Collaborative Learning Session

1
Collaborative Learning Session

• Tissue Donation Process
• Annette Gonzalez Glendale
• Jason Hower Pomona
• Beverly Jacoby Santa Barbara/Bakersfield

2
Tissue Donation

• Onelegacy responsible for tissue effective July
  2006
• Serve our community with Tissue Recovery Offices
  in Bakersfield, Redlands and Long Beach
• Maintain a full-time staff and additional
  part-time staff of trained tissue coordinators in
  our donation service area to respond to tissue
  donor referrals
• Increased visibility with all units of hospital
• The Future Hospitals will have access to
  Statline to perform their own reconciliation
  reports

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Organs and Tissues That May Be Donated
ORGANS
TISSUES

• Kidneys
• Liver
• Heart
• Lung
• Pancreas
• Small Intestine

Corneas/Eyes Skin Heart Valves Bone Tendons Cartil
age Veins
4
Referral Process/The First Step

• Call OneLegacy with referral immediately or
  within one hour of cardiac death (clinical
  trigger)
• Preliminary Screening Questions will be asked to
  evaluate donor suitability
• Additional screening questions are asked if
  patient meets initial screening criteria
• Family is approached by Onelegacy at the hospital
  or by telephone

1-800-338-6112
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Preliminary Screening Questions

• Name, hospital, unit and phone number
• Patients name, age, race and sex
• Date and time of admission and death
• Preliminary cause of death
• Medical Record number

Potential Donor
Medically Ruled Out
Answer Extended Screening Questions
Document Referral
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Medically Unsuitable Patients

• If patient is deemed medically unsuitable, a
  referral number is assigned. This number is
  written in the Progress Notes, Tracking Form, or
  whatever hospital policy dictates.
• There is no need to mention donation to the
  family.

7
Medical/Behavioral Interview

• Next of kin interview to ensure medical
  suitability and the absence of
• - Hepatitis / HIV risk factors
• - Active infections
• - Degenerative neurological disease
• - Dementia
• - History or presence of malignancy
• If there is a delay in reaching the family, the
  tissue coordinator will
• - Request that the body not be released

8
Family Approach

• For organ cases Procurement Coordinator
  approaches family at hospital
• Statline Donor Family Services Coordinator will
  speak to the family at the hospital if convenient
  or will contact next-of-kin at home
• Calls made as soon as possible.
• If family consents for tissue donation, informed
  consent is recorded

9
Donor Management

• Continue eye care
• Lacrilube (or artificial tears)
• Close eyes, cover with gauze and tape closed
• Transport decedent to refrigerated morgue
• Within 12 hours of death

10
Tissue Recovery

• Medical chart review
• Review Consent Medical Behavior forms
• Physical assessment
• Re-evaluate plasma dilution
• Obtain blood for serology testing

11
Tissue Recovery

• Organ and Tissue Donation
• Tissue Recovery follows Organ Recovery in the OR
• Tissue Donation
• Recovery in OR, Morgue, or Aseptic area
• Tissue Recovery Technicians

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Post Recovery

• Body is reconstructed
• The House Supervisor and OR Charge Nurse will be
  informed of the completion of the recovery and
  Body Transport or the Onelegacy Tissue Recovery
  Team will arrange to transport the patient to the
  morgue
• Tissue Recovery Team is responsible for
  post-tissue recovery clean-up
• Tissue is quarantined, tested, and then processed

13
Recovery Times
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Tissue Donation

• Tissue Benefits and Uses

15
Bone

• Reconstructive surgeries
• bone cysts, trauma and tumors
• Spinal fusions
• spine/disc and scoliosis repair
• Hip replacements
• Implant prosthetic devices

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A new perspective on life!
Spinal curvature
After bone grafts
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Skin

• Increases burn survival from 17 to 77
• Promotes healing
• Temporary coverage
• Protects against
• fluid loss
• Infection
• Decreases pain

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Full Thickness Burn
2.5 years post-op (Courtesy Dr. Voorhees)
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Heart Valves/Pericardium

• Replace defective heart valves
• Better valve pressure than porcine or mechanical
  valves
• No need for anti-coagulation drugs
• Treatment of choice for pediatrics women of
  childbearing age

20
Connective Tissue

• Tendons and Ligaments
• Replace or strengthen damaged tissues in knees
  and other joints
• Cartilage
• Facial reconstruction
• Fascia
• Uterine Bladder slings
• Hernias

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Vascular Grafts

• Coronary bypass surgery
• Restores blood flow
• Prevents amputation

22
Cornea

• The cornea is the transparent, dome-shaped window
  covering the front of the eye
• It is a powerful refracting surface, providing
  2/3 of the eye's focusing power

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The Gift of Sight
A precious gift
A world of darkness
transplanted
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Family Services
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Tissue Donation

• Thank You!