudes towards accepting organ donation. Therefore, it is necessary to implement educational interventions for changing the critical care nurses’ attitudes in order to increase their empathy.

scholarly journals The donor potential of twenty six donor bases in the Russian Federation: external audit (a pilot project)

2020 ◽  
Vol 48 (3) ◽  
pp. 153-161
Author(s):  
V. L. Vinogradov ◽  
K. K. Gubarev ◽  
A. I. Zakhlevnyy ◽  
D. S. Svetlakova
Keyword(s):  
Intensive Care ◽  
Brain Injury ◽  
Brain Death ◽  
Organ Donation ◽  
Intensive Care Units ◽  
Pilot Project ◽  
Secondary Brain Injury ◽  
External Audit ◽  
Potential Donor ◽  
Donation Process

Rationale: The imbalance between the need for donor organs and their current availability is a growing problem for all countries. An assessment of potential donor numbers is considered to be an important step towards better understanding of the problem as a whole at the national scale. This would help to build up a concept of a successful strategy to resolve this inequity.Aim: To analyze the use of external audit of the efficacy of identification of potential organ donors with confirmed brain death.Materials and methods: As a part of a pilot project aimed to increase the efficacy of donor bases of the Russian Federal Medical Biological Agency (FMBA), we retrospectively analyzed 5932 medical files of patients who died from 2014 to 2018 in the departments of resuscitation and intensive care units of 26 medical establishments serving as a donor bases in Moscow, Orenburg, Saratov, Abakan, Stavropol and FMBA of Russia. The probability of brain death was assessed with a special QAPDD (Quality Assurance Program in the Deceased Donation Process) technique focused on organ donation after brain death which is used for external audit in Spanish hospitals.Results: Clinical manifestation of brain death were identified in 20.3% (95% confidence interval (CI) 18.4–22.4) of the patients aged 18 to 65 years with severe primary and secondary brain injury who died in the departments of resuscitation and had been maintained on mechanical ventilation at least 12 hours until their death was confirmed. The rate of potential donor identification with clinical manifestations of brain death in the donating in-patient departments was 12% (95% CI 10.5–13.7) of those who died with severe primary and secondary brain injury. The external audit performed in 26 donating in-patient departments, has shown that 41% (95% CI 35.8–46.4) of potential donors with brain death were not identified.Conclusion: With the use of the QAPDD technique in our study, we found that 41% of potential donors were not identified in the Russian in-patient clinics participating in organ donation. Based on the information obtained during the audit of medical files in intensive care units, we can make realistic conclusions on the current system of organ donation, identify potential pitfalls in the identification procedures of potential donors, increase the efficacy of donation process, and to improve the system as a whole. The process could become effective only through the activities of specially trained donor hospital transplant coordinators.

Organ Donation and Transplantation: A Survey of Critical Care Health Professionals in Nontransplant Hospitals

2005 ◽  
Vol 15 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Susan Marie Chernenko ◽  
Louise Jensen ◽  
Christine Newburn-Cook ◽  
David L. Bigam
Keyword(s):  
Critical Care ◽  
Organ Donation ◽  
Tertiary Care ◽  
Potential Donor ◽  
Hospital Administrators ◽  
Donation Process ◽  
Care Health ◽  
Tertiary Care Centers ◽  
Descriptive Survey

Context Exploration of the role of critical care professionals in improving organ donation within Canada has been limited to tertiary care centers while donor potential in smaller nontransplant hospitals remains unknown. Objective To gain an understanding of the knowledge, attitudes, and perceived barriers that healthcare professionals in 5 nontransplant hospitals in Alberta have toward organ donation and transplantation, and to identify factors that influenced participation in the donation process. Design A descriptive survey of critical care professionals. Setting Five nontransplant hospitals in Alberta, Canada. Results Of the 135 respondents, 98 were critical care nurses, 32 were physicians, and 5 were hospital administrators. Respondents were least knowledgeable about transplant statistics and religious beliefs regarding donation, although overall, attitudes reflected positive support for organ donation. Respondents exhibited reluctance in approaching a potential donor family, and believed inadequate resources were allocated for organ donation. Conclusions Educational programs are needed to increase knowledge of organ donation and transplantation as well as the development of an in-house coordinator program in nontransplant hospitals for critical care personnel.

Death and dying

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Spinal Cord ◽  
Organ Donation ◽  
Cranial Nerve ◽  
Death And Dying ◽  
Organ Donor ◽  
Cerebral Hemispheres ◽  
Cardiorespiratory Control ◽  
Brainstem Death ◽  
Heart Beating ◽  
Reticular Activating System

Confirming death using neurological criteria (brainstem death) 530Withdrawing and withholding treatment 532The potential heart-beating organ donor 534Non-heart-beating organ donation 538The brainstem provides the anatomical link between the spinal cord and cerebral hemispheres relaying sensory and motor impulses between the periphery and higher cortical centres. It also contains cranial nerve nuclei, the reticular activating system and cardiorespiratory control centres, the destruction of which underlies the process of confirming death according to neurological criteria (brainstem death)....

Health Sustainability and Socialization Agents Roles in Organ Donation

2020 ◽  
pp. 184-202
Author(s):  
Pushpavalli Maniam ◽  
Izzal Asnira Zolkepli
Keyword(s):  
Organ Donation ◽  
Organ Donor ◽  
Health Issues ◽  
Potential Donor ◽  
Starting Point ◽  
Health Initiatives ◽  
Socialization Agents ◽  
Duality Of Structure ◽  
Sustainable Health

This article explores how sustainable health can be encouraged through the role of socialization amongst the youth in Malaysia in the context of the decision-making process towards becoming an organ donor. This is imperative for the nation especially the policymaker and health business sector in designing strategies pertaining to health issues. The concept of the ‘duality of structure' is used as a starting point to link between health sustainability and health communication on organ donation in congregating intergenerational equity by uncovering the structural properties or conditions which either enable or constrain the future of health initiatives. Therefore, this article is aimed to focus on the values and norms commonly transferred by the socialization agents regarding the behavioral development of the potential donor. Data was gathered using self-administered questionnaires from 162 youth. The findings illustrate that the supportive influence from agents of socialization affected towards certain degree on the behavioral formation on becoming an organ donor.

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