updates on organ donation

7/25/2019 Updates on Organ Donation

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UPDATES IN ORGAN

DONATION

Mrs Anusha Verghese

Medical Surgical NursingPIMS


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OBJECTIVES

Delineate the criteria required toqualif a! a "otential or#andonor

E$"lain factor! in%uencin# or#an

donation "roce!!& E$"lain the i'"ortance of a tea'

a""roach to fa'il con!ent Pro(ide a #eneral under!tandin#

of the donation "roce!!


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Or#ani!ation hel"in# )ith or#an donation* Tran!"lant! "ro#ra''e! in India

+O,AN -oundation .INOS/ 0 Ta'il Nadu1 AndhraPrade!h1 +ahara!tra

234 Or#an! !hared& . 25206idne!1 70,eart!1 5809i(er /

+O,AN -oundation .INOS/ 0 Ta'il Nadu1 AndhraPrade!h1 +ahara!tra

234 Or#an! !hared& . 25206idne!1 70,eart!1 5809i(er /

-ORTE1 BANGA9ORE 32 Or#an! Shared

. 32 0 6idne!1 50 ,eart1 50 9i(er /

-ORTE1 BANGA9ORE 32 Or#an! Shared

. 32 0 6idne!1 50 ,eart1 50 9i(er /

ZTCC, Mumbai 55 Organs Shared - all kidnes

ZTCC, Mumbai 55 Organs Shared - all kidnes

O!"O, N#$elhi %e& 'rgans shared

O!"O, N#$elhi %e& 'rgans shared

SO!T, C'chin ( 'rgans shared

SO!T, C'chin ( 'rgans shared


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Ta'ilNadu Net)or: for Or#an Sharin#Share Organs Sa)e *i)es

$r#Amal'r+a)anahan,C'n)ener, Cada)erTrans+lan Pr'gramme,-Mail .or#an!tran!"lant;#'ail&co'

Donor! -ro' TN ?*i)er 4480idne 5278Pancreas =Small "'&el 2Total +a@or or#an! 225?

/ear Val)e 123C'rnea 46(Skin 31

"l''d Vessels 3Total Or#an! 378=

Transplants So Far

Performance Report : From Oct 2008 to Oct 31, 2015
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Organ donation

Organ donation is the process

of remoing tiss!es or organs

from a lie, or recentl" dead,person to #e !sed in another$

The former is the donor and the

latter is the recipient$

People of all ages can #ecome

donors$


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ORGANS T,AT CAN BEDONATED


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uDonation

Identication and Referral

+aintenance DNRDi!connection of Ventilator !u""ort

Pronounce'ent of rain death

-a'il Refu!al to con!ent for donation

Settin# quiet1 "ri(ate area1 near ut out of the ICU &

S"ea:in# to the fa'il o(er the dead "atient! ed i! di!re!"ectful

and unacce"tale& Decou"lin# The act of a""roachin# a fa'il for or#an donation'u!t e done in the a""ro"riate ti'e1 )ith due re!"ect for their lo!!&The 'u!t e #i(en ti'e to ad@u!t to the lo!! of their lo(ed one&

The r!t !hould in(ol(e the "h!cian and hi! e$"lanation thattheir lo(ed one ha! died&

The !econd the tran!"lant coordinator !hould #o later to e$"lainaout or#an donation and otain infor'ed con!ent&


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Identifin# a PotentialDonor

5& Or#an donor! 'u!t e 'aintainedon a (entilator to :ee" life0!a(in#or#an! o$#enated&

2& The Gla!#o) Co'a Scale 'u!t eF 8

3& There 'u!t e a neurolo#icalin!ult


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Cardio0re!"iratordeath&

*'ss '7 cardiac7unci'n#

*'ss '7 res+ira'r7unci'n#

P'enial issue d'n'r

C'rnea, hear )al)es,skin, l'ngb'nes,sa+nen'us)eins#

Non0 reco(eralerain death&

Irre)ersible l'ss '7brain-sem 7unci'n#

P'enial 'rgan andissue d'n'r

/ear,lungs,kidnes,

+ancreas,li)er,inesine,

issues


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Ideni7ing a P'enial $'n'r

,ere! a li!t of !o'e t"e! of "atient! )ho 'aeco'e donor!

#un!hot )ound

'otor (ehicle accident )ith clo!edo"enhead in@urie!

cerero0(a!cular accident

dru# o(erdo!e

ano$ic in@ur han#in#

dro)nin#

cardiac arre!t

"ri'ar rain tu'or )ithout 'et!


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Denition!

Tran!"lant Coordinator

A "er!on a""ointed a ho!"italto coordinate all 'atter! relatin#to re'o(al or tran!"lantation ofhu'an or#an!ti!!ue!


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3.

COLLABORATION

WITH HEALTH

CARE TEAM

3.

COLLABORATION

WITH HEALTH

CARE TEAM

2$%&'('%)&

)SS*SS+*(T,

')-(OST'%T*ST'(-./&) Tiss!e

t"ping and %ross

match,

O()R

+)()-*+*(T

2$%&'('%)&

)SS*SS+*(T,

')-(OST'%T*ST'(-./&) Tiss!e

t"ping and %ross

match,

O()R

+)()-*+*(T

4 .EDUCATION4 .EDUCATION

5.CHECK PATIENTHAEMODYNAMIC

SUPPORT,VENTILATOR

SUPPORT

5.CHECK PATIENTHAEMODYNAMIC

SUPPORT,VENTILATOR

SUPPORT

ROLE OF TRANSPLANT COORDINATOR

6.FAMILY SUPPOR

, COMMUNICATION

CONSENT

6.FAMILY SUPPOR

, COMMUNICATION

CONSENT

7.OPERATIONROOM

SCHEDULING

,COMMUNICATION,

PREPARATION

7.OPERATIONROOM

SCHEDULING

,COMMUNICATION,

PREPARATION

1.DONAR

IDENTIFICATION,

REFERRAL,ONSITE

RESPONSE

1.DONAR

IDENTIFICATION,

REFERRAL,ONSITE

RESPONSE

.ORGAN

ALLOCATION

AND

SURGICAL

RECOVERY

.ORGANALLOCATION

AND

SURGICAL

RECOVERY

! .PATIENT

FOLLOW"UP

! .PATIENT

FOLLOW"UP


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ORGANPROCURE+ENT

ORGANTRANSP9ANT


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NUC9EAR SCAN

GA++A CA+ERA AND ISOTOPE& TC 77 ,+POA COST RS 38??

TI+E 2?+INS

-A+I9H CAN STAH IT, PATIENTDURING PROCEDURE ANDEP9ANATION O- PATIENT

PROGRESS DONE IT,DISP9AHING PICTURES


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MANAGEMENT OF BRAIN DEAD DONOR


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INTENSIVE CARE +ANAGE+ENT -OR T,EPOTENTIA9 ORGAN DONOR

Rule! of 5??!& +aintain ,eart rateK 5?? eat!'in

+aintain BP at 5?? !!tolic1

+aintain urine out"ut at 5??cc "erhour1

:ee" PO2 at 5?? '',#&

Place Cenral line and Arerial line /8POT/!MIA -Mainain n'rm'hermia

&ih &arming9c''ling blanke :;#

check CVP :6-43 mm '7 hg>


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INTENSIVE CARE+ANAGE+ENT

,HPOTENSION6ee" +AP L


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ENDOCRINE SUPPORT

+ET,HPREDNISO9ONE 58+G6GBO9US15G+DAH

TRIODOT,HRONINE.T3/ = +CGBO9US13+CGS,R

T,HROIN T= 12?+CGS BO9US15?+CGS,R

VASOPRESSIN ?&802&= UNITS,R

INSU9IN IN-USION 15UNIT,R.TITRATE B9OOD G9UCOSEAT 58? +GD9 5>? +GD9/


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,OR+ONA9 SUPPORT

I+PROVES ORGAN DONATIONAND GRA-T SURVIVA9&

INCREASES TISSUEOHGENATION AND DONAR 9UNGRECOVERH&

I+PROVES CARDIAC

-UNCTION.INCREASESABP1CARDIAC OUTPUT19V-UNCTION/&

DECREASES INOTROPE


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AI+

T' mainain

hae'odna'ic!tailit7'r o"ti'alor#an "erfu!ionunil

'rgans are retrie(edfro' rain dead+aien


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ORGAN DONATION PROCESS


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*i)er rans+lan


32/61

,EART TRANSP9ANT


33/61

,EART TRANSP9ANT


34/61

,EART TRANSP9ANT


35/61

9un# Tran!"lantation


36/61

6idne tran!"lant


37/61

A+END+ENTS


38/61

The Tran!"lantation of ,u'anOr#an! .A'end'ent/ Bill1 2?55

Se+ember, 3( - !e)ie&C'mmiee se u+ ' e?amine+r')isi'ns '7 T/O Ac and he !ules#

The Tran!"lantation of ,u'anOr#an! .A'end'ent/ Bill1 2?55$ra7ed b Minisr '7 /ealh#


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T,O ACT TO COVER BOT,ORGANS * TISSUES

Re#ulation of re'o(al1 !tora#eand tran!"lantation of hu'anor#an! and ti!!ue! forthera"eutic "ur"o!e!

Pre(ention of co''ercial

dealin#! of hu'an or#an! andti!!ue!

CO S


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REUIRED CONSENTREUEST Manda'r 7'r IC@ d'c'r, in c'nsulai'n

&ih rans+lan c''rdina'r ' reuesrelai)es '7 brain dead +aiens 7'r 'rgan

d'nai'n#

!ec'rd '7 all brain dead +aiens and ha'7 he ne? '7 kin &h' are a++r'ached '

be ke+#


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S"ecial Pro(i!ion for Re'o(al ofCornea!

Technician "o!!e!!in# !uchqualication! and e$"erience1 a! 'a

e "re!cried1 'a enucleate an ee&

C i i f B i


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Certication of BrainDeath ?+ansi'n '7 ceri7ing +anel '7 e?+ers#

In addii'n ' neur'surge'n 9 neur'l'gis,!ur#eon "h!ician and an

ane!theti!t inten!i(i!tn'minaed 7r'ma +anel alread a++r')ed b heA++r'+riae Auh'ri#


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-orei#n National!

Authori!ation Co''ittee to "rohiit

or#an tran!"lantation )here reci"ient

i! a forei#n national and donor i! an

Indian national&

A""ro(al of Authori!ation Co''ittee

required 0 Donor and or reci"ientein# near relati(e! are forei#n

national!&


44/61

+inor!

No hu'an or#an! or ti!!ue! to e re'o(ed

fro' li(in# 'inor for tran!"lantation&

E$ce"tion!

-a'ilial donation of re#enerati(e cell!

.)hen a thera"euticall co'"arale adult

donor i! not a(ailale/

6idne tran!"lant! et)een identical t)in!

.En!ure no #enetic di!order "re!ent& No

i''uno!u""re!!ion required for reci"ient

t)in/&


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+entall challen#ed

No hu'an or#an or ti!!ue to e

re'o(ed fro' the od of a 'entall

challen#ed "er!on efore hi! death

for the "ur"o!e of tran!"lantation&

+ental illne!! li:e de'entia1

!chio"hrenia

+ental retardation


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Tran!"lant Coordinator!

+andator for ho!"ital!1 "rior tore#i!tration a! a tran!"lant centre1 to

a""oint a Tran!"lant Coordinator&


47/61

A""ro"riate Authorit

Sin#le 'e'er od

Central Go(ern'ent for Union

Territorie! 0 Director General of

,ealth Ser(ice!1 Go(ern'ent of India

State Go(ern'ent for State! 0

Secretar .,ealth/ or the Director of

,ealth Ser(ice! of the StateGo(ern'ent concerned&


48/61

Po)er! of the A""ro"riateAuthorit

To #rant re#i!tration to a ho!"ital for

the re'o(al1 !tora#e and

tran!"lantation of an hu'an or#an&

To !u!"end or cancel !uch

re#i!tration&

To enforce !tandard! for ho!"ital!

en#a#ed in the re'o(al !tora#e ortran!"lantation of hu'an or#an!&


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Po)er! of the A""ro"riateAuthorit

To in(e!ti#ate an co'"laint orreach of an "ro(i!ion of the Act orthe Rule!&

To in!"ect ho!"ital! "eriodicall fore$a'ination of the qualit oftran!"lantation and follo)0u" 'edicalcare to the reci"ient! a! )ell a!

donor!& Po)er to !u''on "er!on!1 !ee:

"roduction of docu'ent!1 i!!ue!earch )arrant!&


50/61

Ad(i!or Co''ittee

To a!!i!t A""ro"riate Authorit in thedi!char#e of it! function!

Con!tituted for a "eriod of t)o ear!

Re"re!entation fro' an NGO )or:in#

in the eld of or#an or ti!!uedonation

A th i ti


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Authori!ationCo''ittee! ,o!"ital le(el Authori!ation

Co''ittee!

State or Di!trict le(el Authori!ation

Co''ittee! Central Go(ern'ent to "re!crie

co'"o!ition of Authori!ationCo''ittee! to en!ure unifor'it

Actual a""oint'ent! 'ade re!"ecti(e State Go(ern'ent! UnionTerritorie!&

,o!"ital A thori!ation


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,o!"ital Authori!ationCo''ittee /'s+ial d'es m're han 35

rans+lans annuall

Medical direc'r9su+erinenden

T&' d'c'rs n' +ar '7 rans+laneam

T&' members 7r'm s'cie

$irec'r9secrear '7 healh ser)ices


53/61

National Re#i!tr

Cenral B')# ' de)el'+men andmainain nai'nal regisr '7 reci+iens#

)aluai'n '7 scienic and clinical saus

'7 'rgan rans+lanai'n#


54/61

National Or#an Retrie(al1 Ban:in#and Tran!"lantation Net)or:

Organ !erie)al D "anking Organisai'n

:O!"O> se u+ a AIIMS in Ne& $elhi#

sablishmen '7 a nai'n-&ide ne&'rk, '

include. All rans+lan cenres

All rerie)al 'rganisai'ns

All ceried /*A esing labs

In 7uure all rauma cenres, all dialsis

cenres, all h's+ials &ih IC@s


55/61

National Or#an Retrie(al1 Ban:in#and Tran!"lantation Net)or:

Mainain &aiing lis '7 +aiens a&aiingrans+lanai'n#

$iEeren liss 7'r diEeren 'rgans#

%aciliae maching '7 'rgans hr'ugh ac'm+ueriFed daabase#

OM * P lti


56/61

OMence! * Penaltie!

Enhance'ent of Penaltie!

Re'o(al of hu'an or#an )ithout authorit I'"ri!on'ent 0 U" to 5? ear!

-ine 0 U" to R!&2? la:h

Re'o(al of hu'an ti!!ue )ithout authorit

I'"ri!on'ent 0 U" to 3 ear! -ine 0 U" to R!&8 la:h! 2? la:h!

9i(e unrelated or#an donation fal!e

docu'ent! I'"ri!on'ent 8 to 5? ear!

-ine R!&2? la:h to R!&5 crore


57/61

OMence! * Penaltie!

Penaltie! for doctor! -ir!t oMence na'e !truc: oM fro'

State +edical Council for three

ear! Second oMence na'e !truc: oM

"er'anentl

: l


58/61

Po)er to +a:e Rule!

E$"and rule0'a:in# "o)er! of CentralGo(ern'ent to "ro(ide for

ualication and e$"erience to e"o!!e!!ed a technician to e eli#ile for

enucleatin# a cornea&

Condition! for an ane!theti!t inten!i(i!tand !ur#eon "h!ician for ein# includedon the 'edical oard for certication of

rain death& ualication! and e$"erience required for

the "o!ition of tran!"lant coordinator&

The co'"o!ition of Authori!ation

Co''ittee!&


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D


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Donar a""


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T,AN6 HOU

In 'end

i! 'e#innin#

-T#S#li', %'urGuares

updates on organ donation

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