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Legal Aspects of Donation

Advisory Committee on Organ Transplantation Informed Authorization for Vascularized Composite Allograft Kurt Shutterly Chief Operating Officer. Legal Aspects of Donation. Authorization Family Authorization First Person Authorization Pronouncement of Death

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Legal Aspects of Donation

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  1. Advisory Committee on Organ Transplantation Informed Authorization for Vascularized Composite AllograftKurt Shutterly Chief Operating Officer

  2. Legal Aspects of Donation • Authorization • Family Authorization • First Person Authorization • Pronouncement of Death • Medical Examiner/Coroner Communication

  3. Authorization Requirements for Organ Donation • Brain Death and Cardiac Death • When to Approach: • Brain Death Pronouncement • Family Decides to Withdraw Support • DNR/CMO Patient • Unstable Potential Donor

  4. First Person Authorization • Drivers License • Living Will • Donor Card • Authorization Document

  5. Matching the Donor and Recipient for VCA • Selection Criteria from TX Center • Screening • Identification Process • Donor/Recipient Match

  6. Providing the Opportunity for Vascularized Composite Allograft (VCA) • The “Request for the Gift” • When to approach? • Recipient information • Authorization required • First person authorization

  7. Informed Authorization • No Additional Costs • Funeral Home Viewing • Reconstruction • Prosthesis • Recipient Information • Media • Donor Family Follow Up

  8. Recovery Process • Coordination • Preparation of Hand and Forearm • Perfusion • Retrieval • Transportation • Reconstruction • Follow Up

  9. An Organ Procurement Organization’s Experience with VCA • Donor Families support VCA • Five hand Transplants in 18 months • Ability to do much more • National List needed for Allocation • Reconstruction and Funeral Home Relations

  10. Post Donor Review • It’s all about the “Gift” • Funeral Home • OR Staff • Donor Hospital • Transplant Surgeons

  11. Family Meeting

  12. CAMC General Feedback CRNA Donor Advisory Group Member Hospital Chaplain I acknowledged her generous gift of life that she shared with another in need and told the mother that this was the first gift of this kind that we had ever had donated from CAMC. I was thrilled to take part in this particular CORE case.  This is the ultimate gift in my opinion, and I want you and your organization to know that you always have my support. Being able to take part in that groundbreaking case was wonderful and overwhelming.  I was very excited and thrilled about this  unique situation since we had been doing  kidney transplants and organ donation  for over 20 years

  13. Transplanted • J.A.,female, 27 years • Occupation – Student/Mother • Cause of Amputation: ischemic gangrene after Nota virus infection 2004 • Amputation: both lower and upper limbs Amputation level: distal wrist and fingers • Transplant Side: Right wrist

  14. Post Transplant

  15. Transplanted • S.A.,female, 33 years, RHD • Occupation – Customer Service Agent • Cause of Amputation: ischemic gangrene after Meningococcal septicemia 2003 • Amputation: Both upper and lower limbs Amputation level: R & L distal forearm • Transplant Side: Bilateral forearm

  16. One Month Post Transplant

  17. Thank you!

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