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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.

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