Tissue Donation: An Overview

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• Tissue DonationAn Overview

Name Ireneo Alvarez Title Manager or Recovery
and Technical Services
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Tissue Facts

• One tissue donor can save and heal 50 people
• 1,000,000 people are helped annually with tissue
  allograft transplants
• 2,500,000 deaths occur in the U.S. annually
• 5 of referred deaths become tissue donors

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Organ Tissue DonationPathways
OneLegacy
HOSPITALSCORONERSFUNERAL HOMES
HOSPITALS
Organ Donation/Recovery
Tissue Donation/Recovery
Transplant Centers
Tissue Processors
Organ Recipients
HospitalsOral Surgeons
Tissue Recipients
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Tissue Transplant History

• 1662 Meekren used a piece of dog skull to repair
  a defect in a Russians soldier skull
• 1878 MacEwen credited with the first successful
  human (allograft) bone transplant
• 1905 Zirm performed the first human corneal
  transplant
• 1950s Herndon Chase performed whole knee joint
  transplantation on a dog

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Standards and Regulatory Agencies

• U.S. Food and Drug Administration (FDA)
• American Association of Tissue Banks (AATB)
• Eye Bank Association of America (EBAA)
• State of California

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Tissue Donation Potential

• ALL AREAS OF THE HOSPITAL
• Call within 1 hour of all deaths

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Cornea/Eyes Heart Valves Skin Bone Tendons Cartila
ge Veins
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Clinical Triggers Card
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Potential Tissue Donor

• Patients that expire by cardiac death
• Patients facing imminent brain death are also
  potential organ donors
• 97 of U.S. deaths are cardiac death

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Nurse or Physician Responsibilities

• Within 1 hour of cardiac death, call OneLegacy
  with referral

1-800-338-6112

• Provide support to help OneLegacy evaluate donor
  suitability
• Please refrain from mentioning donation to the
  family

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Preliminary Screening Questions

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

Medically Ruled Out
Potential Donor
Answer Extended Screening Questions
Document Referral Number
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Approach for Tissue Donation

• Extended screening questions asked to finalize
  medical suitability
• Consent obtained from the legal next of kin and
  recorded at hospital or at home (via phone)
• As with organ donation, families may choose which
  tissues are recovered
• Referral number for the patient is provided

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Tissue Recovery

• Nurse continues eye care
• - saline solution papertape eyes shut
• Patient refrigerated within 12 hours to maximize
  donation due to different recovery times for
  various types of tissue
• Tissue recovery performed in OR ability to
  recover in morgue provided it is an aseptic area
• Hospital staff not required during tissue
  recovery OneLegacy brings own staff and equipment

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ORGANIZATIONAL CHART
Recovery Locations Manager
DRC-2 (Donor Recovery Coordinator)
DCI (Donor Information Coordinator)
DRC-1 (Donor Recovery Coordinator)
Rounds Staff (RD,LA,SA)
Techs (RD,LA,BK,SA)
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DRC Responsibilities

• DRC
• Point of contact in tissue services for all
  matter relating to recovery operations
• All communications re cases dispositions to go
  through DRC
• Coordination of all cases
• Dispatch teams (Regions)
• Ocular pending list
• Delegate regional office rounds staff to expedite
  release
• Oversee rounds staff at all locations and ensure
  timely screening
• Data entry
• Log all tech response times in database
• Generate shift reports
• Morning Report
• DRC worksheet
• CNR Reports
• Consents scan and e-mail to family services

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Responsibilities

• Review all paperwork and address any corrections
• Work PTC to coordinate organ / tissue consented
  donor
• Make arrangements for recovery team with hospital
  staff
• Locate medical chart
• Dispatch ocular tech first / recovery team

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Reports

• Automated Reports
• Morning Report
• DRC worksheets
• CNR reports
• Rounds
• End of Shift reports for screening
• Cases reported, consented, and recovered from
  Coroner cases

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Database

• Basic Donor information
• Tissue Allocations
• Coroner info
• NOK-Consent Info
• Case completion and notes
• Screening staff
• Inputting cases screened at coroners offices

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Recovery

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

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Thank you!