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Organ and Tissue Donation Reference Guide

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Organ and Tissue Donation Reference Guide Powered By Docstoc
					  Organ and Tissue
Donation Reference Guide.




       The gift of life.
                Pass it on.
      Table of Contents.


 1.   Donation and Its Importance.

 3.   The Wisconsin Donor Network.

 5.   What can be Donated.

 8.   Types of Donors.

 9.   Brain Death.

12.   The Donation Process.

13.   Family Discussion Guide.

16.   Frequently Asked Questions.

21.   Religious Views on Donation.

28.   Ethical Issues in Donation and
      Transplant.

31.   History of Transplant.

39.   Glossary of Terms.
                                   Donation and
                                     Its Importance.




        Visit our website at
     www.wisdonornetwork.org
       and click on “Donor/
     Recipient Profiles” to see
     some of the lives that have
      been saved and touched
      through organ donation.




1.
Scientific, surgical and medical
advancements have made it possible since
the 1960s to transplant many human organs
and tissues with great success.

Transplantation of vital human organs, one of the most
complex medical endeavors, is no longer considered an
experimental procedure, but a common life-saving therapy.
Transplant is the only medical option for thousands of men,
women and children suffering from organ failure. Without
receiving a transplant to replace their failing organ, many die.

Transplantation, however, can only occur if donated
organs and tissues are available. The need for organs and
tissues for transplant continues to exceed donations in all
areas of the country. Although most people support organ
and tissue donation, many have not signed a donor card
or talked about their wishes with their family. Despite the
well-publicized advances in transplant surgery, there is
still a critical shortage of donated organs and tissues.

Taking appropriate steps to be a donor upon death is very
simple. On the back of your Wisconsin driver’s license is
space to indicate intent to be an organ and tissue donor.
A uniform donor card serves the same purpose. On both
documents are options for you to indicate your wishes to
donate any usable organs and tissues, or designated
organs and tissues. The first step is to select the appropriate
box and sign your card. As important as signing the
license, though, is talking with your family. Let them
know your wishes. At the time of death, the organ
procurement organization will want to ensure that the
family supports the donation. Being aware of your wishes
ahead of time makes the situation easier on your family
when they know they are reaffirming what you wanted.


                                                                   2.
                                  The Wisconsin
                                    Donor Network.

                                  The Wisconsin Donor Network is
                                  the designated organ procurement
                                  organization supporting the transplant
                                  community in eastern Wisconsin.
                                  An organ procurement organization is federally
                                  designated to cover every area of the United States
                                  geographically to oversee the organ donation process
                                  in that area. The WDN is located in Milwaukee and
                                  serves 2.3 million people in a 10-county region,
                                  including Door, Kenosha, Manitowoc, Milwaukee,
                                  Ozaukee, Racine, Sheboygan, Walworth, Washington,
                                  and Waukesha counties.

        Visit our website at      The Wisconsin Donor Network is also affiliated
                                  with the 45 acute-care hospitals in eastern Wisconsin,
     www.wisdonornetwork.org
                                  the transplant programs at Children’s Hospital of
     and click on “About Us” to   Wisconsin, Froedtert Memorial Lutheran Hospital
     meet our staff and for any   and St. Luke’s Medical Center, as well as the
      contact information that    Wisconsin Lion’s Eye Bank and several tissue banks.
          you may need.                                                      .
                                  Below (middle): Rear Admiral Kenneth P Mortisugu, MD, MPH, U.S. deputy
                                  surgeon general, delivers the keynote address on the lawn of the governor’s mansion
                                  at the Governor’s Donor Memorial Service.
                                  Below: (right): WDN staff at the Governor’s Donor Memorial Service.




3.
In addition to recovering organs for transplant, the
Wisconsin Donor Network also provides public and
professional education about the tremendous need for
organ and tissue donors. It is the region’s primary, most
current source of information regarding organ/tissue
donation and transplant.

We are a member of the Association of Organ Procurement
Organizations, Coalition on Donation, the United Network
for Organ Sharing, and the Wisconsin Coalition on Donation.

For up-to-date information and data about donation and
the number of people waiting for organs in Wisconsin and
throughout the country, visit www.wisdonornetwork.org.

Below: Wisconsin Donor Network Volunteer Christine Brown, kidney-pancreas
transplant recipient, speaks at the Governor’s Ceremony.




                                                                            4.
                       What Can
                          Be Donated.



         Organs              Ti s s u e s
                            corneas

         lungs                heart valves
                                   skin
          heart
                                 bone
        liver
                              blood vessels
         kidneys

      pancreas                  cartilage/
                                ligaments
     small intestine




5.
We aren’t limited to helping others through
organ and tissue donation only upon death.
Living donation is becoming increasingly
common, especially for organ donation.
Living kidney donations have proven successful for decades,
since we have two kidneys and only need one to live a full,
healthy life. More recently, transplant professionals have also
developed procedures for removing a portion, or “lobe” of
a healthy individual’s liver or lung to transplant into someone
needing a transplant.

Bone - Supports the body, protects vital organs. Used in
facial reconstruction, limb salvage, correction of birth
defects, cancer treatments, spinal and oral surgery.
Bone marrow - Forms blood cells. For treating patients
with leukemia.
Cartilage - Connective tissue that serves as skeletal tissue
in some parts of the body, such as nose and outer ear.
Facial and other cartilage reconstruction.
Corneas - Allow light to enter the eye. Restore sight to
some people with blindness.
Heart - Pumps blood to all body systems. For patients with
end-stage heart disease.
Heart valves - Control flow of blood in the heart by opening
and closing with each heartbeat. Used to reconstruct the
poorly formed heart valves in children, or the diseased
valve in adults.
Intestine (small) - Portion of digestive tract important for
absorption of nutrients. Treats patients with digestive and
absorption disorders (most commonly young children).



                                                                  6.
     Kidneys - Extract waste from the blood; produce important
     hormones. Eliminate need for dialysis.
     Liver - Instrumental in energy regulation, makes proteins,
     removes wastes from the blood. For patients with end-stage
     liver disease.
     Lungs - Organs of respiration. For patients with cystic
     fibrosis, emphysema, or other end-stage lung disease.
     Pancreas - Secretes enzymes necessary for digestion,
     secretes insulin that regulates blood sugar. For treating
     diabetes by eliminating the need for insulin injections,
     reduces risk of losing sight or limb.
     Saphenous veins - Longest vein in the leg, which carries
     blood from the leg back to the heart. Used in patients to
     bypass obstructions in the heart, or to reconstruct blocked
     or damaged vessels of the leg.
     Skin - Protects the body against dehydration, injury and
     infection. Used as a temporary covering for burn patients,
     decreases pain, infection, scarring, heat loss and fluid loss.
     Tendons - Attach muscle to bone. Used for sports-related
     joint injuries.


     Bottom (right): “It has given me my health back as well as the chance to watch my
     children grow and spend time with them.” - liver recipient Keith Keller, Grafton




7.
                           Types of Donors.


Living Donors     Organ Donors                  Tissue Donor
                  Brain dead individual         Individual whose cardiac
                  whose cardiopulmonary         and respiratory function
                  function is artificially      have ceased.
                  maintained on a respirator.


Blood             Heart                         Eyes


Bone Marrow       Lungs                         Bone


Semen             Liver                         Skin


Kidney            Pancreas                      Tendons


Liver (portion)   Kidneys                       Ligaments


Lung (portion)    Intestine                     Heart Valves


                  After cessation of
                  cardiopulmonary function,     Saphenous and
                  an organ donor may also       Femoral Veins
                  be a tissue donor.

                          Body Donation
Research                                                       Education

                                                                           8.
                                                              Brain Death.

           One issue related to organ                                The criteria for determining brain
                                                                     death were first established in 1968
           donation that is often                                    by a group of Harvard Medical
           misunderstood is the                                      School specialists. These criteria
           concept of brain death.                                   have been refined with experience
                                                                     and endorsed by the American
           Many people do not realize that                           Medical Association, medical ethicists,
           to donate organs a person must be                         the government, and accepted by all
           “brain dead.” Most people are more                        major religions in the country.
           familiar with the concept of “cardiac
           death,” which means that the heart stops                  Before the development of life-
           functioning. With brain death, the brain                  support machinery, such as the
           stops functioning.                                        ventilator and the respirator, anyone
                                                                      in this condition suffered cardiac
           Brain death is death. It is the                           arrest very quickly because the lack
           cessation of all brain function,                          of oxygen to the body caused the
           meaning that the patient is unable to                     heart to stop beating. Now, however,
           breathe spontaneously and has no                          the definition of death is more
           memory, consciousness, knowledge,                         complex. With life-support equipment,
           thought, feeling, sight, touch or any                     a patient can receive oxygen and the
           other sense. It is permanent,                             vital organs can “function” for some
           irreversible, and not the same as                         time even after the brain has died.
           being in a coma or vegetative state.                      The time can vary from a couple
           The brain is irreparably destroyed.                       of hours to a couple of days.




     Above: WDN volunteers help individuals become potential organ donors by informing them of the importance of signing
     the back of their driver’s license at the Wisconsin State Fair.
9.
Brain death usually occurs when a person receives a severe
head injury or suffers a stroke or a burst blood vessel in the
brain. When an unconscious patient who has suffered such
an injury is first brought to the hospital, he or she is
connected to a ventilator immediately as a life-saving measure.
Only later, after the patient is stabilized, is it possible to
determine the condition of the brain. Following specific
guidelines, the physician taking care of the patient in the
intensive care unit orders certain tests to determine if there
is any brain function. If the results indicate that no function
remains, the patient is brain dead. The person may look as if
he or she is only asleep and able to awaken at any moment.
But in fact the personal, intellectual and social characteristics
that made that person an individual are gone. Without the
ventilator, the person would make no effort to breathe and
the heart would soon stop.

It is at this point that the physician explains the patient’s
status to the family. Also, because time is limited, the family
is also informed of the option for organ donation. For the
organs to be successfully used to save the lives of others,
they must be removed as soon as possible. If the family
members agree to donate their relative’s organs, the
ventilator that has supplied oxygen to the patient all along
remains on to keep blood flowing to the organs. This is a
concept that many people find hard to understand, but it is
the key to organ donation. If the family decides not to
donate, the ventilator is discontinued.

Organs can only be used for transplant if they are
oxygenated and functioning up until the moment they are
removed from the donor. This is why donated organs must
come from a person who is brain dead and whose organ
function has been maintained artificially. Otherwise, the
organs are not useful for transplant. This isn’t the case for
tissue donation. Tissues don’t require the continuous supply

                                                                    10.
      of blood and oxygen like organs do, so tissue donation can
      take place after a cardiac death, as well as brain death.

      Although the definition of brain death has gained legal,
      ethical and religious acceptance, it has posed new
      problems for health care professionals and ethicists. The
      question becomes, how and when do you recognize the
      moment of death of the brain dead patient?

      For most people it is important to have a definitive ending
      when a loved one dies in a hospital, to visit the bedside of
      that person to pay last respects. In the case of someone
      who is brain dead and whose organs are being donated,
      the family may visit the bedside but may be faced with a
      person who looks perfectly normal. The chest moves up
      and down because of the mechanics of the ventilator, the
      body may be intact except for the internal head injury, and
      the person is warm to the touch. It is a difficult situation,
      but one that families need to understand if they are to
      comprehend the death and donation process.

      Because this is a trying time for family members, organ
      donation is not always easy to talk about. This is why
      discussion beforehand is so strongly encouraged. The best
      time to discuss organ donation for the first time is not
      during the grieving period. If the family members have
      discussed the issue before, the decision is much easier and
      they can begin to feel that in some way, their loved one will
      go on living through others. The decision to donate often
      eases some of the pain, and is especially comforting when
      the family members know their relative’s wishes.

      It has also been found that most families find a great deal
      of comfort in organ donation. They feel that something
      positive has come from an otherwise tragic event. This
      feeling of comfort is even stronger when they know for
      sure, based on previous discussion, that their loved one
      supported organ donation.




11.
                                        Donation Process.

These steps will
                                           Patient is admitted. All efforts are made to
always occur,                                          stabilize the patient.
but the sequence
and time frame                                  All efforts to save the patient fail.
between events
may vary. After                             Present or pending declaration of death.
consent is
obtained, the
                                             Wisconsin Donor Network is notified
entire process                             for evaluation of this patient as a potential
may vary from                                          organ/tissue donor.

a few hours
to more than 20.                              Family is given the option to donate
                                                     organs and/or tissue.


                                          Management of care is transferred to WDN or
                                           designated tissue bank. Further evaluation is
                                        completed with the assistance of the donor hospital.


                                                 Organ and/or tissue allocation
                                                   process is implemented.


                                         Organ and/or tissue are recovered surgically.
Above: “I am grateful for the family
who gave me the gift of life. I thank
God for every day now.”
  - heart recipient Marcie                         Family and hospital receive
    Keckhaver, Burlington
                                                   follow-up correspondence.


                                                                                               12.
                                        Family
                                      Discussion Guide.

      Since the most critical step in              about organ donation, a television
                                                   program that discusses death or
      the organ donation process is                transplantation, or the death of a
      the support of the family for                celebrity or someone the family
                                                   knew. It may be difficult for members
      a donation, it’s important for
                                                   of your family to discuss organ
      families to discuss donation                 donation in relation to themselves,
      and understand each other’s                  but less difficult in relation to others
                                                   or an event or news story. Bring up
      wishes before a tragedy occurs.              the subject when it is time for your
                                                   driver’s license to be renewed, since
      There are many ways to approach the          you will have a chance to consider
      subject of organ donation with your          organ donation at this time.
      family, but a few suggestions might
      help you plan the discussion.                No matter how you decide to approach
                                                   the subject, try to be as well-informed
      Designate a time for the discussion          as possible by reading this booklet,
      and ask each member of your family           visiting the WDN website or calling
      to think about their feelings and            the WDN if you have questions.
      questions beforehand. Suggest that
      they write down their questions ahead        Now that you have decided how to
      of time. These questions can be used         begin the discussion, you should be
      to break the ice and stimulate discussion.   prepared for a variety of reactions

      Bring up the subject one evening to test
      your family’s reaction. If they seem
      interested, proceed as long as the
      discussion continues. If there seems to
      be a lack of interest or family members
      have other things to do, try another
      time, or tell them you’d like to set
      aside a time to discuss the issue.
      Be prepared to bring up the topic in
      relation to other events – a news story


13.
among members of your family. It is quite possible that
someone will become angry or anxious during the
discussion. More than likely, the anxiety is related to the
issue of death rather than to the idea of organ donation itself.

If someone becomes upset, remain calm. Try to find out
gently why the person is upset. Remember the “positive
approach” that the talk you are having is about giving life
to another human being. Enlist the help of others in the
family. If this positive approach does not work, respect the
person’s wish to leave the room or to end the conversation.
Perhaps he or she will be able to discuss the subject at
another time, or will be better able to handle the topic
one-to-one rather than in a family group.

Another possible reaction to the subject is humor. You may
find that someone in the group will begin to make jokes
about organ donation, transplantation or even death to deal
with his or her own anxiety about the discussion. Or, the
humor will be a way to lighten the mood. This reaction is
normal. Don’t overreact to the jokes by making the person
feel uncomfortable, but don’t encourage the humor either.
If you continue in a serious vein, the rest of the group will
follow your lead.

Throughout the discussion, keep the conversation on an
even keel and always focused on the topic at hand. The best
way to do this is to listen carefully to what each person
says and to respond in a non-judgmental way. If someone
expresses an opinion that you disagree with, it is important
for you to remain objective and to recognize each person’s
right to a particular point of view. You may ask that person
about his or her opinion, but do it directly, without
questioning the person’s right to think independently.


                                                                   14.
      If someone in the group becomes angry with someone else
      because of an opinion, it will be up to you to point out that
      there is no right or wrong in this discussion. Everyone
      should feel comfortable expressing an opinion without fear
      of criticism. The important thing is to discuss the issue
      openly and to learn how each family member feels about
      organ donation.

      Remember, as difficult as this may seem, keep in mind how
      much more difficult it would be if the discussion had to take
      place at a traumatic time when your family has just been
      told that a loved one has been critically injured or has died.


      Below (top, left): Mary Nachreiner, donor mom, speaks at the Wisconsin Coalition on
      Donation’s 20th Anniversary of National Organ and Tissue Donor Awareness Week.

      Below (bottom, left): Governor Doyle proclaims April as “Donate Life Month”
      throughout Wisconsin, presenting the proclamation to the Wisconsin Coalition
      on Donation.

      Below (right): The event was highlighted by a display on the dramatic impact of organ
      and tissue donation. Starting from the center of the room, 50 individuals moved with
      lengthy ribbons to the outside walls, covering the rotunda with a striking starburst
      display, visually illustrating the potential impact just one person can make on so many
      lives. One Decision = Many Gifts.




15.
                              Frequently
                            Asked Questions.

I’m afraid that if I carry a signed license or donor card,
they won’t do everything to save me in an accident.
Emergency responders and healthcare workers are committed to saving
lives. Your survival is always their first priority. Donation is considered
only when all efforts to save the individual’s life have been exhausted. The
physicians who treat you in an emergency room are in no way connected
with transplant surgeons or the medical team that would recover organs.

I’m too old to donate. You wouldn’t want anything from me!
Although the upper age limit for organ donation is usually in the 70s, each
potential donor is evaluated on a case-by-case basis. Sometimes, our age in
years is not an accurate reflection of our health and vitality! Tissue donors
can be even older. Most importantly, an older person can have a positive
influence on his or her family’s discussion about donation. If you think that
donation is worthwhile, then you should sign your license and talk about it
with your family. Organ viability will be determined at death.

I’ve had cancer. Or, I have (name a disease). I couldn’t donate.
Every potential donor is evaluated at the time of his or her death to
determine the suitability of the organs or tissues for transplant. Most
diseases would not rule out donation, including cancer. Everyone,
regardless of health history, has the opportunity to give the gift of life.

Organ donation is disfiguring. I don’t want to be cut up.
Organ and tissue donation is a very careful surgical procedure. Great care is
taken so that an open-casket service is still possible with any type of donation.
Funeral arrangements can continue as scheduled.

What about Mickey Mantle? Celebrities or rich people
get priority for transplant.
Celebrity transplants tend to get more media coverage, so it may seem to
be common. In fact, most people can only name a few celebrity transplant
recipients, yet 20,000 people like you and me receive the gift of life each
year. Because organ donor programs don’t know the financial status of the

                                                                                    16.
      recipients on the list, having lots of money does not affect
      who will receive organs for transplant. Mickey Mantle was
      very, very sick at the time he was put on the list and was
      unexpectedly lucky to be matched with a liver so quickly.
      Walter Payton, on the other hand, died after getting listed
      for a liver transplant.

      What is brain death?
      Brain death occurs when a person has an irreversible brain
      injury that causes all brain activity to stop permanently.
      Some organs are still useable after brain death. The
      standards for determining brain death are very strict.

      Can someone recover from brain death?
      No. If you hear stories about people who were brain dead
      and recovered, those people were not actually brain dead.
      They were in a deep coma with slight brain activity. They
      would not have been considered for donation.

      I think it’s against my religion.
      All major religious groups in the United States support organ
      donation, or the individual’s personal choice for donation.
      You should contact your clergy for more information
      regarding your denomination’s position on donation.

      It’s not fair that families are charged for donation.
      A donor’s family is not charged. Any cost related to the
      recovery of organs and tissues are ultimately paid by a
      recipient’s insurance company. Families are still responsible
      for costs resulting from trying to save the donor’s life, but
      not for any costs resulting from the donation.

      Will I be paid for donation?
      No. It is illegal to buy or sell organs in the United States.

      I’ve heard something about for-profit organ or
      tissue donation agencies. What is that all about?
      It is illegal in the United States to buy or sell human organs
      or tissue. Organ procurement organizations oversee the
      donation process for human organs — heart, lung, liver,
      kidney, pancreas and small intestines. OPOs are non-profit.

17.
Tissue recovery agencies recover human tissues — skin,
bone, veins, heart valves and connective tissue such as
ligaments, tendons and cartilage. Unlike organs, tissue
has to be “processed” before it can be used. The processing
is performed by an organization that may be for-profit or
non-profit. The controversy is the concept of these
organizations “profiting” from processing human tissue.
In the tissue processing industry, the argument against for-
profit tissue processing organizations is the “commodification”
of the human body and the notion of people profiting from
others’ deaths and donation of their tissue. The argument
for for-profit tissue processing organizations is that these
organizations are able to direct more money into research
and development and find more uses for tissue, resulting
in being able to help more people.

Are they going to start using cloning for
transplanting organs?
Cloning has been widely covered in the media. Theoretically,
it could have an application in organ transplantation — not
for cloning a human being as a source of organs, but to
clone human cells to grow them into kidneys, livers,
hearts, etc. At this point it’s all theoretical and no one
knows if it’s possible. Plus, there are important ethical
issues that need to be addressed. The transplant field of
medicine is closely monitoring research developments but
too much is unknown at this point to say if cloning for
transplant is possible or appropriate.                            Above: “My transplant
                                                                  has given me energy and
                                                                  freedom. I have freedom
What about those guys who received                                to exercise without taking
mechanical hearts? Why can’t man-made                             insulin shots (had taken
                                                                  them since age 11) and
organs be used instead of transplanting                           now life without dialysis.
human organs?                                                     I have a new found energy
                                                                  and I am forever grateful.”
Several men have recently been the recipients of new,
                                                                    - kidney and pancreas
artificial hearts to replace their diseased, dying ones.              recipient Gail Halloran,
Early results have been very encouraging; one patient was             Milwaukee



                                                                                      18.
      even discharged home, but this device is still experimental.
      Artificial hearts may hold promise as a transplant treatment
      someday, but considerably more research, testing and
      product development will be needed first. Artificial heart
      development for wide-spread use is still many years away,
      at the earliest.

      Must I have an orange dot on my license to
      become a donor?
      No. The two things necessary to indicate your wish to
      be an organ or tissue donor are to sign the back of your
      license or a donor card and share your wishes with your
      family. Orange “donor dots” are a helpful tool to remind
      you and family members of your wishes.

      Is it necessary to sign my license since my
      family will have the ultimate decision
      anyway?
      It’s a formal declaration by you of your wishes and is an
      additional reminder to your family of your wishes.

      Why does my decision involve my family?
      It’s a personal decision to be a donor.
      Very often, a signed license or donor card can’t be found
      at the time when someone may be eligible for donation,
      so family members are approached by donation
      representatives. Sharing your decision will relieve your
      family of the burden of making the decision for you at
      a very traumatic time. When families talk about donation,
      it ensures that the decisions made at the time of death are
      the ones that were desired.

      How do they decide who gets the organs?
      How bad the illness is, how long the person has been
      waiting and how close the blood type and other important
      medical factors match the recipient are part of the
      decision. Race, gender, income and social status are never
      considered when determining who receives an organ.




19.
Can I choose what is donated?
Yes, on the donor card you can specify what you want
to donate.

May I designate where or to whom my
organs may be donated?
You may direct a donation to someone with whom you have
a family or community connection. You cannot, however,
restrict your donation to anyone based on their religion,
race, age or reason for their disease. For example,
requesting that your liver not go to a patient with a history
of drug or alcohol abuse would not be allowed because it
is discriminatory. Your options would be to donate or not
to donate.

How many people can a single donor benefit?
One person has the potential to help more than 50 people.
Donation can dramatically improve, even save, the lives
of those suffering from organ failure, bone defects, burns
or blindness.

Can you donate an organ while you are
still alive?
Some transplants can use part of the liver. Thousands of
kidney transplants are from living donors. Parts of a lung
may also be transplanted.

Below: Runners and walkers participate in Sarah’s Stride run/walk. Sarah’s Stride
raises funds for organ donor awareness efforts throughout southeastern Wisconsin.




                                                                                    20.
                                   Religious Views
                                        on Donation.

                                 AME & AME Zion
                                 (African Methodist Episcopal)
                                 Organ and tissue donation is viewed as an act of
                                 neighborly love and charity by these denominations.
                                 They encourage all members to support donation as
                                 a way of helping others.

                                 Amish
                                 The Amish will consent to transplantation if they
                                 believe it is for the well-being of the transplant
                                 recipient. John Hostetler, world-renowned authority
                                 on Amish religion and professor of anthropology
                                 at Temple University in Philadelphia, said in his
                                 book, Amish Society, “The Amish believe that
                                 since God created the human body, it is God who
                                 heals. However, nothing in the Amish understanding
                                 of the Bible forbids them from using modern medical
                                 services, including surgery, hospitalization, dental
                                 work, anesthesia, blood transfusions or immunization.”

                                 Assembly of God
                                 The Church has no official policy regarding organ
                                 and tissue donation. The decision to donate is left
                                 up to the individual. Donation is highly supported
                                 by the denomination.

         All major religions
                                 Baptist
      support organ and tissue   Though Baptists generally believe that organ and
      donation and the concept   tissue donation and transplantation are ultimately
           of brain death.
                                 matters of personal conscience, the nation’s
                                 largest Protestant denomination, the Southern
                                 Baptist Convention, adopted a resolution in 1988
                                 encouraging physicians to request organ donation


21.
in appropriate circumstances and … “encourage voluntarism
regarding organ donations in the spirit of stewardship,
compassion for the needs of others and alleviating suffering.”
Other Baptist groups have supported organ and tissue donation
as an act of charity and leave the decision to donate up to
the individual.

Brethren
While no official position has been taken by the Brethren
denominations, according to Pastor Mike Smith, there is a
consensus among the National Fellowship of Grace Brethren
that organ and tissue donation is a charitable act so long as
it does not impede the life or hasten the death of the donor
or does not come from an unborn child.

Buddhism
Buddhists believe that organ and tissue donation is a matter
of individual conscience and place high value on acts of
compassion. The Reverend Gyomay Masao, president and
founder of the Buddhist Temple of Chicago said, “We honor
those people who donate their bodies and organs to the
advancement of medical science and to saving lives.” The
importance of letting loved ones know your wishes is stressed.

Catholicism
Catholics view donation as an act of charity and love.
Transplants are ethically and morally acceptable to the
Vatican. According to Father Leroy Wickowski, director of
the Office of Health Affairs of the Archdiocese of Chicago,
“We encourage donation as an act of charity. It is something
good that can result from tragedy and a way for families to
find comfort by helping others.” Pope John Paul II has stated,
“The Catholic Church would promote the fact that there is
a need for organ donors and that Christians should accept
this as a ‘challenge to their generosity and fraternal love’
so long as ethical principles are followed.”

                                                                 22.
      Christian Church (Disciples of Christ)
      The Christian Church encourages organ and tissue donation,
      stating that we were created for God’s glory and for sharing
      God’s love. A 1985 resolution, adopted by the General
      Assembly encourages “… members of the Christian Church
      (Disciples of Christ) to enroll as organ donors and prayerfully
      support those who have received an organ transplant.”

      Christian Science
      The Church of Christ Scientist does not have a specific
      position regarding organ donation. According to the First
      Church of Christ Scientist in Boston, Christian Scientists
      normally rely on spiritual instead of medical means of healing.
      They are free, however, to choose whatever form of medical
      treatment they desire — including a transplant. The questions
      of organ and tissue donation is an individual decision.

      Episcopal
      A resolution passed at the 1982 General Convention at
      the Episcopal Church stated that “The Episcopal Church
      recognized the life-giving benefits of organ, blood and tissue
      donation and encourages all Christians to become organ,
      blood, and tissue donors as part of their ministry to others
      in the name of Christ, who gave His life that we may have
      life in its fullness.”

      Greek Orthodox
      According to the Rev. Dr. Milton Efthimiou, director of
      the Church and Society for the Greek Orthodox Church
      of North and South America, “The Greek Orthodox
      Church is not opposed to organ donation as long as the
      organs and tissues in questions are used to better human life,
      i.e., for transplantation or for research that will lead to
      improvements in the treatment and prevention of disease.”

      Gypsies
      Gypsies are a people of different ethnic groups without a
      formalized religion. They share common fold beliefs and
      tend to be opposed to organ donation. Their opposition is
      connected with their beliefs about the afterlife. Traditional
      belief contends that for one year after death the soul

23.
retraces it’s steps. Thus, the body must remain intact because
the soul maintains its physical shape.

Hinduism
According to the Hindu Temple Society of North America,
Hindus are not prohibited by religious law from donating
their organs. This act is an individual’s decision. H.L. Trivedi,
in Transplantation Proceedings, stated that, “Hindu mythology
has stories in which the parts of the human body are used for
the benefit of other humans and society. There is nothing in
the Hindu religion indicating that the parts of humans, dead or
alive, cannot be used to alleviate the suffering of other humans.”

Independent Conservative Evangelical
Generally, Evangelicals have no opposition to organ and
tissue donation. Each church is autonomous and leaves the
decision to donate up to the individual.

Islam
The religion of Islam believes in the principle of saving
human lives. According to A. Sachedina in his Transplantation
Proceedings’ (1990) article, Islamic Views on Organ
Transplantation, “… the majority of the Muslim scholars
belonging to various schools of Islamic law have invoked the
principle of priority of saving human life and have permitted
the organ transplant as a necessity to procure that noble end.”

Jehovah’s Witness
According to the Watch Tower
Society, Jehovah’s Witnesses believe
donation is a matter of individual
decision. Jehovah’s Witnesses are
often assumed to be opposed to
donation because of their belief
against blood transfusion. However,
this merely means that all blood         Above: WDN volunteer Kay Bauer (lung
                                         recipient) delivers a keynote address at
                                         the Tree of Life Ceremony at Froedtert
                                         Memorial Lutheran Hospital’s annual        24.
                                         Transplant Picnic.
                               must be removed from organs and tissues before
                               being transplanted.

                               Judaism
                               All four branches of Judaism (Orthodox, Conservative,
                               Reform and Reconstructionist) support and encourage
                               donation. According to Moses Tendler, Ph.D., an Orthodox
                               rabbi, chairman of the Bio-Ethics Commission of the
                               Rabbinical Council of America, “If one is in the position to
                               donate an organ to save a life, it’s obligatory to do so, even
                               if the donor never knows who the beneficiary will be.” The
                               basic principle of Jewish ethics — ‘the infinite worth of
                               the human being’ — also includes donation of corneas,
                               since eyesight restoration is considered a life-saving
                               operation.” In 1991, the Rabbinical Council of America
                               (orthodox) approved organ donations as permissible, and
                               even required, from brain dead patients. The Reform
                               movement looks upon the transplant program favorably.

                               Lutheran
                               In 1984, the Lutheran Church in America passed a resolution
                               stating that donation contributes to the well-being of
                               humanity and can be “… an expression of sacrificial love
                               for a neighbor in need.” They call on members to consider
                               donating organs and to make any necessary family and legal
                               arrangements, which may include signing a donor card.

                               Mennonite
                               Mennonites have no formal position on donation, but are
                               not opposed to it. They believe the decision is up to the
                               individual and/or his or her family.
“I’m living proof that organ
transplantation does work.”
   - heart recipient           Moravian
     Holly Licht, West Allis   The Moravian Church has made no statement addressing
                               organ and tissue donation or transplantation. Robert E.
                               Sawyer, president, Provincial Elders Conference, Moravian
                               Church of America, Southern Province, stated, “There is
                               nothing in our doctrine or policy that would prevent a
                               Moravian pastor from assisting a family in making a decision
                               to donate or not to donate an organ.” It is, therefore, a
                               matter of individual choice.

25.
Mormon
(Church of Jesus Christ of Latter-Day Saints)
The Church of Jesus Christ of Latter-Day Saints believes the
decision to donate is an individual one made in conjunction
with family, medical personnel and prayer. They do not
oppose donation.

Pentecostal
Pentecostals believe that the decision to donate should be left
up to the individual.

Presbyterian
Presbyterians encourage and support donation. They respect
a person’s right to make decisions regarding his or her own body.

Seventh-Day Adventist
Donation and transplantation are strongly encouraged by
Seventh-Day Adventists. They have many transplant hospitals,
including Loma Linda in California. Loma Linda specializes
in heart transplantation.

Shinto
In Shinto, the dead body is considered to be impure and
dangerous, and thus quite powerful. “In fold belief context,
injuring a dead body is a serious crime … ” according to E.
Namihira in his article, Shinto Concept Concerning the Dead
Human Body. “To this day it is difficult to obtain consent from
bereaved families for organ donation or dissection for medical
education or pathological anatomy … the Japanese regard
them all in the sense of injuring a dead body.” Families are
often concerned that they not injure the itai, the relationship
between the dead person and the bereaved people.

Society of Friends (Quakers)
Organ and tissue donation is widely supported by Unitarian
Universalists. They view it as an act of love and selfless giving.

                                                                     26.
      United Church of Christ
      The Reverend Jay Lintner, director, Washington Office of
      the United Church of Christ Office for Church in Society,
      stated, “United Church of Christ people, churches and
      agencies are extremely and overwhelmingly supportive of
      organ sharing. The General Synod has never spoken to this
      issue because, in general, the synod speaks on more
      controversial issues, and there is no controversy about
      organ sharing, just as there is no controversy about blood
      donation in the denomination. While the General Synod
      has never spoken about blood donation, blood donation
      rooms have been set up at several General Synods.
      Similarly, any organized effort to get the General Synod
      delegates or individual churches to sign organ donation
      cards would meet with generally positive responses.”

      United Methodist
      The United Methodist Church issued a policy statement
      regarding organ and tissue donation. In it, they stated that,
      “The United Methodist Church recognizes the life-giving
      benefits of organ and tissue donation, and thereby
      encourages all Christians to become organ and tissue
      donors by signing and carrying cards or driver’s licenses,
      attesting to their commitment of such organs upon their
      death, to those in need, as a part of their ministry to others
      in the name of Christ, who gave his life that we might have
      life in it’s fullness.” A 1992 resolution stated, “Donation is
      to be encouraged, assuming appropriate safeguards against
      hastening death and determination of death by reliable
      criteria.” The resolution further stated, “Pastoral-care
      persons should be willing to explore these options as a
      normal part of conversation with patients and their families.”

      (Adapted from UNOS/SEOPF “Organ and Tissue donation:
      A Reference Guide for Clergy,” 1995)




27.
                                      Ethical Issues
                                            in Donation
                                       and Transplant.
                                      Organ donation and transplant involves
                                      a number of ethical considerations.
                                      Medical ethicists address these issues
     Visit our website at             with a great deal of care and
www.wisdonornetwork.org               consideration so that donation and
  and click on “Available
                                      transplant are used in the best interest
Resources” to see a variety
 of the materials available
                                      of our society.
   at no charge, from the             All ethical issues are extremely complex and
Wisconsin Donor Network.              involve many aspects, influences and ramifications.
                                      The following list gives a very brief, simplistic
                                      overview of common ethical considerations and
                                      prominent views from each side. It is not intended
                                      to be a complete synopsis or endorsement of any
                                      particular perspective.

                                      Ability to pay for transplant - Should
                                      transplant centers be able to reject some patients
                                      due to the patients’ inability to pay?
                                      Yes - transplants are very expensive and providing
                                      expensive treatments at no cost can drain the
                                      resources of healthcare providers, potentially
                                      leading to cutbacks and inability to provide
                                      treatment to additional patients.
                                      No - everyone should be afforded basic healthcare
                                      and shouldn’t be allowed to suffer or die due to
                                      lack of funds.
Above: “I’ve never been athletic
before in my life. All of a sudden,   Allocation - Is the allocation process fair and
I can be.”
                                      ethical? Should organs be given to prisoners, and
   - lung recipient
     Kay Bauer, Richfield             people with self-inflicted medical conditions,
                                      such as alcoholism and drug addiction?

                                                                                            28.
      Yes - “Worthiness” should not be considered, only medical
      necessity. Trying to determine who is the most worthy of
      an organ transplant by evaluating character, morality and
      societal role is not only impossible, it creates a competitive
      “caste” medical system in which people vie for transplants
      by proving their social value.
      No - A precious resource like organs, of which there are
      not enough to satisfy the need, shouldn’t be wasted on
      people who put themselves in their situations due to illegal
      or immoral behavior while other, law-abiding people wait.

      Cloning - Should cloning technology be used to increase
      the availability of transplantable organs?
      Yes - It’s a potentially huge development in transplant
      technology that could save thousands of human lives,
      possibly erasing the transplant waiting list.
      No - It manipulates nature, may lead to unknown,
      unforeseen medical complications, and is unethical or
      immoral based on the definition of “when life begins”
      and what constitutes the creation of life.

      First-person consent - Should a family be able to
      “over-rule” what an individual expressed regarding organ
      donation on his/her driver’s license or uniform donor card?
      Yes - The welfare of a living family is more important than
      a deceased individual and nothing should be done that
      would traumatize a hurting, grieving family even more.
      No - The deceased person legally expressed his/her wishes
      regarding donation and those wishes should be honored.

      For-profit vs. not-for-profit tissue banking -
      Should for-profit tissue banking be allowed?
      Yes - These organizations are able to direct more money
      into research and development and find more uses for
      tissue, resulting in being able to help more people.
      No - Companies that profit financially from tissue donations
      “commodify” the human body and the notion of people
      profiting from others’ death and tissue donation is offensive.

      Living donation - Should transplant centers perform
      living organ donation for transplants, especially riskier
      procedures such as living liver and lung donations?

29.
Yes - These are low-risk, live-saving surgeries and
transplant centers are obligated to help families who
desperately want to save their loved ones’ lives.
No - There is too much risk to donors — perfectly healthy
individuals who do not need the surgery, especially for
liver donations, and contradicts doctors’ basic tenet of
“due no harm.”

Payment for donor families - Should donor families
(or living donors) receive payment for organ donations?
Yes - It would serve as an incentive to increase donation
and donor families are the only ones in the transplant
process who don’t benefit from their organ donation.
No - It’s illegal, would not serve as an incentive to increase
donation and is offensive to donor families.

Presumed consent - Should our system be that
everyone is “presumed” to be a donor, unless he/she has
“opted out,” unlike the system of “opting in,” in which
people have to express their desire to be donors?
Yes - It would greatly increase the number of organs
available for transplant and still give people the same
option of whether or not they want to be donors.
No - It would give the medical system too much authority
over organ donations and violate our civil liberties as citizens.

Xenotransplant - Should genetically engineered
animals be raised for the purpose of supplying transplantable
organs to people?
Yes - Animals are already raised for human consumption
and it’s a potentially huge development in transplant
technology that could save thousands of human lives,
possibly erasing the transplant waiting list.
No - It manipulates nature, may lead to unknown,
unforeseen medical complications, and is cruel to animals.

                                                                    30.
                                       History of
                                          Transplant.

                                           1949: Establishment of U.S. Navy
                                           Tissue Bank.

                                           1953: First corneal transplant in
                                           Wisconsin at Marquette Medical School.

                                           1954: First kidney transplant
                                           (Dr. Joseph E. Murray, Peter Brent
                                           Brigham Hospital, Boston, MA).

                                           1955: First fresh heart valve
                                           allograft put into descending aorta
                                           (Dr. Gordon Murray).
      Historical Highlights in
      Organ and Tissue Transplant          1962: First fresh heart valve
                                           transplants in cardiac position
      Medicine and Law.                    (Sir Brian Barrat-Boyes, New
                                           Zealand, and Dr. Donald Ross,
      1822: Fresh autograft of skin
                                           United Kingdom).
      (Dr. Burger).
                                           1963: First liver transplant (Dr.
      1869: Fresh allograft of skin        Thomas Starzl, University of
      (Dr. Jacques Louis Reverdin,         Colorado, Denver).
      Switzerland).
                                           1963: First lung transplant (Dr.
      1906: First corneal transplant       James Hardy, University of
      (Dr. Edward Zirm).                   Mississippi, Jackson).

      1908: Successful cadaveric knee      1964: First eye bank in Wisconsin,
      joint transplant (Dr. Eric Lexer).   Wisconsin Lions Eye Bank, opens
                                           in Milwaukee.
      1911: First use of homologous vein
      tissue in arterial reconstruction    1966: First simultaneous
      (Dr. Yamanouchi).                    pancreas/kidney transplant (Drs.


31.
Richard Lillehei, William Kelly, University of Minnesota,
Minneapolis, Minn.).

1967: First successful liver transplant (Dr. Thomas
Starzl, University of Colorado Health Sciences Center,
Denver, Colo.).

1967: First heart transplant (Dr. Christian Barnard, Groote
Schur Hospital, Cape Town, South Africa).

1968: First isolated pancreas transplant (Dr. Norman
Shumway, Stanford University Hospital, Stanford, Calif.)

1968: National Conference on Commissioners on Uniform
State Laws draws up first legislative proposal addressing
organ donation, the Uniform Anatomical Gift Act (UAGA).

1968: St. Luke’s Medical Center performs first heart
transplant in the Midwest.

1969: First pancreas transplant (Dr. Lillche, University of
Minnesota, Minneapolis).

1969: The Anatomical Gift Act is established in Wisconsin.

1971: Introduction of cryopreserved human skin allografts.

1974: Use of cyropreserved venous allograft (Dr. Dent and
Dr. Weber).

1975: First use of cyropreserved heart valves (Dr. Mark
O’Brien, Australia, and Dr. William Angell, Stanford          Left: “It has renewed my
                                                              faith in the goodness of
Medical Center, Palo Alto, California).                       the human race. It has
                                                              drawn me closer to my
                                                              Lord. I thank Him each day
1977: Assembly Bill 177 allows the placement of the           for another day of life.”
Uniform Donor Card authorization on the back of the             - heart recipient Duane
Wisconsin driver’s license.                                       Dumez, New Berlin



                                                                                 32.
      1978: Introduction of cyclosporine as a major
      immunosuppresant.

      1978: Kidney transplants included under Medicare
      coverage (Social Security Act Amendment, P.L. 92-603).

      1980: National Conference of Commissioners on Uniform
      State Laws recommends Uniform Determination of Death
      Act for adoption by all 50 states.

      1981: First heart/lung transplant (Dr. Norman Shumway,
      Stanford Medical Center, Palo Alto, California).

      1983: First successful single lung transplant (Dr. Joel
      Cooper, Toronto Lung Transplant Group, Toronto General
      Hospital, Canada).

      1983: Froedtert Memorial Lutheran Hospital performs the
      first liver transplant in Wisconsin.

      1984: National Transplant Act (P.L. 98.507) establishes
      National Task Force on Organ Transplantation, legislates
      federally funded centralized waiting list for organ
      recipients, outlaws buying and selling of human organs,
      mandates establishment of scientific registries to monitor
      transplant centers, organ procurement organizations
      and hospitals.

      1985: Oregon, California and New York are first states to
      pass laws mandating that hospitals ensure that families
      of potential donors are offered the opportunity to donate.

      1986: First successful double lung transplant (Dr. Joel
      Cooper, Toronto Lung Transplant Group, Toronto General
      Hospital, Canada).

      1986: Consolidated Omnibus Budget Reconciliation Act
      (P.L. 99-509) amends Social Security Act to require all
      hospitals to adopt policies and procedures for
      identif ication of potential donors and notif ication
      of families of their option to donate. This Routine
      Notif ication requirement supersedes state laws and
      directly ties Medicare funding to hospital compliance.

33.
1986: First tissue bank in Wisconsin, Wisconsin Tissue
Bank, is established at St. Luke’s Medical Center.

1986: UW solution, an organ preservation solution, is
developed and becomes the industry standard throughout
the country.

1988: First successful liver-intestinal transplant (Dr. David
Grant, University of London Ontario, Ontario, Canada).

1988: Joint Commission on Accredation of Health
Care Organizations sets donor identif ication and
notif ication standards.

1988: Southeastern Wisconsin Organ Procurement
Organization receives federal designation as an organ
procurement organization. It’s later renamed Wisconsin
Donor Network.

1988: Joint Commission on Accredation of Health Care
Organizations sets donor identification and notification
standards.




                                                                34.
      1989: First successful living-related liver transplant (Dr.
      Christoph Broelsch, University of Chicago Medical Center,
      Chicago, Ill).

      1989: Clinical investigators begin using an experimental
      drug called FK506 for kidney, liver, heart and lung
      recipients. Results suggest that this drug is effective, but
      clinical trials continue to assess its safety and efficacy.

      1990: First successful living-related lung transplant Dr.
      Vaughn A. Starnes, Stanford University Medical Center,
      Stanford, Calif.

      1993: Continuing shortages in Organ and Tissue Donation
      lead to renewed interest in transplanting organs from
      animals such as baboons (xenografting). Baboon-to-human
      liver and heart transplants have been attempted, with
      limited success. A new research strategy involves
      developing a line of pigs with the appropriate human genes
      to help prevent rejection of organs such as hearts, livers
      and kidneys transplanted from these animals.

      1994: The FDA approves a new medication for use in
      transplant recipients: Prograf (formerly known as FK506)
      marks a significant advance in the understanding and
      suppression of the human rejection response and in the
      lessening of unwanted side effects.

      1995: A new study by Dr. Paul Terasaki and colleagues
      at UCLA shows that spouses are an important source of
      living-donor kidney transplants. According to the Terasaki
      study, the three-year graft survival rate for spouse-to




                              Left: The Wisconsin Coalition on Donation hosted
                              a special reception to celebrate Saturn Donor Day.
                              Olympic snowboarding bronze medalist and liver
                              transplant recipient Chris Klug was one of two
                              keynote speakers. Trey Schwab, Marquette
                              University Men’s Basketball assistant coach,
                              also delivered a keynote address.



35.
spouse transplants (85%) is comparable to that seen in
parent-to-child transplants (82%) and better than that
seen in transplants from non-living donors (70%). Living
donation is becoming an increasingly important source of
kidney and other transplants because of continuing
shortages of non-living donors.

1995: Two more new medicines are approved by the FDA
for use in transplant recipients: CellCept (mycophenolate
mofetil), and Neoral, a new formulation of cyclosporine.
These drugs hold promise for providing even better control
of rejection with fewer side effects.

1995: At John Hopkins Bayview Medical Center, Lloyd
Ratner, M.D., and Louis Kavoussi, M.D., perform the
world’s first laparoscopic live-donor nephrectomy in
which a patient’s kidney is removed through a hole
slightly larger than a silver dollar. Laparoscopic
live-donor nephrectomies mean fewer post-op days in the
hospital, speedier recovery, less scarring and decreased
post-operative pain.

1996: The number of kidney transplants using living donors
(both related and unrelated) continues to grow. A total of
11,099 kidney transplants were performed in 1996 – 3,389 of
which involved kidneys recovered from living donors.

1997: The Department of the Navy Bureau of Medicine
and Surgery announces a research breakthrough that
raises new hope that acute transplant rejection may be
prevented and reversed without the need for chronic
immunosuppressant drugs. Navy researchers report that
they are now able to prevent kidney transplant rejection in
primates with different histocompatibility factors through
the use of a combination of a specific fusion protein and a


                                                              36.
      specific monoclonal antibody. Further trials are
      necessary to determine future applicability of the
      technique to humans.

      1997: Wisconsin Donor Network reaches a high of 63
      donors and repeats that number in 1998.

      1998: Wisconsin Donor Network holds first ever Sarah’s
      Stride run/walk to raise funds for organ donor awareness.

      1999: Wisconsin passes legislation allowing state
      employees paid leave to serve as bone marrow or living
      organ donors.

      1999: The Food and Drug Administration approves
      Rapamune (sirolimus), a new immunosuppressant drug
      used to prevent organ rejection in patients receiving
      kidney transplants. This new drug is to be taken along
      with cyclosporine and corticosteroids.

      1999: Froedtert Memorial Lutheran Hospital performs
      the first piggy-back liver transplant in Wisconsin.

      1999: UW Hospital performs first adult-to-adult living
      liver transplant in Wisconsin.

      2000: The United Network for Organ Sharing begins
      pilot testing two new programs aimed at increasing the
      availability of organs for transplantation. In “paired
      exchange,” two incompatible living donor-recipient pairs
      may be able to swap donors so that each recipient can be
      transplanted. Another option is “list-paired exchange,” in
      which a would-be donor who is mismatched with the
      intended recipient can still donate a kidney to the general
      pool. In return, the intended recipient advances on the
      waiting list for a non-living-donor kidney.

      2000: Concern about the well-being of live organ
      donors leads the National Kidney Foundation and the
      American Societies of Transplantation, Transplant
      Surgeons and Nephrology to convene the Live Organ
      Donor Consensus Group. A set of recommended practice
37.
guidelines is developed by this group to assist transplant
physicians, primary care providers and health care planners
provide the best care for living donors and potential donors.
The guidelines are published in the Dec. 18, 2000, issue
of the Journal of the American Medical Association.

2000: Wisconsin passes legislation requiring organ
donation to be taught in all driver’s education programs.

2001: New York becomes the sixth state to pass a law that
grants paid leave for state employees who serve as living
organ donors. These state laws serve to complement the
Organ Donor Leave Act passed by the U.S. Congress in 1999.
It is hoped that these laws will encourage private companies
to make similar allowances for employees who wish to
become living donors and, thus, help to increase the number
of organs donated for transplantation.

2001: Wisconsin Coalition on Donation is formed.

2002: Wisconsin Donor Network reaches a new high with
68 donors.

2002: First pancreas islet transplant in the state is performed
at UW Hospital and Clinics.




Right: “It was the best thing we could
ever do and then meeting Joan
(recipient), seeing how wonderful she’s
doing tells me I know that I made the
right choice.”
   - donor mom Cindy Montag,
     Hartford (of son Mark)

                                                                  38.
                                      Glossary of Terms.


                                      Allocation: The system of ensuring that organs and
                                      tissues are distributed fairly to patients who are in need.

                                      Allograft: Organ or tissue transplants between
                                      individuals of the same species.

                                      Bone Marrow Transplant: Bone marrow is removed
                                      from a healthy individual and given to a patient in
                                      need of it. The most common reasons for a bone
                                      marrow transplant are leukemia and aplastic anemia.

                                      Brain Death: Total irreversible cessation of all brain
         Visit our website at
                                      functions, including the brain stem, demonstrated
                                      by: lack of responsiveness to stimuli, absence of all
      www.wisdonornetwork.org         reflexes, and an absence of spontaneous breathing.
       and click on “Transplant       An EEG or other tests may be used by the physician
      Links” to get a list of other   to establish brain death.
         donor related links.
                                      Brain Stem: Area of the brain that controls heartbeat
                                      and respiration.

                                      Cornea: The transparent outer coating of the eye
                                      that covers the iris and pupil. Corneas can be donated
                                      and transplanted.

                                      Deceased Donors: Non-living donors are those
                                      whose organs or tissues are donated after they have
                                      been declared dead.

                                      Dialysis: Process of removing toxins, or waste product
                                      of metabolism, and fluid from the blood. Normally
                                      the kidneys perform this function, but if they are
                                      damaged by disease or trauma, dialysis must be used.

39.
Donor Card: Legal document used by a person who
wishes to make an anatomical gift after death. Donor cards
can be obtained by contacting the Wisconsin Donor Network.

DOT: Division of Organ Transplantation. Federal office that
is part of the Health Resources and Services Administration.

Extra-Renal Organ: Any organ other than the kidney.

Eye Bank: A not-for-profit organization that provides
tissue for corneal transplantation, research and education.
Donated eyes are retrieved, evaluated and distributed by
an eye bank.

Fascia: A fibrous membrane that covers and supports
the muscles.

Graft: Tissue or organ that is transplanted or implanted
into the body to repair a defect or replace a permanently
damaged organ or tissue.

Heart-Lung Machine: Device that pumps blood and
oxygenates it while the heart and/or lungs are not
functioning such as during heart surgery.

Immune Response: The body’s defense against foreign
substances that could be harmful — such as bacteria or
foreign tissue.

Immunosuppression: The artificial suppression of the
                                                                Left: “I’m a different person
immune response — usually through drugs — so that the           because of the whole thing.
body will not reject a transplanted organ. Drugs are commonly   I wish everyone could know
                                                                what I know without having
used to suppress the immune system after transplantation        to go through what I had
includes: prednisone, imuran and cyclosporine.                  to go through.”
                                                                   - kidney and pancreas
                                                                     recipient Tom Zielinski,
Living Related Donor (LRD): An organ or tissue donor                Milwaukee
who is in good health, who matches the recipient with


                                                                                    40.
      regard to his/her immune system, and who donates an
      organ (kidney) or tissue (blood, bone marrow) to a relative
      or friend.

      National Organ Transplant Act: Signed into law Oct. 19,
      1984, this law (P.L. 98-507) established the Task Force on
      Organ Transplantation and the National Organ
      Procurement and Transplantation Network. The act also
      authorized financial assistance for organ procurement
      organizations, prohibited the sale of organs, and called for
      the establishment of a bone marrow registry of donors.

      Omnibus Budget Reconciliation Act 1987 (OBRA):
      Required the establishment of hospital protocols for organ
      donation and standards for organ procurement organizations.
      Also, the act provided one-year coverage of immunosuppressive
      therapy post-transplant.

      Organ Donor: The donor who meets brain death criteria
      and has a heartbeat. This type of donor is maintained on a
      ventilator until the organs are removed in surgery. Tissue
      donation can follow the removal of organs.

      Organ Procurement & Transplantation Network (OPTN):
      Federally mandated national system that establishes
      policies and procedures for organ sharing, membership
      criteria, and data collection. Also provides professional
      education. Operated by UNOS.

      Organ Procurement Organization (OPO): An organization
      responsible for donor identification and care; organ
      removal, preservation, and transportation of organs. OPOs
      employ transplant coordinators who work with donor
      families and provide educational programs to hospitals.
      OPOs were designated by the U.S. government in 1987
      to provide services to assigned counties and the hospitals
      within them.

      Preservation of Organs: The technique used to keep organs
      or tissue viable once they are removed from the donor.
      Preservation fluids and reduced temperatures assist in
      preserving the organs. Organs have a limited preservation time.

41.
Rejection: The immune process of ridding the body
of foreign tissue by production of antibodies and local
systematic inflammation.

Routine (Required) Request: Legislation requiring hospitals
to have, in writing and in practice, protocols for providing
the organ/tissue donation option to families of potential donors.

Task Force on Organ Transplantation: Created by the
National Organ Transplant Act of 1984, this group examined
the status of transplantation in the U.S. and issued its report
to Congress in April 1986.

Tissue Bank: An organization responsible for tissue donor
identification and tissue recovery. Tissue banks employ
recovery coordinators who work with donor families and
provide educational programs to hospitals. Tissue banks
have not been designated by the U.S. Government and can
provide services for any hospital.

Tissue Donor: Tissue recovery may take place after organ
recovery or an autopsy. Tissues include bone and related soft
tissue, saphenous veins, heart valves, skin and corneas.




  Right: WDN volunteers and
  donor parents Carol and Larry
  Kress staffed the WDN booth at
  the Froedtert Hospital Transplant
  Picnic, handing out information,
  answering questions and selling
  hundreds of dollars of shirts.



                                                                    42.
      Tissue Typing: The process of characterizing the human
      lymphocyte antigens in an individual. Tissue typing is done
      for all donors and recipients.

      United Network for Organ Sharing (UNOS): Non-profit
      organization that operates the National Organ Procurement
      and Transplantation Network in the U.S. All transplant
      centers, OPOs, and tissue typing laboratories are required
      to be members of the United Network for Organ Sharing.
      UNOS members set policy for transplantation in the U.S.
      and conduct professional education programs for
      transplant personnel.

      Uniform Anatomical Gift Act (UAGA): Legislation passed
      in all 50 states that provides for the voluntary donation of
      tissues and organs by individuals for transplantation. It
      also prohibits the sale of organs and tissues for profit.

      Ventilator: Machine that supplies oxygen to a patient who
      is unable to breathe unassisted.

      Xenograft: Organ or tissue grafts between different species.




                                       Left: “My transplant has given me a
                                       whole new outlook on life! I have more
                                       energy and haven’t felt this good in
                                       years. But none of this would have been
                                       possible if not for my donor family. It
                                       means people helping out others in a
                                       life-saving proportion. What more can
                                       be said with such acts of kindness? I
                                       have been so blessed and seeing things
                                       transpire in my life which I might not
                                       have been able to.”
                                                     - liver recipient
                                                       William Schneider, Kenosha

43.
 9200 W. Wisconsin Ave.
  Milwaukee, WI 53226
     1-800-432-5405
www.wisdonornetwork.org

				
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