What can be transplanted?
Kidneys, heart, liver, lungs, pancreas, small bowel, corneas, heart valves and bone can all be transplanted. Skin can be used to treat patients with severe burns. Techniques are improving all the time and it may soon be practical to transplant other parts of the body.
If I want to go ahead with organ donation what do I do?
If you would like to consider an organ donation, you will need immediate advice. This can be sought from the hospital or coroner’s officer. They will contact a Tissue Donor Co-ordinator or a Donor Transplant Co-ordinator who will be able to discuss the options of the donation with you in more detail. The coroner must be told and must agree before a donation can take place. In a small number of cases, donation may not be possible for medical reasons, or because of the delays when a death has to be investigated.
What organs or tissue can I donate?
The organs that can be donated include heart, lungs, kidneys, and pancreas, liver and small bowel.
Tissue that can be donated includes corneas, skin, bone and heart valves. Corneas can be transplanted to restore the sight of a person who has a severe eye disease or injury. Bone and tendons are used for reconstruction after an injury or during joint replacement surgery. A bone transplant can prevent limb amputation for patients suffering from bone cancer.
Heart valves are used to help children born with heart defects and adults with diseased or damaged valves. Skin grafts are used as protective dressings to help save the lives of people with severe burns.
Most people can donate tissue. Unlike organs, tissue can be donated up to 24 hours after a person has died and can be stored for longer periods.
How do they know you are really dead?
Organs are only removed for transplantation after a person has died. A doctor or doctors who are entirely independent of the transplant team certify death. Death is certified in the same way for people who donate organs as for those who do not.
Most organ donors are patients who die as a result of a severe head injury, brain haemorrhage or stroke and who are on a ventilator in a hospital intensive care unit. In these circumstances death is diagnosed by brain stem tests. The ventilator provides oxygen that keeps the heart beating and blood circulating after death. These donors are called heart-beating donors. Organs such as hearts and lungs, which deteriorate very quickly without an oxygen supply, are usually only donated by a heart-beating donor.
Patients who die in hospital but are not on a ventilator can, in some circumstances, donate their kidneys, and in certain circumstances, other organs. They are called non-heart-beating donors.
Both heart-beating and non-heart-beating donors can donate their corneas and other tissue such as skin, bone and heart valves.
Will they just let you die if they know you want to be a donor?
No. The doctors looking after a patient have to make every possible effort to save the patient’s life. That is their first duty. If, despite their efforts, the patient dies, only then can organ/tissue donation be considered and a completely different team of doctors would be called in.
Can I donate if I die in the accident and emergency department?
Yes, in a small number of hospitals, patients who are certified dead on arrival or die in the accident and emergency department can donate organs, in particular kidneys that are able to tolerate longer periods without oxygen than other organs.
For this to happen however, steps have to be taken to preserve the kidneys until the next of kin are contacted and can let their wishes be known. This includes a special technique in which the kidneys are flushed with a cold preservative fluid. This is done through a small tube that is inserted into a blood vessel in the groin.
This must be done within minutes of death to ensure the kidneys remain suitable for transplantation and the deceased is not deprived of the opportunity to donate. If the wishes of the deceased are known (for example they are on the NHS Organ Donor Register), this procedure will be performed. However, organ donation itself will never take place without full discussion with the relatives.
Does donation leave the body disfigured?
No. Organs are always removed with the greatest of care and respect for the person by trained surgeons. This takes place in a normal operating theatre under the usual conditions. Afterwards the wound is carefully stitched and covered by a dressing. Only those organs and tissue specified by the donor or their family will be removed.
Relatives may see the body after the operation if they wish. The transplant co-ordinator will stay with the family during the whole process if the family wishes.
Tissue can be retrieved in an operating theatre, mortuary or funeral home. Specially trained teams, who always ensure that the donor is treated with the utmost respect and dignity, carry it out. The cosmetic appearance of the donor is restored following all types of donation. If the family wishes to view their relative following donation then this will be facilitated by the transplant co-ordinator.
Does being a donor cause delays to funeral arrangements?
No. Once relatives have agreed to donation, surgery is performed as soon as possible. The whole process of donation is usually completed within 12 hours.
Does a donor’s family have to pay the cost of donation?
No. There is no question of any payment at all. The NHS meets the costs related to the donation of organs.
Will the NHS pay the cost of the funeral?
No. Funeral costs are met either by the family or from the person’s estate and not by the NHS or any Government authority.
Can a donor be under sixteen?
Yes, if he or she has expressed such a wish and the parents or guardian agree to donation.
Can older people be donors?
Yes, in the case of cornea and some other tissue, age does not matter. For other organs it is the person’s physical condition, not age, which is the deciding factor. Doctors decide in each case which organs/tissue are suitable. Organs from people in their seventies and eighties are transplanted successfully.