Organ

1
Organ Tissue Donation

• The Gift of Life
• As presented by the Transplant Team of
• Scott Grunwald
• Dan Maloney
• Robert Moulton
• Philip Wilke
• Michelle Wilson
• Cheng Yang

2
Introduction

• Do you know of anyone who has received a
  transplant?
• Have you known any donors, living or deceased?
• Was the decision already made, or were you a part
  of the decision making process?

3
Where does it all begin?

• Brain death
• The standards for determining brain death are
  very strict.
• Brain death occurs when a person has an
  irreversible brain injury that causes all brain
  activity to stop permanently.
• Only then is a person considered for donation.

4
What organs can be transplanted?

• Some of the organs that can be used in
  transplants include
• Heart
• Lungs
• Liver
• Kidneys
• Pancreas
• Bone Marrow
• Tendons
• Corneas
• Skin
• Veins

5
Heart

• Regardless of donor blood type, babies (less than
  one year old) can successfully accept heart
  transplants.
• Other common heart disease that may lead to heart
  transplants include
• Coronary heart disease
• Cardiomyopathy
• Congenital/valvular heart disease
• Hypertensive heart disease
• Over 2000 heart transplant surgeries have been
• conducted each of the last five years in the
  United States

6
Pancreas

• The pancreas is a five to six inch gland located
  behind the stomach. The pancreas produces enzymes
  that are used for digestion, and insulin, which
  is essential for life because it regulates the
  use of blood sugar throughout the body.
• The most common disease that leads to pancreas
  transplants is Diabetes mellitus.
• After a donee receives a pancreas transplant they
  will no longer have to inject insulin in their
  body because their body will produce it naturally.

7
Skin

• The skin is often referred to as the largest
  organ in the body.
• A skin transplant is called skin graft.
• While the best skin grafts come from the patients
  own skin, it is possible to receive skin from
  another person.
• One of the most common reasons for an individual
  to need a skin graft, is because their skin was
  badly burned.

8
Liver

• The liver has numerous functions that are
  necessary for life
• It processes nutrients absorbed from food in the
  intestines and turns them into materials that the
  body needs for life.
• It also secretes bile to help digest fats, and
  breaks down toxic substances in the blood such as
  drugs and alcohol.
• The liver is also responsible for the metabolism
  of most drugs.
• There are generally two main reasons for an
  individual to need a liver transplant those
  cases caused by viruses (Hepatitis B and C) and
  those caused by alcohol.

9
Bone Marrow

• Transplantation of bone marrow cells, and more
  recently stem cells collected from the blood,
  have been used as part of the treatment for
  leukemia and other cancers for the past twenty
  years.
• Donated bone marrow must match the patient's
  tissue type. It can be taken from the patient, a
  living relative (usually a brother or a sister
  allogeneic), or from an unrelated donor .
• Bone marrow transplant prolongs the life of a
  patient who would otherwise die.

10
Kidney

• The kidneys are a pair of reddish-brown organs
  located on either side of the spine just below
  the diaphragm, behind the liver and stomach.
• The primary function of these bean shaped organs
  is to remove waste from the body through the
  production of urine.
• Some common diseases that lead to kidney
  transplants include
• Kidney Stones
• Wilms Tumor
• Diabetes
• Renal Cell Carcinoma

11
Burdens vs. Benefits

• Burdens of transplantation
• Life-long battle with anti-rejection drugs
  containing immuno-suppressive agents
• Benefits
• New life to live!
• In Wisconsin, if you donate a kidney, you are
  eligible for a tax deduction of up to 10,000 for
  your expenses.

12
But, Ive heard..

• Myths about organ donation
• Wealthy people can buy organs.
• Uniform Anatomical Gifts Act (UAGA) (1987)
• Mickey Mantle (pg. 388)
• Carroll Shelby
• It costs money to donate.
• Not a dime to the donors family
• Living donors may be reimbursed for travel
  expenses, hotel bills and lost wages.
• Doctors may let me die so they can transplant
  organs to their other patients
• Life saving comes first

13
And, Ive heard.

• Transplants dont ever work, they are
  experimental
• In 2004, there were 26,984 heart, liver, kidney,
  pancreas intestine transplants performed in the
  U.S.
• Transplants are standard medical procedure with
  high success rates
• Donation disfigures the body delays the funeral
• Discreet surgical incisions make regular funeral
  arrangements appropriate (formal burial)
• Operation to harvest organs done with 24 hrs
  after death

14
Then, Ive heard..

• Business travelers are drugged and their kidneys
  stolen to be transplanted on the black market.
• Information on the Internet can be misleading
• Matchingdonors.com or wisdonorsnetwork.org
• People with cancer cant donate their organs.
• Everyone, regardless of health history, has the
  opportunity to give the gift of life.
• Most religions oppose donation.
• Most, if not all, support donation.

15
Stop- Why is thinking about Organ Donation
so Important?

• As of April 4, 2005, there were 87,400 people on
  the national transplant waiting list.
• 61,192 are awaiting a kidney transplant
• 17,261 are awaiting a liver transplant
• There were 1,561 people on the Wisconsin
  transplant waiting list.
• 1,128 are awaiting a kidney transplant
• There were 825 people on the South-Eastern
  Wisconsin (our neighbors) transplant waiting
  list.

16
Here is the Reality!

• Each day 17 people die while waiting for the
• gift of life.
• AND-
• Another person is added to the waiting list
  every
• 16 minutes!!

17
How does it all work?

• Uniform Anatomical Gifts Act (UAGA) of 1987
  provided an easier way for people to make a
  testamentary donation of vital organs for medical
  research or transplant.
• Donor may revoke the offer
• Designation of one gift does not restrict the
  harvesting of others
• Hospitals are the donees of the anatomical gift.
  (Not doctors)
• Sale and purchase of organs is prohibited.
• People who act in good faith in accordance with
  the Act cant be held liable in any civil or
  criminal action relating to the transplant.
• Wisconsin adopted their own version (W.S.A.
  157.06)
• Sets their own rules in regards to organ donation
  and harvesting of organs

18
How does it all work?

• Formation of United Network for Organ Sharing
  (UNOS)
• Centralized network containing names of patients
  on the waiting lists
• Formation of a network of Organ Procurement
  Organizations like Wisconsin Donor Network and
  University of Wisconsin Hospitals and Clinics OPO
  (UWHC OPO)

19
When the time comes

• Who do they choose?
• UNOS determines the status of the people on the
  list and use the following criteria
• Blood typing and matching criteria
• Length of time on waiting list
• Geographical location of organs donee
• Severity of illness
• Other medical criteria
• Some expediencies with children under 11 years
  old

20
What can you do?

• Seriously think about whether or not you want to
  be a donor!
• Then- indicate your request on your drivers
  license or a donor card
• Check the box for any needed organs and parts.
• Or list the specific organs and tissues you would
  like to donate.
• Next- Sign your name. If your license is
  laminated prior to your filling out the
  anatomical request portion, just write over the
  lamination. Place an orange donor sticker on
  your license also.
• Finally- inform your family of your decision.

ORGAN DONOR
21
With a candal or two

• UCLA
• University of California Willed Body Program was
  suspended after the director and another person
  were arrested for selling body parts for profit.
• Lucrative underground trade in corpses and body
  parts, even though there are federal laws banning
  the sale of organs and tissues.

22
And closer to home.

• Williams v. Hofmann (66 Wis.2d 145)
• Willful and intentional mutilation of a corpse,
  negligence in communicating an erroneous and
  premature death message.
• Husband signed the consent for kidney removal
• Doctors acting in good faith according to the
  Uniform Anatomical Gift Act.

23
And, on a related note--

• Controversial Issues
• Tissue Sterilization Process- (BioCleanse) by
  Regeneration Technologies, Inc.
• Taking tissue of various types and sterilizing it
  to reuse it
• Extremity Transplants- Swedish doctors have
  successfully transplanted hands.
• Xenotransplantation involves using the organs
  from animals and transplanting them into humans.
• Heart valves of pigs

24
You said, Animals?

• Cloning
• Have you heard of the most controversial business
  in the Madison area? You can have your cat
  cloned for 50,000 at Genetic Savings Clone,
  Inc.
• Have you ever heard of Dolly, the sheep?
• What are considered to be natural human clones?

25
Cloning

• Dolly the sheep
• Many animals have been cloned
• 1st mammal to be cloned from adult cell
• Worlds most famous
• Cow
• Anti-rejection test
• Pig
• Good for organ donors
• Organs similar to humans
• Size and structure

26
Cloning

• Did we realized that we have natural human
  cloned?
• Twins
• Cloning is a big issue
• Might be used to clone humans
• Ethical concerns
• United Nations
• Ban human cloning

27
Invitation

• You are invited to a presentation by Tim Olsen of
  the Wisconsin Donors Network in Room 1019 on
  Thursday, April 28th at 930am.
• By the way, that is during class!
• Bring all of your question on becoming a donor,
  he will answer them!
• Thank you for your attention, and now on to
  Jeopardy!