“Don’t think of organ donation as giving up a part of yourself to keep a total stranger alive. It’s really a total stranger giving up almost all of themselves to keep a part of you alive.”
– Unknown
Forever Grateful, Meeting Wednesday Saved My Life.
A friend said to me recently, “I’m so grateful that you and Wednesday are now one. Neither of you were going to make it on your own.” Personally, I think that is a lovely way to look at organ donation. Together, Wednesday and I live with and for each other, going from strength to strength. This post looks at the different types of organ donation.
When you receive an organ transplant you are not told anything at all about the type of organ donation or who your donor and their family are. You do not know how they died or where they lived. Through the transplant process, I have become aware of a few things. I was called 24 hours before the transplant operation was scheduled. I knew that the organs were retrieved in the early hours of Wednesday morning. The heart was transported quite a distance before arriving at St Vincent’s Hospital, Sydney at 8 am Wednesday morning.
My Donated Heart Arrives
At the time the heart arrived, I was already in the theatre prepped and ready to go. The lead surgeon was standing beside me when he was told Wednesday, my future heart had arrived. Prof J. went out to check the status and viability of the heart. He came back rubbing his hands together. He then gave the thumbs up, saying “it’s great! Let’s go.” It was surreal watching the esky containing Wednesday being carried into the theatre.
That was the last thing I remember until Thursday afternoon waking up in ICU.
There had been a “false start” call on the Friday before meaning the heart transplant was cancelled. At the time I was not given a reason. I could have been the standby option or our match was not good or the heart was not viable. After my heart transplant the transplant surgeon told me I was lucky. Stating that I had received the better heart than Friday’s option. It is so strange to collect little snippets of information while having so many questions unanswered.
There are living organ donations (kidney, partial liver, etc.) and deceased persons organ donation(heart, lungs, pancreas, intestines, etc.). Alive or dead, all donors are Donor Heroes: See the post What You Need To Know About Organ Donation for more information about donor heroes.
This post will focus on deceased organ donation and a later post will unpack living organ donation. The following is an overview and I have provided references if you want to take a deeper dive into the types of organ donation after death.
Types of Organ Donation: A Guide To Understanding
Making an informed decision about organ donation is crucial, and understanding the various pathways and criteria can help you navigate this complex process. For a detailed overview of national guidelines, visit TSANZ. Below is an outline of the key types of organ donation and important considerations.
The Gift of Organ Donation: Types and Pathways Explained
There are three main forms of deceased organ donation including:
Brain Death Donation (BDD)
Brain Death Donation (BDD) involves donors who have experienced a catastrophic head injury, illness, or tumour resulting in significant bleeding and swelling of the brain. As Brain death is an irreversible condition. Therefore, it is confirmed through rigorous testing and brain scans conducted by senior medical specialists. Despite being on life support machines to maintain organ function, the person is clinically deceased. Donors are typically in an intensive care unit, connected to machines for breathing, oxygen, and medication to preserve organ function. Organ donation surgery takes place when transplant teams are ready, with the donor being transferred to the operating theatre for the procedure.
Extended Criteria Donors (ECD)
Due to the critical shortage of available organs, Extended Criteria Donors (ECD) are increasingly considered for transplantation. ECD donors may be older individuals or those with a history of smoking, cancer, or infections, and might have engaged in higher-risk behaviours. While these factors introduce additional risks, transplant doctors will thoroughly discuss these with you to ensure you are fully informed if offered an organ from an ECD donor.
Donation after Circulatory Death (DCD)
Donation after Circulatory Death (DCD) occurs when a patient’s circulation has permanently ceased. Potential DCD donors have suffered severe, irreversible head injuries or illnesses and cannot survive without life support. Following discussions with the family and treating specialists, a decision is made to withdraw life support, and end-of-life care is provided. Once death is confirmed, a rapid transfer to the operating theatre is conducted, and organ retrieval surgery commences.
What happens to a retrieved heart?
There is a limited time after a heart is retrieved where the precious lifesaving organ remains viable for transplantation into a suitable recipient. You may have already heard about the “Heart In A Box”.
The Organ Care System (OCS)
The Organ Care System (OCS), often referred to as “heart-in-a-box,” is an advanced machine designed to assess and improve the function of hearts from DCD donors before transplantation. This system supplies the heart with warm, oxygen-rich blood and nutrients, allowing it to beat continuously during transport and providing protection from cold ischemia. The OCS enables the heart to be transported over greater distances while maintaining viability. Upon arrival at the transplant centre, the heart undergoes a final assessment. If it meets the criteria for donation, the transplant proceeds. The OCS is essential for heart donations after circulatory death, ensuring the best possible outcomes for recipients.
A Precious Gift In Context Of Grief
Organ donation is such a profound gift in the context of great grief. I earnestly empathise with the grief donor families experience. As many have, I have lost loved ones too. While they were registered donors the nature of their deaths prevented organ retrieval. I think that is extra sad. The reality is only 1% of all deaths each year occur in circumstances where organ retrieval is viable. Of this 1%, 44% of registered donor families decline organ donation after the death of a loved one. This statistic makes organ transplant almost exceptional odds.
I feel such sorrow for Wednesday’s family grieving her loss. Then I remember that she now has a new family who loves and admires her. A family filled with love, support and gratefulness.
For more detailed information, please access the resources below.
You are welcome to share your story by leaving a message in the comment section below.
X
Wednesday
References
Mayo Clinic. (2022). Organ Donation: Donor Types and Organ Matching. Retrieved from https://www.mayoclinic.org/search/search-results?q=types%20of%20organ%20donation
National Institutes of Health (NIH). (2023). Understanding Brain Death and Organ Donation. Retrieved from https://www.nih.gov
NHS Blood and Transplant. (2021). Types of Organ Donation. Retrieved from https://www.organdonation.nhs.uk
Transplant Society of Australia and New Zealand (TSANZ). (n.d.). National Guidelines. Retrieved from www.tsanz.com.au
United Network for Organ Sharing (UNOS). (n.d.). Organ Donation Process. Retrieved from https://unos.org
Hey people!!!!!
Good mood and good luck to everyone!!!!!
All the best to you!
x
Wednesday