6.1 Understanding tissue-only donation
Most patients who die in the ICU and many that die in the wards can be considered for tissue donation. If a family of a patient in either the ICU or a hospital ward volunteer donation, please contact the donor coordinator.
Tissues that can be donated for transplantation include:
- eyes for corneas and sclerae
- skin
- heart valve tissue.
Tissue banks all have their own exclusion criteria. For example, many patients with a history of cancer can donate eye tissues but not heart valves and skin. The donor coordinator along with the tissue banks will determine which tissues can be donated.
Tissue donation can be facilitated a number of hours after cessation of circulation.
All potential tissue donors are carefully screened to reduce the risk of transmission of disease or infection from the donor to the potential recipient(s).
This includes:
- review of the clinical record, including record of intravenous fluids administration
- completion of the Medical/Social Questionnaire for tissue-only donation
- completion of the Physical Assessment of the Donor Form
- blood testing for infectious disease testing.
The donor coordinator can complete the Medical/Social Questionnaire and the Authority for Organ and Tissue Donation Form with the family by phone. In the Auckland region the donor coordinator can meet with the family to complete this documentation.
Some families may wish to complete the consent and other documentation prior to the death of their relative.
The donor coordinator will discuss with the ICU the timing for taking of the donor bloods.
Eye donation
Eye donation can be considered for patients aged 10 years and upwards, with no upper age limit. It can be facilitated in hospitals, hospices and funeral services throughout New Zealand.
Following eye donation, the shape of the eyelid is maintained with a small plastic shield.
The corneas are transplanted within three weeks of donation to restore sight. Transplantation of sclerae repairs eyes that have been damaged by injury or disease.
Heart valve tissue donation
The donation of heart valve tissues can be considered for newborn babies ≥3.5kg up to patients 70 years of age. The donor coordinator will advise which hospitals can facilitate heart valve tissue donation (when organs are not being donated).
The aortic and pulmonary valves and patches from the pulmonary arteries can be donated and transplanted, often to newborn babies. The heart valve tissues can be stored for up to five years.
Skin donation
Skin donation can be considered for patients 10 years and over, with no upper age limit. It can be facilitated in the Auckland and Waikato regions.
The skin is removed from the front and back of the legs only. Donated skin can be stored for up to five years and is used as a temporary dressing for patients with severe burns.
6.2 Sequence of events in tissue-only donation
A patient is dying or has died, or donation has been raised by the family.
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ODNZ is contacted to discuss the potential for tissue donation.
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Donor information is obtained.
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Consent of the coroner is obtained when required.
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Required documentation is completed by the ICU staff and/or the donor coordinator
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Blood is taken as requested by the donor coordinator. Donor coordinator advises if blood samples are to be sent or remain with the patient.
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Donor coordinator organises tissue donation and informs ICU of arrangements.
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Donor coordinator provides feedback for family and ICU staff.
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Donor coordinator informs relevant hospital staff or NIIO that tissue donation has been completed.