Q. Which Organs Can Be Donated?
A: Currently, someone may be able to donate his or her heart, kidneys, liver, lungs, pancreas, and small intestine depending on their age, medical condition and circumstances at the time of death. Each organ is evaluated for possible donation individually. Many patients who are organ donors may also be candidates for tissue donation following the organ recovery.
Q: Who can be an organ donor?
A: All people – regardless of age – can be considered as potential organ donors. Each patient is considered individually after death has been declared. You should discuss your wishes about organ and tissue transplantation with your family so there will be no confusion regarding your wishes to donate.
Q: What is brain death?
A: There are two ways to pronounce death. Death may be pronounced when a person’s heart stops beating (Cardiac Death) or when the person’s brain stops functioning (Brain Death). Brain death occurs when blood, the oxygen it carries, cannot flow to the rest of the body because he or she is on a ventilator (breathing machine). In brain death, the organs and tissue remain viable and can be removed for transplantation. The organs and tissue are only removed after brain death has been declared by a physician. This physician is never part of a transplant team. Lastly, a situation called donation after cardiac death is possible. Organs are then recovered for transplantation after the person’s breathing and heartbeat has stopped.
Q: Is there an age limit to be able to donate?
A: There is no age limit for organ donation. The Donor Network has successfully procured organs from donors as young as a few days to adults in their 90s. A patient’s medical history is more important than the age of the donor. If a patient has a normal functioning organ and is in good health, then organ donation is certainly an option.
Q: What kind of diseases affect donation?
A: Presence of active cancer, active HIV or active infection would absolutely rule-out donation. If a person has a history of Hepatitis, more information would need to be obtained at the time of death. Patients who have Hepatitis C may still donate organs to a patient who also has Hepatitis C. The same is true for Hepatitis B – but this happens less frequently.
Q: Will my decision affect my medical care?
A: No. There are strict legal guidelines that must be carefully followed before brain death can be declared and organs removed. The doctors who treat a patient at the time of death are in no way involved with those responsible for organ removal. Organ donation is considered only after every effort has been made to save the patient’s life.
Q: Will my family have to pay for donation?
A: There is no charge to the donor family. All hospital costs related to the organ recovery are paid for by the Organ Procurement Organization (OPO)
Q: When must organs be removed?
A: Organs must be removed as soon as possible after the determination of brain death, while circulation is being maintained artificially. Tissue may be removed within 12 to 24 hours.
Q: Will organ donation interfere with funeral arrangements?
A: Organ donation does not disfigure the body or delay funeral arrangements. The organs are removed with respect in an operating room under sterile conditions.
Q: How is a potential recipient identified?
A: The United Network for Organ Sharing (UNOS)
Q: Will the recipient know who donated the organ?
A: The identity of the donor and the donor’s family are guarded. A recipient can know the donor’s sex, approximate age and state in which he/she lived. The identity of the recipient is also protected.
Q: How successful are organ transplants?
A: Success rates
Q: What happens when there is a need for an organ and insurance will not cover it?
A: Most organ transplants are covered by third party reimbursement insurance and Medicaid Medicare. In some instances, there may be an insurance cap whereby the member is only eligible for a certain amount of funding for surgical procedures. In those cases, every transplant program has social workers who will investigate those cases and support the patient in terms of writing special requests and/or petitioning the cap, so that the patient can receive the transplant. In New York State, we have seldom heard of patients needing life-saving organs that have been turned down because of insurance limits.
Q: Which factors are considered, (and in what order), when you decide who gets an available organ donation?
A: Organs are placed according to six standard criteria.
1. Severity of illness
2. Time waiting (when were they placed on the list)
3. Blood type
4. Tissue Type
5. Size (Organs must fit properly in the thoracic cavity).
6. Location (Placement in the nation goes according to regions. New York is in UNOS Region 9. Therefore, when we recover organs in New York, we make every effort to place them in New York. The numbers of miles away from the transplant center are included in the patient’s placement criteria on the list.)
Q: Do organ procurement organizations such as the New York Donor Network have an ethics committee?
A: Organ procurement organizations have a standing ethics committee, but also regroup if necessary for a particular case. In every region there is an ethics committee for procurement. Also, every hospital has an ethics committee that meets on a case by case basis depending on the particular circumstances associated with a donor case. The national organization (United Network for Organ Sharing – UNOS) also has a very active ethics committee.
Q: Do you have details about how many people in New York are waiting for specific organs?
A: We have statistics on every aspect of donation. You can also access that information through the www.UNOS.org
Q: If there are no compatible recipients in New York, how is it decided where the organ goes?
A: We access a computerized list of all patients waiting for a transplant and the list will direct us. The manager of that list is the United Network for Organ Sharing. In the U.S. we place organs locally, then regionally, then nationally. Because of time constraints and the viability of the organ, we make every effort to offer organs to centers closest to New York or the organ procurement center where it was procured. As an example, an organ may go to Pittsburgh, next, and so on. We would not offer it to, let’s say, California, because that is too far and it takes too long to fly an organ out that distance. Each organ has time limitations for viability. Therefore, time is of the essence in placement.
Q: Are New Yorkers, the first consideration in organs available in New York or is it a national need basis?
A: Yes, New Yorkers are first in line for New York-recovered organs. There are special circumstances, however, in regards to kidneys that mandate when a kidney matches a recipient’s tissue type and all antigens exactly. Then we are obligated through policy to send the kidney to the person that matches it perfectly, even if that means California. If we didn’t place it this way, it would be like having an identical twin and denying the other person to receive the perfect kidney match. Identical matches have much higher success rates.