In the event of your death it may be possible to donate organs (heart, lungs, liver, kidneys and pancreas) or body tissues (eye tissue, heart valves and skin).
Organ transplants can be life-saving for heart, lung and liver recipients, while kidney and pancreas transplants dramatically improve the lives of recipients.
Organ donation is only possible when a person is on a ventilator in an intensive care unit, usually with devastating brain damage. Fewer than 1% of all deaths happen this way.
Tissue donation is possible in most circumstances when people die.
Tissue transplants include heart valves to save the lives of babies and young children, skin to treat people with severe burns and eye tissue to restore sight and repair eyes.
If you want to be an organ or tissue donor in the event of your death, have a conversation with your family, whanau or those people closest to you and let them know. You may wish to talk with them about what organs and tissues you would want to donate.
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There is no official donor register in New Zealand.
You can indicate your wish to be an organ donor or not when you apply for a driver’s licence or when you renew your licence. If you would like to donate your organs and tissues following your death, the word 'donor' will be printed on your licence. This is an expression of your interest only.
The most important step is to make sure your family and friends know whether or not you want to be a donor. In the event of your death, your family will always be asked if they know your wishes. If you have told them there is nothing else you need to do.
You can choose which organs and tissues you would like to donate. Organs and tissues that can be donated – depending on your age and medical history – are heart or heart valves, lungs, liver, kidney, pancreas, eyes and skin. Make sure your family knows which organs and tissues you are willing to donate, as only these organs and/or tissues will be retrieved following your death.
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Many people are unaware that it is possible to donate tissues (eye tissue, heart valves and skin) following death and that unlike organ donation, tissue donation can occur in most circumstances when people die (at home, on a hospital ward, in a hospice).
People of all ages can be skin donors and donated skin is the preferred dressing for people with severe burns. Although there are synthetic alternatives to skin available, donor skin is still regarded as the gold standard of dressings. It protects wounds, reduces scarring and allows time for the patient’s own skin to grow back. Being able to cover a large burn with real skin is not a cosmetic exercise it is a lifesaving one.
Organ Donation NZ works with the NZ Skin Bank (managed by the NZ Blood Service) to facilitate the donation of skin tissue following death (deceased donation). Live skin donation is not currently possible.
Donor skin can be stored at the NZ Skin Bank in Auckland for up to five years.
Some people might wonder what their family member will look like after a skin donation. During a donation a paper thin layer of skin is removed from the front and back of the legs only. This means that the area can be covered and the donation does not interfere with the person’s appearance so an open casket is still possible.
We don’t currently have enough skin donors in NZ, more are needed.
If you want to be a skin donor following your death, have a conversation with your family about donation and let them know what organs and tissues you would want to donate.
There is no age limit for becoming an organ or tissue donor.
Doctors will assess your organs following your death to determine whether donation is possible. Sometimes for medical reasons, you may not be able to donate your organs; however the donation of body tissues (eye tissue, heart valves and skin) can happen in most circumstances.
If you wish to become an organ or tissue donor, make sure you discuss this with your family. In the event of your death, a health professional will ask your family if they know your wishes. If you have told them, there is nothing else you need to do.
Very few medical conditions prevent you from being an organ or tissue donor.
Following your death, doctors will assess the suitability of your organs and tissues for donation. While some organs may not be suitable, other organs and tissues will be able to be donated and transplanted. You may still be able to donate your eye tissue (corneas) to help restore someone’s sight, heart valves to save the lives of babies and young children, and skin to treat people with severe burns.
For example, people with severe asthma may not be able to donate their lungs, but may be able to donate their heart, liver, pancreas and kidneys, along with tissue like eyes, heart valves and skin. While people with cancers, such as breast or prostate cancer, can donate eye tissue, but not heart valves or skin.
There are a number of factors that the transplant units consider when deciding who will receive an organ. These factors can include:
- Blood group
- Tissue type
- Height and weight compatibility
- Medical urgency
- Time on the waiting list
Organs are only removed from a donor if there are suitable recipients on the waiting list.
Funeral arrangements are not usually affected by organ or tissue donation.
After a family has agreed to donation, the organs and tissues are removed respectfully from the donor using normal surgical procedures. So there is no reason to delay arrangements. It is still possible for your family to take your body home or to your marae and to have an open casket following donation.
The doctors and nurses will always fight to save your life to the best of their ability. Only after they are absolutely sure there is no chance you will recover will organ and tissue donation be considered.
Following your death, a health professional will ask your family if they are aware of your wishes to donate. This is why it’s important to have a conversation with your close family or friends about donation. If you want to be a donor, make sure you tell your family what organs and tissues you want to donate.
If the family is aware of the wishes of their relative, this can sometimes make the decision a little easier.
The Organ Donation NZ Donor Coordinators will provide support and follow up for your family before and following donation. They will also give your family brief details about the recipients of your organs and tissues, if they wish to receive this information.
Yes, in most cases, you can donate your organs if you have lived in the UK. People who have lived or visited the UK can donate their kidneys, liver, heart, lungs, pancreas and eyes.
The donation of heart valves, skin and blood is not permitted if a person has visited or lived in the United Kingdom (England, Scotland, Isle of Man and the Channel Islands), Republic of Ireland (Eire) or France between the 1st January 1980 and 31 December 1996 for more than six months. This is due to the risk of transmitting Variant Creutzfeldt Jakob Disease (vCJD), more commonly known as Mad Cow Disease.
Yes, you can still donate eye tissue if you wear glasses.
Eye tissue, including the cornea (lens) and sclera (white outer layer of the eye) is used to restore sight and repair eyes.
Currently around 300 people require a corneal transplant each year, often due to scratches, accidents or injury to the eye. However nearly 50% of transplants are performed for patients with keratoconus (a condition where the cornea becomes thin and cone shaped, blurring vision).
Tissue donation, including eyes, heart valves and skin, can occur in most circumstances when people die, whether it is at home, in hospital or in a hospice. Cornea retrieval operations can also take place at a funeral home.
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When you indicate your wish to donate organs on your driving licence, the organs and tissues are not specified. It’s important your family understands your wishes regarding donation and also which organs and tissue you would be willing to donate.
Organs and tissues that can be donated – depending on your age and medical history – are heart or heart valves, lungs, liver, kidney, pancreas, eyes and skin (in the Auckland and Waikato regions only).
If you were in a situation where organ and tissue donation was being considered, a health professional will always ask your family (or those people called to your bedside) if they know your wishes. They will also be asked to sign a consent form including the organs and tissues that you wish to donate.
If you have had a conversation with your family about your wishes, there is nothing else you need to do.
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The most important step to being a donor is to ensure your family or friends are aware of your wishes. In the event of your death, your family will always be asked if they know your wishes. If you have told them there is nothing else you need to do.
You can choose which organs and tissues you would like to donate. Organs and tissues that can be donated, depending on your age and medical history, are heart or heart valves, lungs, liver, kidney, pancreas, eyes and skin. Make sure your family knows which organs and tissues you are willing to donate. Only these organs and/or tissues will be retrieved following your death.
The most common organ donated by a living person is a kidney. Approximately half of all kidneys transplanted in New Zealand are from living donors. Similarly, a segment of a liver can also be donated from a healthy adult and transplanted to a child or an adult, if they are a family member or close friend.
A healthy person can lead a normal life with only one kidney; however before living donation can take place the person donating his or her organ will undergo a very thorough medical and psychological assessment. For more information visit Kidney Health New Zealand
If you would like to donate your body to medical science, you need to contact the Body Bequest Program at Auckland University. For more details visit www.fmhs.auckland.ac.nz/bodybequest. Alternatively contact the Body Bequest Program at Otago University http://www.otago.ac.nz/medical-school/about/bequest-of-bodies
Most people understand that death occurs when a person's heart and breathing stop, but death also occurs when the brain dies. This is known as brain death.
After a severe head injury or brain haemorrhage (bleeding inside the brain), the brain becomes swollen in the same way that muscles become swollen when injured. As the brain is contained within the skull, which is rigid, the brain cannot expand to make room for the swelling. The pressure of the swollen brain will keep increasing to the point that it cuts off the blood and oxygen supply to the brain. When brain cells die they can never recover and this is brain death.
How doctors confirm brain death
Critically ill people are closely observed and monitored by the intensive care doctors and nurses caring for them. There are a number of physical changes in pupil reaction, heart rate, blood pressure and body temperature that happen when the brain dies. These changes together with the loss of other natural responses such as breathing, coughing and blinking cause doctors to suspect that the brain has died. Two separate clinical assessments are carried out by two appropriately qualified doctors to find out whether or not the brain has died. The time that the second brain death assessment is completed is the time of the death of the person.
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Donation after circulatory death (DCD or 'Non Heart Beating Donation') allows the option of organ donation in patients who have a non-survivable head injury, but do not fulfil brain-death criteria and are therefore not brain dead.
When a patient has a non-survivable head injury a decision to withdraw treatment is made by the medical team and the family. Some time after this decision has been made organ donation would be discussed with the family. If the family is in agreement with donation, treatment would be withdrawn and care would be continued until the patient had died. Organ donation would commence shortly after the death of the patient.
It is important to understand that the decision to withdraw treatment is made entirely independently and prior to any discussion about donation.
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