Organ Donation

Introduction:

• Organ donation is the process by which a person’s organs are removed for the purpose of transplanting them into another person.
• It can be life-saving and significantly improve the quality of life for recipients.
• In the UK, there’s an “opt-out” system, meaning unless an individual has expressed a wish not to donate after death, they will be considered a potential donor.

Types of Donation:

• Living donation: A living person donates an organ or part of an organ. Commonly includes:
  • Kidney
  • Part of the liver
  • Part of the lung
• Deceased donation: Organs are donated after the donor’s death. Can further be categorised into:
  • Donation after brain death (DBD)
  • Donation after circulatory death (DCD)

Factors that Preclude Organ Donation:

• Infectious Risks:
  • HIV (though with advancements, some centres may consider HIV+ donors for HIV+ recipients)
  • Active tuberculosis
  • Prion diseases e.g., Creutzfeldt-Jakob disease
• Malignancy: Most active cancers, to avoid transmission to recipients. Exceptions include:
  • Primary brain tumours (without metastasis outside CNS)
  • Low-risk skin cancers like basal cell carcinoma
• Severe, irreversible organ damage or dysfunction.
• Systemic diseases that could affect organ function.
• Age: While there’s no strict age limit, organ function is assessed and older age might preclude certain organ donations.

Assessment for Organ Donation:

• Thorough medical and social history to assess suitability.
• Relevant investigations, including imaging and blood tests, to check organ function and rule out contraindications.
• Consultation with family or next of kin to ensure understanding and gain consent if needed.

Importance of Communication:

• Engaging in sensitive and clear communication with the donor’s family is essential, ensuring they understand the process and implications.
• Respect for religious and cultural beliefs.
• Addressing any concerns or misconceptions promptly.

Ethical Considerations:

• Respect for autonomy: Ensuring informed consent is obtained.
• Beneficence: The act of donation should have a net positive effect on the recipient.
• Non-maleficence: Ensuring minimal harm to living donors.
• Justice: Ensuring equitable distribution of organs.