A Behind-the-Scenes Look at Organ Procurement
by Laura Miyashita
Behind the scenes of every organ transplant lays a complex system of getting donated organs to individuals on the transplant wait list. All told, it requires the teamwork of more than a dozen people to identify an organ donor and work with family members, the local hospital, doctors and transplant programs so a donor can provide the gift of life.
“The steps that lead up to an organ transplant are a sensitive balance of timing, information-sharing and medical precision,” says Nikole Neidlinger, M.D., medical director for California Transplant Donor Network and a kidney transplant surgeon at California Pacific Medical Center.
California Transplant Donor Network
Overseeing these steps is the California Transplant Donor Network(CTDN), one of 59 federally designated organ procurement organizations (OPOs) in the U.S. The Transplant Network works with more than 175 hospitals in Northern and Central California and Nevada to offer the option of organ and tissue donation to families who have lost a loved one. They are a liaison between organ donors and four Northern California transplant programs: California Pacific Medical Center, Stanford Medical Center, UCSF and Lucille Packard Children’s Hospital.
When a potential donor is identified in CTDN’s service area, a transplant coordinator goes to the hospital to evaluate medical suitability. The coordinator works with the hospital staff to provide appropriate care for the donor and family support. If the deceased individual has authorized donation (on a donor card or registry) or the family consents to donation, the transplant coordinator performs various evaluations to provide an overall picture of the organ’s condition.
Details from the organ donor are then entered into a national database that matches donated organs with transplant candidates. Organs are distributed—or allocated—based on policies established by the national Organ Procurement and Transplant Network (OPTN).
Generally, organs are allocated first to candidates at the local transplant centers with consideration given to the severity of illness and time waiting.
Notifying a Patient
When a transplant program—such as California Pacific Medical Center—learns that an organ is available for one of its patients, the transplant surgeon, nurse coordinator and histocompatibility technician are notified. Arrangements are made to get to the organ donor’s hospital, recover the organs and bring them back to San Francisco for transplant. Simultaneously, the nurse coordinator contacts the wait list patient and notifies him/her to come to the hospital for surgery.
“From the point when I’m notified about a kidney available for one of our patients, it can take many hours to recover that organ and bring it to San Francisco for transplant,” says William Bry, M.D., surgical director of California Pacific’s Kidney Transplant Program. He adds, “For optimal kidney function, the time between removing a kidney from a donor to transplant should be less than 18 hours.”
In 2010, California Transplant Donor Network had 274 local donors who gave 952 organs. An additional 242 organs came from donors in other parts of the country. As the waiting list for organ transplants expands, CTDN continues to promote the California donor registry. Registering as an organ and tissue donor can save the lives of eight individuals, and it helps CTDN ensure that your wishes are followed.
Register to be a donor at donatelifecalifornia.org for California residents or nvdonor.org/donate.html for Nevada residents.
article from Spring Summer 2011Kidney Review newsletter